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Chloe Hall

Child labour

Child labour

UNICEF records that globally nearly one in ten children are forced into child labour. It’s an arresting statistic. Moreover, there’s an important caveat: some of those children are subjected to especially dangerous and degrading work, a consequence of child trafficking. Of the 160 million children estimated to be trapped in child labour approximately half undertake work which is harmful for their physical, moral and mental wellbeing. The International Labour Organisation (ILO) and UNICEF estimate that 79 million children aged 5-17 are presently subjected to hazardous work. That amounts to roughly half of all children trapped in child labour, a number not far off the entire population of Germany.

Why are children forced into child labour?

When a family faces financial ruin children are at their most vulnerable. Perhaps a parent or carer has been made redundant or become ill and is consequently unable to earn an income. Such a personal financial crisis, whether temporary or permanent, is shattering for families which just manage to scrape a living from one week to the next on what little money they have coming in. Children are likely to want to help their families, and in some cultures would be expected to do so.

How harsh is child labour?

We are not talking about some informal domestic work, or a school holiday job, which may even facilitate a child’s natural development, or instil some sense of self-esteem in a young person. UNICEF explains that child labour is much more exploitative. It’s bad enough for a child to receive a very low rate of pay. Yet such economic exploitation is only the beginning. Child labour can often mean physical and mental harm, it can lead to slavery and sexual abuse. Examples of hazardous work include handling and applying potentially toxic agrochemical substances, undertaking strenuous tasks such as carrying very heavy loads, and using dangerous tools and machinery. Moreover, these practices can often necessitate working in very high temperatures, which naturally and quickly lead to dehydration, among other health concerns.

What about the plight of migrant and refugee children?

Refugees have, in the vast majority of cases, been forced from their homelands because of natural disasters or political conflicts. If children are migrating on their own, they are especially exposed to risks associated with child labour. Trafficked children face constant threats of violence and are deprived of even the most fundamental human rights. They may be compelled to participate in illegal operations, for example, acting as drug mules or prostitutes, or be usurped into paramilitary groups. Trafficking and child labour sever children from their daily routines, their education, and their healthcare. They steal young people’s aspirations and bulldoze through their personal rights.

Unscrupulous businesses

There are also unscrupulous businesses which ignore children’s rights for the sake of profit. They may even claim that they are acting in an altruistic fashion, helping to support the poorest people in their societies by being prepared to employ young people and at least pay them something. Beyond these are societal subcultures and criminal elements who operate autonomously beyond the law, and will ruthlessly continue to exploit young people, irrespective of new legislation, ongoing initiatives and research. Sadly, young people who face desperate circumstances can easily become drawn to dishonest profiteers. Unless politicians wholeheartedly invest in rooting out illegal cartels child exploitation is likely to continue. The bottom line is simple enough: until the poorest people are provided with some financial support, some guaranteed legal standing, basic human rights and improved security, illegal practices which exploit children are likely to continue.  

What legislative steps can be implemented to stop children being exploited?

The IPO collects data relating to child labour. This research is pivotal in generating reliable evidence which can be used to draw attention to the harsh reality of child labour. The data is publicised, for example, it can be presented to political decision-makers to heighten awareness. Moreover, UNICEF and the IPO are promoting administrative strategies, for instance, one goal is to ensure that children are issued with an official birth certificate. Such legal documentation should confer unambiguous proof that a child is not old enough to work, so long as potential employers are respectful of such protocols. In addition, if it is devised and implemented in a supportive and rigorous manner, appropriate legislation should help to ringfence children’s status and rights. At the heart of this political intervention stands the issue of deprivation: tackling poverty will significantly reduce child labour. Government policies which protect and promote social development programmes in education, healthcare, gender equality and decent employment will contribute a great deal in halting child labour.

What obstacles remain?

