Refugee and asylum seeker child and adolescent mental health: A systematic review of racial, ethnic, and contextual disparities.

Recent research indicates that sociostructural factors affect mental health and care across racial and ethnic groups differently. The mental health and care access of refugee and asylum-seeking youth has been studied in various populations and host countries. Yet, despite the increasing numbers of such children, their poor outcomes, and underuse of care, little is known about racial, ethnic, and context-based disparities in these outcomes. To our knowledge, this is the first systematic review to identify the progress and shortcomings in the research of such disparities among refugee and asylee youth, emphasizing ecological dimensions affecting health and care. Using rigorous search and inclusion criteria across the MEDLINE, APA PsycInfo, CINAHL, and Web of Science databases and following Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines, we evaluated the findings and limitations of 63 included studies. These studies compared children or adolescents of distinct racial or ethnic refugee or asylum-seeking populations to each other or to other populations across 30 countries, investigating child and adolescent mental health outcomes (including disorders, symptoms, and mental health care access-related outcomes). We identify specific disparities in outcomes based on racial, ethnic, and contextual differences, with results organized by ecological systems theory dimensions and timescales. Our review highlights that generally, Middle Eastern youth may experience worse outcomes across contexts, that there is a gap in research inclusive of youth from the Americas, and that the mechanisms of sex differences, acculturative stress, and intergenerational transmission may vary by population. We propose actionable steps for research on disparities and interventions in migrant child and adolescent populations. (PsycInfo Database Record (c) 2025 APA, all rights reserved).