Assessing the mental health of Afghan refugee childrenin Peshawar schools

Abstract

Children who are forcibly uprooted from their homes experience enormous losses, increased exposure to violent conflict, and severe deprivation. Much research remains to be done concerning the impact of displacement related adversity on the mental health of children and adolescents. A psychometric screening tool, the Strengths and Difficulties Questionnaire (SDQ), supplemented with anthropologically-informed research methods, was employed to appraise the mental health of 128 Afghan boys and girls, aged 11 to 16, attending four schools in Peshawar, Pakistan. Equal numbers of children were born in Afghanistan and Pakistan, and one third had no father living at home. Parents, teachers and children provided questionnaire data on mental health difficulties and prosocial behaviour, and children's projective drawings and open-ended interviews provided contextual information about life and future expectations in Peshawar. Informants were discrepant in their mental health ratings: 22% of sample children were 'probable' cases for a psychiatric disorder based on combined parent and teacher information, compared to just 5% based solely on information provided by parents. All children had normal prosocial abilities. Contrary to expectation, a purposive sample of children orphaned from one or more close relatives did not differentiate themselves in terms of mental health. Age and gender had no detectable impact on mental health ratings. Children whose fathers were not at home were 6 times more likely to receive abnormal mental health scores from both their parents and teachers (p<0.002). Children themselves reported more difficulties if they had large extended families (p=0.027). Children born in Afghanistan and Peshawar did not differ in their mental health. However, children who