There remain serious societal and political headwinds. For one, the challenges to ending child labour are complicated by the global scale. There are also difficulties associated with officially and accurately documenting child labour, and addressing economic circumstances on a nation by nation basis. Yet collaborating with different peoples and managing varying demographics in which cultural values place differing expectations on children is vital to halting child labour. Additionally, there are developmental trends to assess, including the widespread nature and impact of poverty, and the social implications of limited access to education, and future employment opportunities for both the adult population and young people. The ILO and UNICEF cite sub-Saharan Africa as the region in which child labour is at its highest, globally speaking. The international community needs to support countries in this area to bring about lasting change.

What else is UNICEF doing to help eradicate child poverty?

UNICEF and organisations like ILO continue to publicise and lobby. They state that people around the world need to engage energetically and wholeheartedly in confronting the causes of child labour. They must resist settling for second best practices or, worse, the status quo. By envisaging the better world that we would like to see around us, UNICEF believes that we can finally end child labour and fulfil a central target of the United Nations’ 2030 seventeen Sustainable Development Goals, namely 8.7, which urges that we collectively “Take immediate and effective measures to eradicate forced labour, end modern slavery and human trafficking and secure the prohibition and elimination of the worst forms of child labour, including recruitment and use of child soldiers, and by 2025 end child labour in all its forms.”.

This sounds refreshingly ambitious. Yet an overwhelming majority of people around the world would sincerely subscribe to these ethical principles. It is a question of priorities. UNICEF, the IPO and the United Nations are in the vanguard of championing children’s rights. They continue to lead the fight to stamp out the exploitation of children, and they remain determined to enshrine these fundamental tenets in galvanising and shaping collaborative global thinking, planning and effective action.

Defining child poverty

The far-reaching benefits of a common, multi-dimensional definition of child poverty

The issue of defining child poverty is a surprisingly knotty one. It is a challenge not made easier because the concept of poverty is also an emotive one. Conventionally it has demanded a consideration of financial means, but definitions have only recently begun to look more broadly at available resources, services and freedoms. This is a vital step forwards since poverty is about much more than a lack of income. Definitions need to consider the extent to which people’s basic needs are below their means, whether people have access to a variety of fundamental services, such as rudimentary healthcare and education, and the extent to which they enjoy personal and cultural freedom. Having access to a reliable electricity supply is another fundamental factor.

Future prospects, freedoms and aspirations

Moreover, researchers need to assess employment prospects and whether people have access to meaningful opportunities for work. There is also the question of the level of social protection and support available, and the stability of the local community. However, beyond economic factors, a definition of poverty needs to encompass political circumstances, for example, the extent to which people enjoy social, religious and gender specific freedoms. To what extent do they feel able to speak out for themselves and negotiate with representatives of those in authority? Additionally, what aspirations do people living in poverty hold dear?

The arbitrary nature of a calculated poverty line

Charities and pressure groups still tend to cite a seemingly arbitrary poverty line. This is an estimated economic point below which it is considered impossible to obtain necessities for everyday living. The numbers published, of course, amount to something of a moveable feast. Originally, in the early 1990s a dollar a day became a yardstick by which global poverty could be measured. Subsequent official attempts to update this definition have led to the publication of the latest headline figure of just over two dollars a day. One concern is that definitions like these are based on one currency and therefore the economy of one nation, the relative value of which is constantly fluctuating because of a vastly complex web of domestic and global factors. This makes the processes of formally estimating poverty levels based on the value of the dollar seem less helpful.

Issues arising from a headline figure

Despite some impressive research in the formulation processes, the headline figure unintentionally invites a rather lazy response from people and organisations alike, because by its nature it relies on a very specific figure without conveying any simultaneous insight into personal lifestyles and living conditions. In September 2022 The World Bank revised and republished its monetary quantification of abject poverty. It categorically establishes its ‘new, extreme poverty line’ at $2.15. This crudely means that anyone living on less than this amount of money spends their life in extreme poverty.

In total the World Bank estimates that 648 million people, or about a twelfth of the world’s population, live at this level. Nonetheless this stark, official calculation begs an important question. What about all those people who live on $2.16 a day, or $2.17, etc. What about the hundreds of millions more who live on or just below $3 a day? They would in theory be fifty percent wealthier than their counterparts who find themselves just below the new extreme poverty line. Yet does an extra dollar a day make all the difference? Moreover, the World Bank makes deductions based on the new poverty line. For example, in a bullish statement it lauds trends in poverty reduction made since 1990: ‘the world has made impressive progress in reducing poverty’.

