On 10.12.22 a conference was held for the dissemination of the results of the study with the title: "Life in limbo: Psychosocial Support and Mental Health of Unaccompanied Minors in Greece". The conference took place at the auditorium of the Department of Nursing of the National and Kapodistrian University of Athens.
More specifically, the aim of the conference was to present the challenges and opportunities experienced by unaccompanied minors hosted in Greece and to highlight the results of the study. During the conference, a productive dialogue was conducted regarding the proposals and some good practices highlighted in the study, with the aim of ensuring and improving the mental health of unaccompanied minors residing in long-term accommodation facilities.
The poster and the program of the conference can be found here.
During this period, the 3rd and 4th phase of our study is being implemented; at the same time two postdoctoral studies are being carried out. More specifically, the aim and methodology of phase 3 has already been described (see below).
The aim of phase 4 is to develop a guide for the design, implementation and evaluation of psychosocial support services for unaccompanied refugee minors, based on the results produced in the previous 3 work packages. For this purpose, the analytical tool of the logical framework (W.K. Kellogg Foundation, 2004) is also used. The guide will include, sections on: a) the organizational culture of the accommodation facilities; b) the psychosocial support services provided in these facilities; c) mental health training and clinical supervision of accommodation facilities staff; d) the cooperation between accommodation staff and mental health professionals in Mental Health Centers and child psychiatric clinics; e) the connection with the community, etc.
The two post-doctoral studies that are being carried out are:
- Conflict and violence management in accommodation facilities for unaccompanied refugee minors
The aim of this post-doctoral study is to investigate the conflictual behavior that unaccompanied minors display in their relationships with each other and with staff in residential facilities, as well as the factors that trigger, perpetuate and de-escalate it.
- Use of psychoactive substances in accommodation facilities for unaccompanied minors
The aim of this study is to specifically investigate the use of psychoactive substances by unaccompanied minors as a behavior associated with specific needs requiring specialized care. A critical element is to highlight the extent and severity of the potential substance use by unaccompanied minors in long-term accommodation facilities and the perception of the unaccompanied minors' use by both unaccompanied minors and workers in the country's accommodation facilities.
We are currently implementing the third phase of our study, which aims to formulate an interpretive model that will identify the factors and processes involved in the development, provision and evaluation of psychosocial support and mental health services for unaccompanied minors.
To this end, and based on the analysis of the findings from phase 1 and 2 of the study, in-depth individual interviews are conducted with (1) directors of organizations that run shelter structures or supported independent living apartments (SILs) in different regions of Greece (2) coordinators and workers in shelter structures or SILs from different regions of Greece, (3) mental health professionals from community mental health centers and child psychiatric clinics providing services to unaccompanied minors (4) unaccompanied children;
Through conducting semi-structured individual interviews, we expand on the results of the previous phases of the research. The interviews last 60-90 minutes. The data are analysed according to the Grounded Theory approach of Corbin and Strauss; the software program NVivo is used for the analysis to facilitate the management of the qualitative data. The reliability of the findings is ensured through triangulation methods of researchers and methods.
The 2nd phase of the panhellenic study which explores the UASC’s psychosocial needs and challenges as well as the psychosocial support and mental health services provided to them, is currently underway.
Based on the results derived from the 1st phase of the study, we have been collecting further in-depth data through the use of focus groups with the following sub-samples of participants: (1) coordinators and field workers in shelters and SILs, (2) community mental health professionals to whom UASC are referred to, and (3) male and female UASC 12-18 years old, who live in long-term accommodations (shelters or SILs) across the country.
Focus groups with accommodation coordinators and field workers seek to explore their perceptions and experiences with regard to the UASC’s psychosocial needs, psychosocial difficulties, psychosocial resources, and the effectiveness of the psychosocial and mental health services which are provided to them and facilitate their social integration.
Focus groups with mental health professionals who work in CAMHS (community and hospital-based), seek to explore the psychosocial difficulties and problems experienced by UASC who are referred to community mental health services, the effectiveness of the referral system, the therapeutic interventions, the follow-up procedures, as well as the measures implemented to improve their mental health outcomes.
Finally, focus groups with UASC who live in long-term accommodation facilities (shelters and SILs) in Athens, Thessaloniki and Mytilini, seek to explore the challenges, barriers and opportunities that affect their life and social integration in Greece.
The study includes 4 phases. We are in the process of completing Phase 1 by analyzing data that was collected across the country. The goal of Phase 1 was to map:
- the psychosocial needs of unaccompanied and separated children (UASC) who live in long-term facilities in Greece
- the mental health and psychosocial support (MHPSS) services which are provided to them
- the good practices, gaps and obstacles in MHPSS service provision.
A rapid assessment of the mental health and psychosocial needs and resources was conducted between March and October 2020. The 4-W tool proposed by IASC (2007) was used to document Who is Where, When, doing What to meet the needs of UASC in Greece. The tool was extended to also assess How perceptions converge or differ among those who support UASC, with regard to their needs, availability and effectiveness of MHPSS services.
Five research questions guided the rapid assessment:
- Which are the perceived challenges, psychosocial and mental health needs of UASC who live in long term facilities?
- How these challenges and needs are being addressed, when and by whom?
- What are the perceived gaps and obstacles in providing MHPSS to UASC?
- What are the perceived good practices in providing MHPSS services to UASC
- How perceptions of facility managers, field workers and directors of community mental health services converge or differ as to needs and MHPSS services provided to UASC.
We adopted a exploratory, predominantly quantitative design to identify UASC’s psychosocial challenges, needs, and MHPSS services, as perceived by facility managers, by field workers who provide psychosocial support and by community mental health professionals to whom UASC are referred to. The design also comprised a complementary qualitative component with the purpose to elicit additional data.
A purposeful total sampling approach was adopted. The sample was comprised of all (a) the non-governmental agencies which operate long-term facilities for UASC in Greece, and (b) all the community MHPSS services and child psychiatry clinics to which UASC are referred to, when mental health issues arise.
16 non governmental organizations which operate shelters and SILs were invited to participate. Only one refused participation (response rate 93,75%).
13 community MHPSS services for minors and child psychiatry clinics across the country were identified as referral agencies and institutions by field workers. They were invited and all accepted participation (Response rate 100%).
Three subsamples of participants were invited to complete an online survey.
Subsample 1. N=45 Facility Managers of UASC accommodation (F-Mg).
They assume an administrative role and are responsible for the smooth operation of a shelter or multiple SILs. They collaborate with the NGO’s administration as well as with the team of field workers who assume the care and support of UASC.
Response Rate among F-Mg: 75,56%
Subsample 2. N=40 Facility Mental Health Professionals (F-MHP).
They are psychologists and social workers who belong to the care team responsible for the care of UASC who live in shelters or SILs. Given that each team had often more than one psychologist and social worker, we invited the one with longest experience in providing psychosocial support to UASC.
Response Rate among F-MHP: 68,29%
Subsample 3. N=17 Directors of Community Mental Health Services or Child Psychiatry ClinicsC-MHP). They assume administrative and clinical responsibilities and supervise the mental health care team of a community mental health service or of a Child Psychiatry Clinics in a state hospital to which UASC with serious mental health problems are commonly referred to or hospitalized.
Response Rate among C-MHP: 94,12%
See summary of findings included in the section: REPORTS
UASC-4-PSYCH is funded by the Hellenic Foundation for Research and Innovation (H.F.R.I.) under the “First Call for H.F.R.I. Research Projects to support Faculty members and Researchers and the procurement of high-cost research equipment grant” (Project Number: 16340).