The case in summary: Lonely asylum children and young people in Norway struggle with anxiety, desperation and addiction, and in some cases this can lead to suicide. The state does not have an overview of what follow-up they receive or what needs they have. Long waiting times for asylum applications can worsen the mental health of the asylum children. The health offer for the asylum children varies greatly between the municipalities, and many do not get the help they need, or are unable to accept it. The Directorate of Health is concerned about the situation, and has taken the initiative for a project to improve conditions for the asylum children. The summary is made by an AI service from OpenAI. The content is quality assured by news’s journalists before publication. – There were several people at the reception who drank Zalo or shampoo out of sheer desperation, says a young Afghan man. As a single minor asylum seeker, he spent several years at an asylum reception before he was granted residence. The long wait was nerve-wracking for several of the young people. – They spit bubbles afterwards, he says. We meet him on the street in Oslo. For a year, news has been getting to know former unaccompanied asylum children who are now young men and have ended up outside society. They tell about trainwrecks and a life in chaos. Several go on medication to cope with everyday life. Some tell about friends who commit suicide. – All the lies, the pressure and the middle-of-the-road life take you to the end, said “Rashid”, who also comes from Afghanistan, recently. As a teenager in reception, he struggled to accept mental health care. – Every time I talked about it, there was chaos in my head, and it took a long time before I got it out of my head again. “Rashid” (26) also struggled with mental difficulties as a teenager. No diagnosis discovered before murder No one currently has an overview of how many unaccompanied minor asylum seekers are struggling with their mental health, or what health care services they receive. This is reported by the Directorate of Health and the Institute of Public Health to news. – They are entitled to the same health services as the rest of the population, but whether they actually get it, we don’t know enough about that, says Øyvind Gievær, department director in the Directorate of Health. – In the worst case, it can have fatal consequences, says Kjell-Ole Myrvoll, clinical social worker at the Department of Child and Youth Psychiatry (BUP) in Sjøvegan in Troms, which belongs to the University Hospital in Northern Norway. In 2018, a 17-year-old unaccompanied minor asylum seeker entered Coop Byggmix in Vadsø and killed an 18-year-old with a wallpaper knife. The experts concluded that the perpetrator had most likely been a paranoid schizophrenic for several months before the murder. Despite the fact that he had been in contact with the healthcare system, no one picked it up in advance. He was sentenced to compulsory mental health care. Great variation between municipalities news has previously revealed that missing asylum children are rarely looked for, that they receive too poor care at reception, and that some end up in criminal street environments. Mental difficulties are a common denominator. Many struggle while they sit in reception and wait, shows cases of missing unaccompanied asylum children that news has been given access to from the police since 2015: “…He lived several years on the streets before he came to Norway. Have self harm. He says he was abused and got drugs as payment…””He shouted, cried and howled. He hit his head against the wall, and three employees had to physically restrain him so that he did not injure himself. He also tried to fire the employees”. In another case from 2018, the reception tells of a “boy who struggles mentally and was referred to BUP, but did not start treatment. He has vandalized and threatened employees”. These three boys were over 15 years old and disappeared from the Sjøvegan asylum center in Troms. Sjøvegan asylum reception for unaccompanied minor asylum seekers. Photo: Jenny Myrvoll Kjell-Ole Myrvoll and colleague Randi Elisabeth Jenssen at BUP in Sjøvegan have long worked to follow up young asylum seekers who struggle with psychological difficulties. Eight out of ten who come to them are diagnosed with PTSD. They see that the healthcare provision young asylum seekers receive varies greatly from municipality to municipality, and say that many do not get the help they receive from the healthcare system and reception. – Part of it out of society, out of school, maybe out of work. They are unable to function. In some cases, they end up in an environment they shouldn’t be in, with drugs and crime, says Myrvoll. Kjell-Ole Myrvoll and Randi Elisabeth Jenssen at BUP Sjøvegan. Photo: Martin Mortensen – Young people are very affected – Many struggle with extensive trauma and loneliness. Both experiences from war in their homeland, conflicts, and not least what they were exposed to on the flight to Norway, the clinical social workers tell. It is recommended, but not mandatory, to carry out an early health survey when an asylum child arrives in Norway. The question of mental health is only asked in some cases. The clinical social workers react to that. – It is simply too bad that in Norway in 2024 we will not actually be able to establish good enough offers for these young people, says Myrvoll. Furthermore, they believe that there are too few staff at the reception to follow the young people closely enough. – If there are four on duty out of 40 young people, it is not enough to follow them up, says Myrvoll. – We see anxiety, depression and that they struggle to adapt. The young people are very affected by everything they bring with them, which may make them unable to concentrate at school, unable to sleep. There is absolutely a need for assistance and help, says Jenssen. 