May need a lot of psychiatric help

War and persecution have resulted in large migrations, and current estimates suggest there are 23 million refugees in the world.1 About 120 000 of them are in Britain, mostly living in inner London, where they constitute significant minorities. At least 40% (50 000) are aged under 18 years, and they include increasing numbers of unaccompanied refugee children—nearly 500 in 1995. Despite their growing numbers, these children's mental health needs and service provision have received little attention.

Studies from the United States, mostly in refugee children from South East Asia but more recently those from former Yugoslavia, indicate that serious psychiatric disorder is present in 40-50%.2-4 Since refugee children will have been exposed to similar stressors wherever they find refuge, it is reasonable to take that figure as an estimate of prevalence in Britain. This is far higher than the estimates of psychiatric …