A multi-dimensional approach to defining poverty

The World Bank, however, does acknowledge the importance of a multi-dimensional approach to defining poverty. It devotes a good deal of space and energy into commending an overarching assessment. So, it seems disappointing that the bank insists on headlining with a misleadingly precise-sounding monetary value, simply supplying eighteen links to other pages where important factors and analyses are cited. Many readers would simply not invest the time to look beyond the headline figure. Essentially, defining poverty needs to prioritise and embrace consistent presentation, emphasis and, above all, evidence-based information.

What makes poverty statistics influential?

Suffice to say that whatever poverty line figure is put forwards, the methodology produces a very low income value. However, any headline figure, however eye-catching, masks a far more complex set of circumstances. In dismissing such statistical approaches as highly limiting, Don Mathews has neatly pinpointed one reason that poverty statistics enjoy such influence, that is, to justify governments’ financial planning. A baldly statistical emphasis fails to shed light on specific social complexities that contribute to the notion of living standards.

The need for a holistic approach

So, a more holistic approach to defining poverty, and with it child poverty, is preferable. Increasingly, experts have argued that poverty needs to be viewed through the eyes of the people in question. For example, we should be assessing what their aspirations are, and to what extent they consider that they enjoy personal freedoms and rights. It may be a mistaken approach simply to judge situations through western eyes.

In building a robust, multi-dimensional definition of poverty and child poverty, we need to challenge lazy assumptions and expectations. While this is not an easy prospect it is vital in attaining a meaningful definition and the benefits which can arise from it. Moving away from a reliance on headline statistics and sound bite descriptions also requires a concise and embracing verbal explanation. Another hurdle concerns people’s conceptions of poverty relative to their own circumstances and societies. For instance, a child living in poverty in the UK may still look considerably better off than a child who lives in sub-Saharan Africa, simply because of the level and quality of services available from the state.

Another statistical issue: revising figures promptly

UNICEF presents an unequivocal argument that globally speaking, the majority of people in poverty, are children. Their headline figures are shocking: ‘Across the world, about 1 billion children are multidimensionally poor, meaning they lack necessities as basic as nutrition or clean water.’ UNICEF concludes that although a third of the world’s population is made up of children, they comprise up to half of those trying to live on less than $1.90 a day. Of course, this figure clashes with the latest World Bank revision, and such inconsistencies are naturally unhelpful in defining and then devising strategies to reduce poverty. Imposing monetary benchmarks only shifts people in a narrowly statistical sense, but certainly not in terms of their actual circumstances.

A further numerical inconsistency

UNICEF goes on to deduce that 356 million children are presently living in absolute poverty, another socio-economic overarching term which also clashes with the World Bank’s tag. Addressing poverty inconsistently does not change the fact that these children experience the poorest living standards, develop the fewest skills for later life, and earn the lowest wages when they become adults. Moreover, UNICEF starkly presents the bottom line: these poorest children are twice as likely to die than their better off peers. Future collaborative efforts to reduce child poverty would surely benefit from the common use of universally accepted terminology and methodology.

Undoubted progress

UNICEF chairs the Global Coalition To End Child Poverty. It too celebrates the fact that over the past thirty years administrative and co-operative strides forward have been taken to address and reduce child poverty. There are encouraging data, leading to the affirming claim that child poverty has been reduced by over fifty percent since 1990. This statistic means that malnutrition has been reduced, safe drinking water has been made available to many more people, education has been expanded, and fundamental healthcare services have been established alongside better sanitation. Because of this life expectancy is improving in diverse communities, and children may even have improved employment opportunities.

