A systematic review and meta-analysis of mental health and psychosocial support for displaced children, young people and families

In the year ending December 2024, nearly 21,000 children and young people applied for asylum in the UK, of which more than 4,000 were separated. Although most displaced children and young people adapt well psychosocially, many are disproportionally affected by circumstances such as traumatic experiences, poverty, interruption of regular routines, limited access to resources and breakdown of social supports. It is therefore essential that evidence-based, culturally sensitive, anti-racist and trauma-informed support is offered. Existing evidence suggests that some interventions for displaced children and young people can be effective, but there is also evidence of psychosocial interventions potentially worsening outcomes. Further, it is well-established that effective interventions can be highly challenging to implement in this context, although it remains unclear what the key barriers and facilitators of implementation might be. Alongside various other evidence-based Practice Guides, this work will contribute to the implementation of the Children's Social Care National Framework in the UK, as recommended by the Independent Review of Children's Social Care. The purpose of this systematic review is to identify and summarise the available evidence of the effectiveness of Mental Health and Psychosocial Support (MHPSS) for displaced, refugee and asylum-seeking children and young people. MHPSS is defined as any type of support that aims to protect or promote psychosocial well-being or prevent or treat mental health conditions (UNHCR, 2024). Importantly, the use of this definition typically includes the need for careful considerations of holistic, culturally sensitive and trauma-informed approaches that are scalable, sustainable, and take the lived experience and practitioner experiences into account when designing, delivering and evaluating services (Tol et al., 2023). MHPSS can include direct individual or group psychotherapies, parent-focused interventions, service-focused programmes and school and community programmes. Where possible (i.e., based on the available literature) we will use meta-analytic methods to understand the pooled effect of interventions, as well as key moderators of this, such as the type of intervention; the methodological quality of the study; the population of focus; and the role of caregiver involvement. Alongside establishing effectiveness, a further goal is to identify barriers and facilitators to the implementation and scalability of effective MHPSS, including drawing on the views and needs of population sub-groups, such as separated children and young people seeking asylum. This dual focus will provide the necessary evidence (and identify key gaps in this evidence) to inform the development of a Practice Guide for senior leaders to support displaced children and families. Objectives: 1. Use systematic review methods to identify the scale and quality of evidence available on MHPSS for displaced children and young people. 2. Where possible (based on available literature), we will use meta-analytic methods to identify the pooled effect of existing MHPSS interventions and programmes, in terms of their effectiveness in reducing mental health difficulties and improving wellbeing or any secondary outcomes of interest. 3. Use moderator analysis and narrative synthesis to assess the research and programme elements associated effective MHPSS interventions and programmes (e.g., trained v lay facilitator; caregiver involvement; age of sample; gender; country). 4. Use both moderator analysis (where possible) and narrative synthesis to explore the effectiveness of MHPSS programmes and interventions for particular sub-groups (e.g. younger or older children; separated children seeking asylum; country of origin; gender). 5. Use a narrative synthesis approach to identify key barriers and facilitators for the implementation and scalability of MHPSS programmes and interventions, particularly within the UK context.