Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, UK
Paediatric Department, University College London Hospitals NHS Foundation Trust, London, UK.
Arch Dis Child. 2022 May;107(5):456-460. doi: 10.1136/archdischild-2021-322319. Epub 2021 Oct 16.
(1) To describe a novel integrated pathway for unaccompanied asylum-seeking children (UASC).(2) To evaluate a population engaged with this service.
Description of the integrated pathway (objective 1) and retrospective evaluation, using data from community paediatrics, infectious diseases (IDs) screening and a sexual health (SH) service (objective 2).
Unlinked data were collected from three services across three National Health Service (NHS) trusts in London.
All Camden UASC engaged with the service from 01 January 2016 to 30 March 2019.
A multidisciplinary approach prioritising the health needs of UASC including a childre and adolescent mental health service (CAMHS) clinican and a health improvement practitioner. There are low thresholds for onward referral and universal asymptomatic screening of UASC for ID.
Data on demographics, unmet health needs and known outcomes.
Data were available for 101 UASC, 16% female, median age 16 years (range 14-17). Physical assault/abuse was reported in 67% and 13% disclosed sexual assault/abuse, including 38% of female UASC. Mental health symptoms were documented in 77%. IDs warranting treatment were identified in 41% including latent tuberculosis (25%) and schistosomiasis (13%). Interpreters were required for 97% and initial non-attendance rates at follow-up were 40% (ID) and 49% (SH).
These data demonstrate high rates of historical physical and sexual assault/abuse, unmet physical, mental and emotional health needs among UASC and significant barriers to engaging with services. An integrated pathway has been successfully implemented and shown to deliver appropriate, joined-up care for UASC, consistent with current recommendations, with the potential to improve outcomes.
(1) 描述一种新的无人陪伴寻求庇护儿童 (UASC) 综合途径。(2) 评估参与该服务的人群。
描述综合途径（目标 1）和使用社区儿科、传染病 (IDs) 筛查和性健康 (SH) 服务的数据进行回顾性评估（目标 2）。
从伦敦三个 NHS 信托基金的三个服务中收集未链接的数据。
2016 年 1 月 1 日至 2019 年 3 月 30 日期间，所有参与 Camden UASC 服务的人。
一种多学科方法，优先考虑 UASC 的健康需求，包括儿童和青少年心理健康服务 (CAMHS) 临床医生和健康改善从业者。对于 UASC，有低门槛的转介和普遍的无症状 ID 筛查。
人口统计学数据、未满足的健康需求和已知结果。
101 名 UASC 的数据可用，其中 16%为女性，中位年龄 16 岁（范围 14-17 岁）。67%报告了身体攻击/虐待，13%披露了性攻击/虐待，包括 38%的女性 UASC。77%记录了心理健康症状。需要治疗的 IDs 占 41%，包括潜伏性肺结核 (25%) 和血吸虫病 (13%)。需要口译员的比例为 97%，ID 随访的初始非就诊率为 40%，SH 为 49%。
这些数据表明，UASC 存在较高的历史身体和性攻击/虐待、未满足的身体、心理和情感健康需求的发生率，以及与服务接触的重大障碍。已成功实施综合途径，并为 UASC 提供了适当的、连贯的护理，符合当前建议，有可能改善结果。
