Mental health crises among youth in the context of migration - a cross-sectional study of psychiatric emergencies.

backgroundAdolescents face various challenges that can negatively affect their mental health. Unmanaged stress may lead to mental health crises. Adolescents with a migration background may face additional challenges, making them especially vulnerable and at increased risk for mental health disorders. As migrant adolescents represent a considerable proportion of the adolescent population worldwide, including in Germany, it is crucial to ensure accessible and appropriate mental health care in order to prevent mental health crises in adolescent migrants. It is thus essential to identify specific stressors among migrant adolescents. However, the few current findings on mental health crises in this group remain heterogeneous, highlighting the need for further research. We analyzed the sample characteristics of migrant youth presenting as emergencies at the Child- and Adolescent Psychiatry (CAP) in Tübingen, Germany. We additionally applied exploratory analyses with migration background as a correlate of psychosocial burden to determine which stress factors were particularly likely to be associated with mental health crises in migrant youth.

methodsWe used cross-sectional data from patients (mean age = 14.7 years; 76% female) with emergency presentations at the CAP Tübingen from 2020 to 2024. The study was preregistered and approved by the ethics committee on 11/21/2018 (project number: 848/2018BO1).

resultsWe found that migrant adolescents tended to make less use of mental health services, with emergency presentations often serving as their first point of contact with mental health care. They were also more often diagnosed with posttraumatic stress disorder, anxiety disorder, or psychotic disorder. The role of a migration background in mental health crises remained unclear; however, financial strain and experiences of loss seemed to be prominent stressors, particularly in migrant adolescents.

conclusionsIt remains clear that a migration background should be included as a risk factor for mental health crises rather than as an indicator. Migrant adolescents are exposed to heterogenous stress factors, thereby rendering it challenging to derive clear implications for treatment and emphasizing the need of further investigations. Yet, findings highlight the importance of facilitating access to lower threshold mental health services for migrant adolescents and the need for early identification of symptoms in order to prevent the escalation into acute emergencies.