Avoiding complacency

While such progress sounds reassuring, it is vital to remember that huge numbers of children remain in multi-dimensional poverty. Huge disparities persist, and naturally these guarantee that hundreds of millions of the poorest children are being left further behind. Political initiatives like UNICEF’s Sustainable Development Goals are bringing governments together on the international stage to address child poverty. The ultimate, and rightly ambitious, aim is to eradicate multi-dimensional child poverty within the next decade, meaning that children will have what they need not only to survive but to fulfil their potential and hopefully thrive. Achieving that efficiently and effectively would be aided by organisations and governments adopting a consistent, embracing overview, which relies less on statistical headlines and uses uniform terms coherently to reinforce descriptions of personal circumstances.

Making Christmas feel like Christmas

The John Lewis Partnership has teamed up with Action for Children, aiming to make a lasting difference to young people in care across the UK. This year’s Christmas advert adopts a refreshingly new style for the company’s traditional festive campaign. Their commercial, titled ‘The Beginner’, introduces Ellie who represents one of 108,000 children in the UK care system. Sad faced, she arrives at her foster home just prior to Christmas Day where she is warmly greeted by her new foster parents. As a first impression she notices a skateboard in the hallway and the cast on her foster father’s arm. In fact, he is battered and bruised from repeated attempts to master some fundamental skateboarding moves, a hobby he understands means a lot to Ellie, whose sole possession appears to be a well-loved board.What the advert doesn’t reveal is that a young person goes into care in the UK every seventeen minutes. That amounts to approximately 30,000 each year. Moreover, Action for Children, suggests that 60,000 children referred to social services each year were referred the previous year as well but, for a variety of reasons, were not offered any support. For some young people, receiving vital help from the state is a very slow process.

Media impressions of Christmas

Conventionally, the media tend to promote generic impressions of Christmas, with families gathered around a strikingly decorated Christmas tree, opening neatly wrapped presents, heartily eating and drinking fine fare, and generally enjoying a carefree time away from life’s more usually hectic routines. Perhaps there are red and green knitted stockings draped over the soft furnishings, a roaring fire with a pet dog stretched out in front of the fireplace, and ornate decorations completing the festive scene. However, for many families and children this impression of Christmas time is a far cry from the harsher reality of 2022. This begs two questions, how many children experience a less than happy Christmas? And, what can we do to make Christmas feel like Christmas, irrespective of material and commercially driven impressions and expectations?

Christmas can be stressful

The answer to the first of these questions is difficult to determine but suffice to say that it is probably rather more than you would imagine. There are several important socio-economic factors which frame individual family contexts. Ironically, for many parents Christmas can prove to be a stressful time. There are deadlines to be met at work, shopping to be bought, meals to be prepared, presents to be organised, cards and messages to be sent, relatives to be visited – sometimes hundreds of miles away – and housework to be completed. Perhaps we can stand aside from the hype for a few minutes to think about what might make a genuinely happy Christmas, especially for children classed as living in poverty. One where materialism does not take centre stage, one where overindulgence is rendered irrelevant, and one where overspending to keep up with expectations doesn’t land families in debt. After all, financial stress and hardship are leading causes of anxiety and depression, and the impact of these mental health conditions can deeply affect children.

The link between poverty and mental wellbeing

Official figures confirm that child poverty in the UK is increasingly widespread. However, Christmas can prove to be a difficult time and not just because of the financial constraints imposed by hardship. Poverty and mental health issues are indisputably linked. For example, anxiety and depression are more prevalent among young people whose personal circumstances mean that they are eligible for free school meals. Moreover, statistically speaking, children whose families face hardship are less likely to attain good examination grades than their peers. This fact can naturally undermine their self-esteem and prove to be educationally demotivating. Consequently, the festive season with its material expectations is likely to present additional sources of stress to young people who may already feel socially disadvantaged. So, while for a majority of children Christmas can be an exciting and even a magical time of year, for a sizeable minority it might prove to be divisive, isolating, and it can even undermine self-confidence.