80 per cent of the asylum children who come to BUP Sjøvegan are diagnosed with PTSD. Photo: Linn-Hege Bakkehaug Waiting makes life difficult A number of research articles and surveys in recent years confirm the picture that asylum-seeking children and young people struggle with or develop psychological difficulties in Norway. The mental health of asylum children and young people The Fafo report “A safe place to wait” from 2018 states the following: “28 percent of young people have four or more of these symptoms and can be characterized as probably very ill. Of these, only 30 percent received follow-up from a psychologist. This is not a pattern that applies if we look at those who have several symptoms – out of twelve young people with seven or more symptoms, only five receive follow-up by a psychologist.” The Directorate of Immigration surveyed 21 receptions in August 2023. They see that long waiting times lead to an increase in self-harm, suicide attempts, more drug use, conflicts, and physical and mental ill-health among residents. Most receptions take measures to provide the best possible care, according to the report. NKVTS and UiO have researched asylum children who arrived before they were 15 years old. They found that upon arrival the children had experienced an average of 5.5 stressful life events (such as the death of a close person, war and violence). 54 percent scored high on PTSD symptoms, 30 percent on anxiety symptoms, and 20 percent on depressive symptoms. Five years later, the average level of depression and PTSD has decreased, but many still have psychological difficulties, especially those who have little money, feel insecure or have an uncertain future. – Furthermore, we find that getting a sense of security (usually through obtaining a residence permit), care and being taken care of, was important in being able to focus on the present and future, school and work. The young people also portray how important it is to understand and adapt to Norwegian culture, and the importance of feeling a sense of belonging to society and being able to contribute to society. Despite psychological difficulties and occasional difficulties in finding friends and creating a network, many of the young people in our study do well at school and at work, says researcher Elin Sofia Andersson at NKVTS. Norce conducted research in 2019 on children and young people who have had their asylum application approved and have been settled in a municipality. Half suffer from PTSD, and many have emotional problems and feel lonely. – It is important to have both pediatric expertise plus refugee knowledge in order to follow them up as best as possible, says researcher Ingrid Kvestad at the Regional Knowledge Center for Children and Young People West (RKBU-West). Several actors point to the fact that the long processing time of asylum applications eats away at mental health. When the Norwegian Directorate of Immigration (UDI) also breaks the deadlines for processing time, the waiting time becomes even longer. Reception managers confirm this in a survey carried out by the UDI in August last year: Most receptions take measures to provide the best possible care, and also refer to various health services, according to the report. The Norwegian Directorate of Immigration is responsible for receptions where asylum-seeking children and young people live, while the individual municipality is responsible for the health offer for receptions in its area. – We depend on reception staff to see that they have a problem, and that they are accepted by the healthcare system, says Gro Anna Persheim, head of department at UDI. Criticism of lack of follow-up Young people tell themselves about how they are doing in a new report from SOS Children’s Village. They have spoken to eight people aged 15-21 who all fled to Norway alone, and have now been granted residency. One of them says: The health offer they receive works randomly from municipality to municipality, according to the report. Although several of them talk about trauma and symptoms that indicate that they need follow-up, none of the young people have been in contact with specialist health services. Daniel Bøhn Rayner. Photo: SOS Children’s Villages – It is highly objectionable, says Daniel Bøhn Rayner, political adviser at SOS Children’s Villages. – It does not help with health mapping when the young people are not followed up with treatment offers and follow-up at the other end. The report includes, among other things, these proposals for measures: State and municipality must together ensure that children receive the mental health care they are entitled to, and that this must happen right from the first meeting with the child. The offer of mental health care must be easily accessible, and offered to all children regardless of whether they make contact or not. Give the children the feeling of being looked after, cared for and belonging to society, and have available channels of communication to seek help. The state worries about the long waiting time The health authorities are also particularly worried about the asylum children who come to Norway alone. – We fear that long case processing times contribute to increasing the psychological challenges in this group, says Øyvind Giæver, director of the living conditions department in the Directorate of Health. Øyvind Gievær. Photo: Dragana Njegic / Directorate of Health Following news’s cases on missing asylum children and supervision at reception, several people within the Directorate of Health have questioned whether the health services are of sufficient quality. They are particularly worried about unaccompanied asylum children over the age of 15. It shows access to an e-mail thread between employees in January last year. “There is without a doubt a socio-economic gain with early health mapping and early health offers for this group”, writes one employee. Willing to ensure better conditions for the children Before Christmas, the Directorate of Health took the initiative for a project to improve the conditions for the unaccompanied asylum children between both the ministries and the directorates in the state. The aim is to ensure better cooperation between the health, immigration, children and youth authorities, child protection and municipalities, according to Gievær. Furthermore, he believes that it is not entirely fortunate that the UDI should be responsible both for the care of the oldest asylum children and for handling their asylum application. – Many will be afraid that if they report a problem, that it could negatively affect their applications or application processing, says the head of department. In February, the Storting will deal with a proposal from SV on a package of measures for unaccompanied asylum children.
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Concern for the mental health of young asylum seekers – news Vestland
