Can we protect refugee children from mental health problems?- a scoping review of modifiable factors to inform preventive interventions.

Abstract

The growing number of refugee children worldwide raises urgent public-health concerns regarding their mental health and well-being. Preventive approaches can mitigate risks before the onset of disorders, yet their development requires a clear understanding of modifiable determinants of mental health. Previous reviews have rarely applied a public-health and prevention lens to distinguish between modifiable and non-modifiable factors. This scoping review aimed to identify and organize potentially modifiable determinants of refugee children's mental health to inform the design of multi-level preventive strategies. Following the Joanna Briggs Institute and PRISMA-ScR guidelines, we conducted systematic searches in PubMed, PsycINFO, and Web of Science for studies published from 2011 to January 2025. Eligible studies reported qualitative or quantitative data on modifiable factors associated with mental health outcomes among refugee and asylum-seeking children and adolescents (0-18 years). Data were analyzed using a socio-ecological framework encompassing individual, family, community, and policy/institutional levels. Forty-nine studies were included. Despite methodological diversity, we identified multiple interrelated modifiable factors influencing mental health, such as coping and language proficiency (individual), parental mental health and family routines (family), social support and discrimination (community), and asylum policies or access to education and health services (policy/institutional). These factors interact dynamically across levels, shaping both vulnerability and resilience. This review provides a prevention-oriented, public-health framework for action on refugee children's mental health. Targeting these interconnected determinants through coordinated, multi-level, and co-designed interventions may enhance resilience, promote equity, and guide policy priorities for refugee child mental-health promotion.