Evaluation and treatment of mental health symptoms among unaccompanied migrant children and adolescents in the United States: A systematic review

Abstract Background Unaccompanied migrant youths are at elevated risk for exposure to trauma and related mental health challenges, but there is minimal evidence guiding best practices. We conducted a systematic review of quantitative studies that examined mental health evaluation and treatment services for unaccompanied migrant youths resettled in the United States (US). Methods In accordance with the PRISMA 2020 statement, a literature search was conducted for empirical studies in nine databases and publicly available search engines. Citation tracking also assisted in identifying additional studies, including from the gray literature. The study protocol was pre‐registered (PROSPERO ID: CRD42023396805). Inclusion criteria required that studies be published between January 1, 2000 and November 11, 2024 and report quantitative results that evaluate mental health status or mental health treatment outcomes for youths (younger than 18 years) who were unaccompanied when they arrived in the US. Descriptive, narrative synthesis was used for analysis of results. Mixed Method Appraisal Tool was used to appraise study quality. Results Of 543 studies screened, 13 ( N = 1494 children)—six cohort studies (retrospective or prospective), five cross‐sectional, one non‐controlled trial, and one program evaluation—met inclusion criteria. Ten evaluated mental health using diverse questionnaires and most focused on trauma‐related symptoms. Three focused on mental health treatment. Findings demonstrated heterogeneous methods of evaluating mental health symptoms and implementing treatment services for unaccompanied migrant youths, although many indicated high rates of reported traumatic exposure. Most reported higher rates of trauma‐related and internalizing symptoms and all treatment studies demonstrated initial promise. Likely due to difficulty in accessing unaccompanied migrant youths, most studies used convenience samples limiting generalizability of findings. Conclusions Rigorous studies with comprehensive collection of sociodemographic characteristics are needed to inform the development of evidence‐based services that accurately detect and effectively treat mental health challenges among unaccompanied migrant youths.