Challenges arising from Christmas school holidays

Beyond the financial and material associations of present giving, the school holidays can also become disruptive because daily routines inevitably alter. Most young people do not mind staying in bed later, nor going to bed later. However, a lack of routine can become disruptive and counterproductive. There can appear to be no obvious sense to each day’s shape, and some young people may simply drift through the holidays. Others have no choice but to take on huge responsibilities during the school break. For example, there may well be a younger sibling to look after during the day, meaning that the school pupil in question fulfils the role of a young carer. Others may be obliged to look for temporary work to help support their family. Perhaps this transpires to be informally arranged and consequently the experience might transpire to be exploitative. These types of change to everyday life can leave young people vulnerable to all sorts of external pressures and commitments. Moreover, given the short days and prevalently chilly, wet weather, there may be limited opportunities to spend time outside, which can lead to a sense of boredom, frustration, or just feeling pent up.

Domestic abuse can become more prevalent at Christmas time

Moreover, there are additional issues facing many young people during the festive season. For instance, some children live in the shadow cast by domestic violence, which is documented to peak at this time of year. At Christmas people tend to consume more alcoholic drinks than usual, and that fact, alongside financial worries and expectations, can intensify domestic tension leading to increases of violent incidents at home. Children are naturally sensitive to family dynamics and can unwittingly find themselves caught in the middle of parental arguments. These can quickly spiral out of control. If you, or somebody you know, is experiencing domestic violence and associated relationship breakdown, help is available at: www.nationaldomesticviolencehelpline.org.uk.

The most important gift this Christmas

Given these issues and pressures it is remarkable how resilient and positive many young people are when coping with their individual circumstances. We can all make a difference to young people’s wellbeing simply by bearing in mind what really matters at this time of the year. I really like Christmas. It can often be a reflective and relaxing time and there are opportunities to spread some happiness and positive sentiments among family and friends. Even in a secular society the idea of a midwinter festival which marks the passing of the shortest days of the year and anticipates a new year, spring time and sunnier days to come, seems instinctively appealing. The festive season does, of course, also offer an opportunity to reconnect with children, as families spend more time together. Lasting, affectionate connections can be rebuilt. Perhaps the most important gift that adults can give a young person is time, alongside sincere attention and love. There is a danger of prioritising a long list of chores which inadvertently side line children.

Planning Christmas together

Moreover, planning together for a simple Christmas time avoids the prospect of over-expectation, and enshrines the notion that little things matter a good deal. Young people have been exposed to Christmas advertising since the beginning of October. That commercially led, drawn out anticipation can be concluded in a matter of minutes as presents are hurriedly opened. Perhaps Christmas could be approached in a more measured manner, wound down gently, and lasting memories could be formed by establishing new family traditions. For instance, something as simple as a walk to look at the festive lights, or a game of charades, or reading excerpts of a traditional story, like some short passages from Charles Dickens’ Christmas Carol.

Making a difference at Christmas

Given that young people learn from what the adults around them do, it ought to be possible to demonstrate what really matters. For example, volunteering for a couple of hours may prove to be affirming and inspiring for a young person, engendering a broader sense of perspective. Or, where possible, planning a small donation to a charity together. For example, Barnardo’s Christmas appeal aims to tackle child poverty by providing food, warm clothes, bedding, and generally spreading a sense of Christmas spirit. Contributing in ways like these could help to offer young people a life changing gift that will empower them to navigate through the material associations of the festive season and nurture an appreciation of thinking about others, no matter what their own circumstances.

Self-help Strategies for Young Refugees’ Mental Wellbeing

UNHCR presents some sobering statistics on the numbers of people around the globe forced to leave their homes. By mid-2022 there were estimated to be 103 million refugees. That is approximately one and a half times the total population of the UK, and about one and a half percent of the world’s population. Of that unimaginably huge number, over a third – or 36.5 million – were under the age of eighteen. Strikingly it is calculated that a thousand children every day are born with refugee status.

The challenges facing these young people and their families are bewildering. Everyday facilities, resources, and community benefits which people in the UK take for granted, amount to little more than pipe dreams. Basic shelter, sanitation, education, health care, nutrition, and earning a living appear dauntingly out of reach, while language barriers and cultural differences in host nations may provoke and embed prejudice and hostility.

