A Task-shifting and Family-focused Approach Towards Mental Health Care for Youth Living in Refugee Camps

Background: In humanitarian emergencies with few specialist resources for mental health care, it is a practical and ethical necessity to allocate available resources to interventions that target youth most in need of support and address contextually relevant factors of influence. Based on the findings of an extensive epidemiological observational study with 230 Burundian refugee youth aged 7 to 15 years and both their caregivers in three refugee camps, we propose a multi-layered mental health service model that is characterized by task-shifting from professionals to non-professionals, close-meshed collaboration between different agencies within camps and inclusion of families at all stages. Discussion: The model prioritizes the identification of youth with clinically relevant mental health problems through extensive screening, who are then provided with trauma- and/or family-focused interventions depending on a more detailed assessment of needs. We emphasize the importance of incorporating evidence-based interventions and evaluating all model components and discuss caveats and limitations concerning the implementation of the model. Conclusion: The paper aims to sensitize researchers and practitioners in the field of mental health care for youth in refugee and other humanitarian settings to the importance of conducting epidemiological assessments of the specific need for interventions and of contextually relevant intervention targets.