Table_1_“I can’t describe how I could get better, but I would like to” - Conception of health and illness of refugee youth in Germany.DOCX

Introduction and objectiveAlmost half of all the people displaced worldwide are children and adolescents. Many refugee children, adolescents, and young adults suffer from psychological stress. However, their utilization of (mental) health services is low, probably due to a lack of knowledge about (mental) health and (mental) health care. The current study aimed to explore concepts of (mental) health and illness of refugee youth as well as assess their mental health literacy (MHL) to arrive at conclusions for improving mental health care access and use.
MethodFrom April 2019 to October 2020, we conducted 24 face-to-face interviews with refugee children and adolescents in an outpatient clinic (n = 8), in youth welfare facilities (n = 10), and at a middle school (n = 6). A semi-structured interview was used to assess knowledge about mental and somatic health and illness as well as corresponding health strategies and care options. The material was evaluated using qualitative content analysis.
ResultsParticipants (N = 24) were between 11 and 21 years old (M = 17.9, SD = 2.4). The coded material was assigned to four thematic main areas: (1) conception of illness, (2) conception of health, (3) knowledge about health care structures in their country of origin, and (4) perceptions of mental health care structures in Germany. Compared to somatic health, the interviewed refugee children and adolescents knew little about mental health. Furthermore, respondents were more aware of opportunities of somatic health promotion, but almost none knew how to promote their mental health. In our group-comparative analysis we observed that younger children possess little knowledge about mental health-related topics.
ConclusionOur results show that refugee youth have more knowledge about somatic health and somatic health care than about mental health (care). Accordingly, interventions to promote the MHL of refugee youth are necessary to improve their utilization of mental health services and to provide adequate mental health care.

引言与研究目标
全球流离失所人群中近半数为儿童与青少年。众多难民儿童、青少年及青年群体饱受心理压力困扰，但他们对（心理）卫生服务的利用率却极低，这大概率源于其对（心理）卫生及（心理）卫生保健相关知识的匮乏。本研究旨在探究难民青年对（心理）卫生与疾病的认知观念，并评估其心理健康素养（Mental Health Literacy，MHL），以期为提升心理卫生服务的可及性与利用率提供参考依据。
研究方法
2019年4月至2020年10月期间，我们分别在门诊诊所（n=8）、青少年福利机构（n=10）及某中学（n=6），对24名难民儿童与青少年开展了面对面访谈。本研究采用半结构化访谈工具，评估受访者关于心理与躯体健康、疾病的相关知识，以及对应的卫生策略与照护选择。研究采用质性内容分析法对访谈资料进行编码与分析。
研究结果
本次研究共纳入24名受访者，年龄介于11至21岁之间（均值M=17.9，标准差SD=2.4）。经编码的访谈资料可归纳为四大主题领域：（1）疾病认知；（2）健康认知；（3）原籍国卫生保健体系认知；（4）德国心理卫生保健体系认知。相较于躯体健康，受访难民儿童与青少年对心理健康的认知较为匮乏。此外，受访者对躯体健康促进途径的认知更为清晰，但几乎无人知晓如何进行心理健康促进。组间比较分析显示，低龄儿童对心理健康相关主题的知识储备极少。
研究结论
本研究结果表明，相较于心理卫生（照护），难民青年对躯体健康及躯体卫生保健的认知更为充分。因此，亟需开展旨在提升难民青年心理健康素养的干预措施，以改善其对心理卫生服务的利用率，进而为其提供适配的心理卫生保健服务。