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Clinical Child Psychology and Psychiatry
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A School-Based Mental Health Service for Refugee Children

Bridget O’shea

St Mary’s Department of Child and Adolescent Psychiatry, Westminster Mental Health Trust, London, UK

Matthew Hodes

Imperial College School of Medicine, London, UK

Gwynneth Down

Great Ormond Street Hospital for Sick Children, London, UK

John Bramley

Hallfield Junior School, London, UK

This article describes a school-based mental health service established to help psychologically distressed refugee pupils. The primary school involved was situated in an inner London borough and had a high proportion of refugee and immigrant children. Teachers identified refugee pupils with psychological difficulties and referred them to an outreach mental health worker who provided treatment on the school site. In addition to clinical interview the strengths and difficulties questionnaire was used as an assessment and outcome measure. In total 14 children (12 boys) were referred to the project. The children had been exposed to high levels of past violence and losses, and experienced ongoing socio-economic adversity. The children mostly had disorders related to these adversities, but a small number also appeared to have specific learning or scholastic difficulties. The difficulties mostly presented in the class as inattention and over-activity. A range of psychological and family interventions were offered, which included seeing the teachers initially, the children alone and relatives. Overall children were helped by the intervention with a reduction in SDQ scores (21.3 to 15.7) and some children showed dramatic benefit. This model seemed acceptable to the children, families and school. The implications of the project are discussed.

Key Words: children • refugees • school intervention • trauma

Clinical Child Psychology and Psychiatry, Vol. 5, No. 2, 189-201 (2000)
DOI: 10.1177/1359104500005002004


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