Anxiety is commonplace among refugee children

As my previous blog explained, for migrant children anxiety is a prevalent condition for which there is limited scope for formal treatment in many host countries. Nor, regrettably, is there much prospect of that situation immediately improving for the vast majority of the 103 million people presently forced into migration. Resources and services in host nations like Uganda (one and a half million refugees), Columbia (two and a half million refugees) and Turkey (over three and a half million refugees) are critically overstretched and underfunded, despite these nations’ best humanitarian initiatives. It is issues such as the impact of personal and political crises on people’s mental health which leads to conditions like anxiety and depression becoming long term and widespread.

A place for self-help strategies

While there is no substitute for professional advice and help, experts do recommend a series of self-help strategies which can prove beneficial in addressing symptoms of anxiety. Raising awareness about the importance and fragility of mental wellbeing is vitally important for everyone, especially for the most vulnerable people in global communities. Mental health first aiders are trained to promote these self-help strategies to empower people of all ages to attempt to regain some sense of control over their emotional wellbeing. By informing young refugees about practical steps endorsed by specialists they are likely to feel more positive in their outlook on their lives. That would amount to a significant start in appreciating and countering symptoms of anxiety, although there is no denying the uphill struggle which they will continue to face without professional treatment.

What self-help strategies are accessible for young migrant people?

Sports and exercise

Experts suggest that taking regular exercise is beneficial in addressing mental health conditions like anxiety. This could be as simple as going for a short walk. For a lot of young people, linking the issue with physical wellbeing is a natural place to begin. Regular exercise is acknowledged to be affirming for mental wellbeing. It improves fitness and can inspire a positive mood. This is a first step on the way to a broader and more positive outlook, which in turn can start to create a sense of self-esteem.

So if, for example, a group of migrant children were given a second-hand football, they would have the potential to improve their physical and mental wellbeing. Of course, unsupervised they might risk physical injuries, but potential benefits could reach comfortably beyond the children’s wellbeing into the heart of their community, if local people became involved in organising some basic training or informal games.

Thanks to organisations like Fairplay For All Foundation, operating in Payatas, young football players who grow up facing extreme poverty have been selected to participate in the Street Child World Cup, representing the Philippines. This is truly aspirational for others in the community. Imagine the liberating sense of fulfilment galvanised by this opportunity. For the majority of those invited to Doha to participate in this year’s global competition, it would have been their first time flying, just one beneficial aspect of such a broadening experience. Having ambitions like these is a powerful motivator and can certainly impact positively on mental wellbeing. By taking some daily exercise, however informally, young people may benefit from a host of other lifestyle improvements. For example, they are more likely to adopt better sleeping routines.

Building friendships

Moreover, social interaction certainly benefits mental health. This is especially vital as young children develop. Building friendships impacts positively on mental wellbeing, for instance by fostering self-confidence and a greater sense of self-esteem. Aberdeen-based charity, Befriend a Child reaches out to young people who face difficult personal circumstances. Volunteers regularly meet up with the children to help them increase their sense of self-worth, develop new skills, reduce isolation and promote positive wellbeing. Friendships can generate a feeling of belonging, together with a positive and purposeful outlook. This means that interaction with other young people can boost confidence and help to provide a broader perspective on other issues, whether through diversion or by changing a child’s dominant moods. Even something as simple as listening to jokes can help to improve outlook. Enjoying good friendships can also foster a common sense of purpose, which is potentially transformative for mental wellbeing.

Maintaining a balanced diet

It goes without saying that eating a well-balanced diet and keeping hydrated are also important to physical and mental wellbeing. It’s vital that information about these important aspects of everyday life are publicised, perhaps even by word of mouth, as a rudimentary element of any basic educational programme. Funding and resourcing a well-balanced diet for refugees is a huge economic and logistical challenge for host nations, but it is still fundamental to address awareness of these issues among young people.

The benefits of safeguarding mental wellbeing

There are of course other important self-help suggestions to safeguard and improve mental health. For example, mental health first aiders recommend deep breathing exercises, which can be performed almost anywhere and at any time. They can quickly bring a sense of calm to anyone feeling symptoms of depression, anxiety or stress. Young people are also encouraged to write an informal journal, if possible on a daily basis, briefly focussing on positive moments in their lives. These could be as simple as a good sleep, or fine weather. Mental health first aiders also commend mindfulness. While this may not immediately appeal to young people the benefits of calmly focussing on our surroundings and listening to our sensory responses are indisputable.

