Mental health of refugee children: comparative study
BMJ 2003; 327 doi: https://doi.org/10.1136/bmj.327.7407.134 (Published 17 July 2003) Cite this as: BMJ 2003;327:134
All rapid responses
I'm afraid I must endorse the thrust of Dr Timimi's analysis.I've
written in rather similar vein (not yet published) to the British Journal
of Psychiatry in relation to their May paper on the mental health of
Kosovan refugees in UK, a paper cited by the other rapid response author
as being similar to yours.
Competing interests:
None declared
Competing interests: No competing interests
This is the second study published recently by psychiatrists who are
identifying 'unmet needs' for mental health service for 'refugee
children'. (See Journal of Psychiatry June 2003). There is no connection
stated betwen the two sets of researchers. They are both involved with
charities which need clients to obtain funding. There may be nothing to
worry about in this but this article does raise questions as to why the
schools were approached first; why the parents were not included in
evaluations, never mind the children themselves; why were the parents and
children not acknowledged when all other parties to this research were
offered thanks; finally were the parents of the children given copies of
this report? There is something dubious about identifying unmet needs in
identified groups in this way. It is fairly obviously that people who
have been through horrendous experiences will need to be treated with
compassion and sensitivity but not that it needs to be mentalised or that
their lives, as Sami Timini suggests, should become the object of the
professional gaze of especially researchers from a different culture.
Competing interests:
None declared
Competing interests: No competing interests
This is a poor study and shows a shocking lack of consideration for
context. The authors use rating scales developed by Western psychiatry
that rates what Western culture considers to psychiatric or mental health
problems and give these rating scales to teachers who have to give their
subjective opinion (and who presumably carry similar racial and cultural
stereotypes to the rest of the population) on these refugee children
(rating scales cannot give objective opinions, as their face validity is
always an issue). Their inevitable conclusion is that these children are
in a terrible state and need more (presumably Western model) mental health
input.
This perpetuates stereotypes about deficits (rather than strengths and the
potential contribution to society refugees can make) and spurs on the
usual rescue fantasies of middle class Western professionals. It obscures
social contributions to the difficulties such children and their families
may have (such as racism, trying understand how the system works,
understanding the laws of the country etc.) and it inevitably marginalises
these communities own conceptualisations of their difficulties and their
traditional ways of solving them.
Competing interests:
None declared
Competing interests: No competing interests
Rapid Responses
I support the continuation of rapid responses to the BMJ.
Barmy, bigoted and scientifically illiterate: it is hard to deny
these criticisms, yet we must let these voices be heard. The rapid
responses of the BMJ are a wonderful outlet for those who will never write
a scientific paper, pass a peer review or a paragraph fit to be published
in a newspaper or journal. The rapid responses serve a very important
function.
I, for one, would regret the demise of this important notice board.
William Pimm
Competing interests:
None declared
Competing interests: No competing interests