Youth Mental Health in the Unaccompanied Refugee Minors Program: Findings from a Descriptive Study

Publication Date: May 13, 2021
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  • Pages: 27
  • Published: 2021


Research Questions

  1. What are the perspectives of URM program staff, foster parents, and youth on prevalence of mental health conditions and use of mental health services?
  2. How do URM programs support URM youth mental health?
  3. What are the challenges and successes in providing mental health services in the URM Program?

Refugee children are often exposed to numerous traumatic experiences and events. While individual responses to traumatic events vary widely, sustained exposure can lead to toxic stress and the development of mental health conditions, including post-traumatic stress disorder, depression, and anxiety. Research also indicates that refugee children who are separated from their parents/caregivers are at increased risk for development of mental health conditions compared to youth who are not separated. Despite these increased risks, refugee youth are less likely to access mental health services and more likely to have an unmet need for these services than their peers. 

The Unaccompanied Refugee Minors (URM) Program serves refugees and other eligible youth within the United States who do not have a parent or relative available to care for them. This report summarizes findings related to mental health from the Descriptive Study of the URM Program. The study examined perspectives from program staff, foster parents, and youth on the prevalence of mental health conditions, the use of mental health services, and challenges and successes in providing these services. The findings are most relevant to those involved in operating the URM Program but may also be of interest to others who serve youth who are recent immigrants or refugees and have experienced traumatic events.


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Despite existing research on the mental health of refugee youth in general, there is little research documenting the mental health of youth served through the URM Program, including prevalence of mental health conditions, services provided to the youth, and challenges and successes in providing these services. The purpose of this report is to begin to fill this gap by describing URM program staff, foster parent, and youth perspectives on the mental health needs of youth in the URM Program and the services provided to support their mental health. 

Key Findings and Highlights

  • Consistent with prior research about refugee youth, URM program staff reported that URM youth have high rates of traumatic experiences and resulting mental health conditions. However, URM program staff and foster parents also report that URM youth are highly resilient, adaptive, and skilled at developing coping mechanisms to process and recover from traumatic experiences.
  • URM programs provide a variety of mental health services to help support URM youth mental health. These services include screenings, individual therapy/counseling, group counseling, psychotropic medication management, substance abuse treatment, and services for victims of torture. 
  • URM program staff identified several barriers to mental health service provision, including stigma and lack of culturally and linguistically appropriate services. However, URM program staff also identified a number of promising approaches for addressing these service barriers, including approaches for developing trust and support to overcome stigma associated with mental health treatment.
  • URM foster parents reported positive changes in URM youths’ attitudes and behaviors after participation in mental health services. Foster parents also described a need for more mental health providers who understand URM youth experiences, as well as challenges overcoming stigma.
  • Some URM youth described positive experiences with mental health services, while others described negative experiences. Overall, youth described feeling emotionally supported by URM program staff, foster parents, and peers.


The report draws mainly from qualitative data collected through site visits to six URM programs, in which the research team conducted semi-structured interviews with URM program staff and community partners, as well as focus groups with URM youth and URM foster parents. This report also incorporates findings from our analysis of administrative data and analysis of surveys conducted by the research team of URM program directors, State Refugee Coordinators, and child welfare administrators. 


Wasik, H. (2021). Youth mental health in the Unaccompanied Refugee Minors program: Findings from a descriptive study, OPRE Report #2021-36, Washington, DC: Office of Planning, Research, and Evaluation, Administration for Children and Families, U.S. Department of Health and Human Services.


Unaccompanied Refugee Minor