Mental health problems, traumatic experiences and subjective treatment goals of treatment-seeking refugee minors

<b>Background:</b> Forced displacement is globally increasing, with children and adolescents being particularly affected. Exposure to armed conflict, the flight itself and challenges of settling in new environments put them at risk of experiencing potentially traumatic events and developing mental health problems, such as post-traumatic stress disorder (PTSD) and depression. Still, limited information is available regarding the traumatic experiences, psychological stress and treatment goals of treatment-seeking refugee children and adolescents.<b>Methods:</b> This cross-sectional study evaluated data from refugee minors seeking treatment at an Outpatient Health Care Center for Refugee Children in Germany. The standard diagnostic procedure included assessing sociodemographic characteristics, traumatic experiences before, during and after flight and mental health problems, including the diagnosis of PTSD and depression. Treatment goals were also examined.<b>Results:</b> From October 2016 to December 2023, a total of 716 refugee minors participated in the study. They were on average 15.13 years old, 56.3% of the sample were unaccompanied, and 72.1% were male. Most participants were from Afghanistan and Syria. Repeated interpersonal violence was frequently experienced in the home country (65.5%), during flight (59.3%), and in Germany (13.7%). The majority of children and adolescents fulfilled the diagnostic criteria of PTSD (57.8%), and the prevalence of depressive episodes was 44.2%, with a comorbidity rate of 35.9%. The majority of refugee minors identified specific treatment goals, particularly for reducing trauma-related symptoms such as negative thoughts, sleep issues, and nightmares.<b>Conclusions:</b> Our findings provide novel data on the mental health problems, pre-, peri- and post-migration traumatic experiences and treatment expectations in a treatment-seeking sample of refugee minors. The findings highlight the importance of developing trauma-focused interventions and improving clinicians' skills to address effects of complex, potentially ongoing, traumatic experiences and to tailor treatment to personal treatment goals. This is essential for providing high quality care for refugee minors.