Dumke Lars, Nagraj Shobhana, Yusuf Salma, Abukmail Hanan, Cinar Erva Nur, Razai Mohammad S, Whyatt Gemma, Hall Jennifer, Breda Joao, Giannaki Anastasia, Scharpf Florian, Behrendt Malte, Schäfer Ingo, Chatburn Eleanor
Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
WHO Athens Office on Quality of Care and Patient Safety, WHO Regional Office for Europe, Athens, Greece.
Eur Child Adolesc Psychiatry. 2025 Aug 27. doi: 10.1007/s00787-025-02833-3.
Forcibly displaced children and adolescents in the World Health Organization (WHO) European Region have high mental health needs, yet few manage to access mental health services, and those who do may encounter inadequate care. This scoping review aimed to identify and synthesize the available evidence on barriers and facilitators to quality mental health care for forcibly displaced children and adolescents in the WHO European Region. We applied the PRISMA guideline extension for scoping reviews, searching five scholarly databases and grey literature published between 2004 and 2025. A total of 7,327 records were screened, with 18 articles included. We used the WHO Quality Standards for Child and Youth Mental Health Services as an analytical framework to map the evidence. The identified studies represented only 7 out of 53 countries in the WHO European Region. Most studies employed qualitative research designs, with a lack of quantitative evidence using quality indicators. Available evidence revealed multiple, intersecting barriers to quality mental health care, including restrictive health care policies, service constraints and a lack of provider competence. Facilitators included the presence of community-based support, networks of interconnected services, task shifting and evidence-based scalable interventions. Major gaps remain in both the data and in the methods used to generate evidence for improving quality of mental health care for forcibly displaced children and adolescents in the WHO European Region. Our review highlighted the discrepancy between the care provided and the recommended WHO Quality Standards for Child and Youth Mental Health Services. There is a need for more targeted efforts to assess and improve the quality of mental health care for forcibly displaced children and adolescents.
世界卫生组织（WHO）欧洲区域中被迫流离失所的儿童和青少年有很高的心理健康需求，但很少有人能获得心理健康服务，而那些获得服务的人可能会遇到护理不足的情况。本范围综述旨在识别并综合关于WHO欧洲区域中被迫流离失所儿童和青少年获得优质心理健康护理的障碍和促进因素的现有证据。我们应用了PRISMA范围综述指南扩展版，检索了2004年至2025年期间发表的五个学术数据库和灰色文献。共筛选了7327条记录，纳入了18篇文章。我们使用WHO儿童和青少年心理健康服务质量标准作为分析框架来梳理证据。所纳入的研究仅代表WHO欧洲区域53个国家中的7个国家。大多数研究采用定性研究设计，缺乏使用质量指标的定量证据。现有证据揭示了优质心理健康护理存在多个相互交织的障碍，包括限制性的医疗政策、服务限制以及提供者能力不足。促进因素包括基于社区的支持、相互关联的服务网络、任务转移以及基于证据的可扩展干预措施。在为WHO欧洲区域中被迫流离失所儿童和青少年改善心理健康护理质量提供证据的数据和方法方面，仍然存在重大差距。我们的综述突出了所提供的护理与WHO推荐的儿童和青少年心理健康服务质量标准之间的差异。需要做出更有针对性的努力，以评估和改善被迫流离失所儿童和青少年的心理健康护理质量。