One important yet understated benefit of being part of a community is the potentially positive impact on children’s mental wellbeing. Bringing young people together, integrating them into informal activities offers a way ahead for migrants and refugees. The benefit of addressing mental wellbeing through self-help strategies may not appear to be as tangible as other fundamental improvements, but in a number of ways it is the most significant of all, helping to transform and empower some of the world’s poorest children.

Signposting help

Various organisations give advice on safeguarding mental wellbeing. For example, the NHS discusses the benefits of self-help tips for improving mental health. Moreover, in 2022 the Mental Health Foundation has produced a series of short, educational films to support refugee mental wellbeing. One tells the story of Mariam, who fled from Syria and now lives in Scotland. The video endorses the Mental Health Foundation’s support programme and promotes tips to improve and safeguard young refugees’ mental health. Hearteningly, in initiatives which the foundation runs in Wales and Scotland, asylum seekers and refugees are recruited and trained to serve as peer leaders. Their role is to foster empathy, understanding, and mental health literacy. By empowering people in this way, young refugees can derive an affirming sense of self-esteem, while appreciating the difference that can be made through constructive mediation.

In conclusion, young refugees can benefit a great deal from talking about mental health issues. Raising awareness and encouraging self-help through educational programmes, however informally, can make a marked difference to the mental wellbeing of young people, particularly when little or no expert medical treatment is available. Community initiatives, especially those which empower people from the refugee community, can prove to be advantageous in more ways than one. Naturally, young refugees benefit from improved knowledge of mental health, but they are also likely to look up to community role models. Anything which inspires young people, no matter what their circumstances across the world happen to be, can become transformational for them, providing them with a more purposeful outlook. This in turn will impact positively on their mental wellbeing.

Mental health issues facing refugee children

In her recent blog for Poverty Child, Samantha Bunce discusses the detrimental impact of poverty on health. An overwhelming catalogue of challenges facing refugee children is documented in an all too sobering account by UNICEF. Displacement, loss and the complete breakdown of routine are only the beginning. Millions of refugee children, many unaccompanied, are confronted by terrible challenges while travelling before they reach their destination, often without any prospect of a return to their former homes and lives. They appear to have very few options to undertake safe migrations, risking unforeseen exploitation and dangers, for example being forced into child labour, marriage, trafficking, let alone the risk of violence and humiliation. It goes without saying that these children are deprived of an education, basic nutrition, organised medical care, as well as possessions, friends and relatives. As personal tragedies unfold and compound, daunting problems await further down the line. How challenging it must be to try fitting into a new community so different to anything previously experienced. Initially there is political bureaucracy to negotiate; inevitable prejudice; language barriers; cultural differences; and the lasting impact left by the pandemic. Organisations like UNHCR, UNICEF, and Save the Children present arrays of statistics to highlight the suffering and deprivation associated with the plight of refugee children, but it is a sad reality that long-term mental health issues can be all too easily overlooked by the new host community. The old notion that a broken leg is easier to treat than a mental health condition, because it is clearly tangible, remains totally applicable.

What forms of anxiety can refugee children experience?

Anxiety occurs in many forms. For example, Separation Anxiety which especially affects younger children. If refugee children are separated from a parent or relatives, then they are susceptible to powerfully specific feelings of being unsafe and unloved. New circumstances and contexts can make them feel bewilderingly upset, even if they are with people they know and love. While it is perfectly natural for children to miss their parents for a few hours or even a few days, imagine the emotional prospect of being separated on a seemingly permanent basis. They may be clinging to hopes of being reunited, as well as vividly recalling final goodbyes. Suddenly having to cope without the support of loved ones, in unfamiliar and dangerous situations would seem utterly daunting to refugee children. Some do take with them one or two personal possessions which they strongly associate with their homes and relatives. While these can prove to be affirmingly comforting they can also provoke poignantly sad memories. The NHS discusses Separation Anxiety here.

