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The "Lost Boys of Sudan"
Functional and Behavioral Health of Unaccompanied Refugee Minors Resettled in the United States
Paul L. Geltman, MD;
Wanda Grant-Knight, PhD;
Supriya D. Mehta, PhD;
Christine Lloyd-Travaglini, MPH;
Stuart Lustig, MD;
Jeanne M. Landgraf, MA;
Paul H. Wise, MD
Arch Pediatr Adolesc Med. 2005;159:585-591.
Objective To assess the functional and behavioral health of unaccompanied Sudanese refugee minors approximately 1 year after resettlement in the United States.
Design A descriptive survey.
Setting Local refugee foster care programs affiliated with the US Unaccompanied Refugee Minors Program.
Participants A total of 304 Sudanese refugee minors enrolled in the US Unaccompanied Refugee Minors Program.
Main Outcome Measures Health outcomes were assessed using the Harvard Trauma Questionnaire and the Child Health Questionnaire. Outcomes included the diagnosis of posttraumatic stress disorder and scores on all Child Health Questionnaire subscales and global single-item assessments.
Results Twenty percent of the minors had a diagnosis of posttraumatic stress disorder and were more likely to have lower (worse) scores on all the Child Health Questionnaire subscales. Low functional and behavioral health scores were seen mainly in functioning in the home and in subjective health ratings. Social isolation and history of personal injury were associated with posttraumatic stress disorder.
Conclusions Unaccompanied Sudanese minors have done well in general. The minors function well in school and in activities; however, behavioral and emotional problems manifest in their home lives and emotional states. The subset of children with traumatic symptoms had characteristics that may distinguish them from their peers and that may inform future resettlement services for unaccompanied minors in the United States.
Author Affiliations: Departments of Pediatrics (Dr Geltman) and Emergency Medicine (Dr Mehta), Boston University School of Medicine, Boston, Mass; Department of Pediatrics, Rehabilitation Institute of Chicago, Chicago, Ill (Dr Grant-Knight); Data Coordination Center, Boston University School of Public Health (Ms Lloyd-Travaglini); Department of Psychiatry, Harvard Medical School, Boston (Dr Lustig); HealthAct Inc, Boston (Ms Landgraf); and Department of Pediatrics, Stanford University School of Medicine and the Centers for Health Policy and Primary Care Outcomes Research, Stanford University, Stanford, Calif (Dr Wise).
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