Fontana Marco, Fattori Francesco, Trezzi Sofia, Conte Massimo, Bernardini Laura, Marando Laura, Michelini Giovanni, Trapani Andrea, Costantino Maria Antonella
IRCCS Ca' Granda Ospedale Maggiore Policlinico Foundation, Child and Adolescent Neuropsychiatry Unit, Via Pace, 9, Milan 20122, Italy.
Codici Ricerca e Intervento, Viale Sondrio, 3, Milan 20124, Italy.
J Migr Health. 2023 Mar 17;7:100177. doi: 10.1016/j.jmh.2023.100177. eCollection 2023.
The recent notable increase in refugees' flows, with refugee children and adolescents relocating worldwide, posed severe challenges to the different national healthcare systems. Social groups such as refugees fleeing from their countries because of persecution, wars and violence are considered at high risk of developing mental health-related problems. Despite international and national policies legally regulating the reception process and protecting health-related rights, including the mental well-being of refugee migrants, there is a theoretical and applied need for evidence-based instruments and procedures to support mental health within this population. Recent evidence refers to the Refugee Health Screener-15 (RHS-15) as a reliable and valid instrument for the early detection of trauma-related mental health problems. In this scenario, this study aimed to test the RHS screening process within a multidisciplinary first intervention reception context for unaccompanied refugee minors.
The RHS-15 was administered with the support of cultural-linguistic mediators to 81 unaccompanied minor residents in a first intervention facility in Milan, Italy. This study aimed to assess psychometric characteristics, such as reliability, sensitivity and specificity feasibility and its implementation within a first intervention reception process.
The analysis resulted in the validation of the RHS in its 13-item format. The results highlighted and confirmed an efficient delivery, excellent reliability and a positive predictive and convergent validity of the 13-item version. Further analysis showed an excellent ability to avoid false negatives, although there was a clear tendency to identify false positives.
The early identification of vulnerabilities among refugee minors is recommended to promote their long-term overall well-being. Integrating the screening results with additional observational elements and more specific diagnostic tools is recommended to gain a comprehensive perspective of the minors' well-being.
近期难民流动显著增加，难民儿童和青少年在全球范围内迁移，给各国医疗体系带来了严峻挑战。因迫害、战争和暴力而逃离本国的难民等社会群体被认为极易出现心理健康相关问题。尽管国际和国家政策对接收流程进行了法律规范，并保护包括难民移民心理健康在内的健康相关权利，但在这一人群中，理论上和实际应用中都需要基于证据的工具和程序来支持心理健康。近期证据表明，难民健康筛查量表15项版（RHS - 15）是早期检测创伤相关心理健康问题的可靠有效工具。在这种情况下，本研究旨在测试RHS在针对无人陪伴难民未成年人的多学科首次干预接收环境中的筛查过程。
在意大利米兰的一个首次干预机构中，在文化 - 语言调解人的支持下，对81名无人陪伴的未成年居民实施了RHS - 15。本研究旨在评估其心理测量特征，如可靠性、敏感性、特异性、可行性及其在首次干预接收过程中的实施情况。
分析结果验证了13项版RHS的有效性。结果突出并确认了其高效的实施、出色的可靠性以及13项版的阳性预测效度和聚合效度。进一步分析表明，该量表具有出色的避免假阴性的能力，尽管存在明显的识别假阳性的倾向。
建议尽早识别难民未成年人中的脆弱性，以促进他们的长期整体福祉。建议将筛查结果与其他观察因素和更具体的诊断工具相结合，以全面了解未成年人的福祉。