Migration, Integration, Migrants, Merge

Generalised Anxiety Disorder (GAD) is a chronic condition. Anyone suffering from GAD is likely to be preoccupied about a past event or specific people a great deal of the time. It can have a hugely inhibiting impact on a child, to the point where it becomes difficult for them to concentrate or socialise. The condition is linked to Social Anxiety Disorder, where children become withdrawn because they feel convinced that they will be judged, mocked, and bullied by those around them. Experiences of child refugees mean that they are particularly susceptible to these mental health conditions. The NHS discusses Generalised Anxiety Disorder and Social Anxiety Disorder here.

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Post-Traumatic Stress Disorder (PTSD)

Unsurprisingly, child refugees commonly suffer from PTSD. They have often witnessed terrible events and losses. They are prone to mental health aftershocks which include panic attacks, nightmares, flashbacks, and persistent preoccupation with what they have experienced. It is vital to understand that these episodes frequently occur when there is no present trigger for them. This can make it difficult for new hosts and communities to appreciate precisely what the child concerned is suffering. The incidents may be over, but the children are highly likely to experience these symptoms of PTSD until formal treatment can be administered, which may not be for a long time, depending on the new host society. And these symptoms can be terrifying, not simply upsetting. The NHS discusses PTSD here.

 

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Mental health first aid approaches

Mental health first aid courses emphasise the importance of providing non-judgemental reassurance and space to young people who are suffering from forms of anxiety. Experts explain that intrusive probing is counterproductive and risks exacerbating anxiety issues, possibly even leading to self-harm. Supportive, sympathetic conversations may convey enough comfort to empower a young person to begin to open up about their feelings and concerns. Listening in a calm manner is an important approach, establishing a sincere sense of trust. It is important that the young person can feel reassured enough to take the lead and explain their feelings. In other words, thoughtful listening is central to reaching out to people with anxiety. Mental health first aiders are trained to avoid patronising approaches which can stifle opportunities for the young person to describe their feelings and reactions. Consequently, it is recommended practice to avoid assertive-sounding language, a simple phrase like ‘How may I help you?’ is far more likely to prove conducive to establishing trust than ‘You have to calm down’. Likewise, ‘You are welcome to come back to see us when you would like to’ would feel more empowering and respectful than ‘You are overthinking your situation’, which sounds judgementally dismissive. Reaching out to young refugees with anxiety conditions is all about building bridges and affording opportunities to talk openly in a safe and supportive context.

It is also important to validate the young person’s anxiety. The triggers and reflections which continue to  prompt their anxiety remain consistently threatening for them. They do not seem irrelevant or irrational and must not be played down. Young refugees need to be assured that they are not alone, that people do care about their situation and that there will be help available. Above all, mental health first aiders are trained never to hold a young person accountable for their condition. Nor will they overwhelm anyone with too much information about specific forms of anxiety, but they will confirm that improvement and recovery are completely possible. Finally, if professional services are available mental health first aiders will recommend those when the time feels right.

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Positive steps forward

The Refugee Council supports families and unaccompanied children arriving in the UK. They have developed a specialist mental wellbeing service for lone young refugees, My View. Their vision is encouragingly ambitious, to help children harness the extraordinary strength and resilience which they have demonstrated in their stories so far. Professional treatment includes one-to-one therapy and therapeutic group meetings. Young people are invited to discuss and express their feelings, for example, through creative arts. There have also been opportunities to participate in psychosocial activities, for instance, an outing to Kew Gardens, or joining an equine therapy workshop, or attending practical sessions at a community garden. Professionals consider the impact of such treatment and activities to be hugely beneficial to the young people concerned. Gratifyingly, approximately eighty percent of participants have acknowledged tangible improvements to their mental health.

In conclusion, child refugees face daunting challenges and displacement leaves them bewildered and susceptible to mental health issues like anxiety. This can manifest itself in various forms, like GAD, PTSD and separation anxiety. If professional treatment is unavailable, mental health first aid can provide support and offer a way ahead for these most vulnerable children.