Family factors

A cohesive, intact family is one of the most important determinants of children's well-being. For young children, secure attachments to parents or caregivers are central to healthy development. Parents and caregivers play a critical role in acting as a secure base for children as they grow.

A supportive and connected relationship with family members is associated with lower emotional distress (Hilario et al., 2014). In contrast, poor, non-supportive family relationships can act as a mental health risk factor for problems such as suicidal ideation (Smith et al., 2011).

• A number of factors can disrupt patterns of healthy attachment:

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  Forced displacement among refugee families and separation from caregivers can be highly stressful, in particular for young children. Separation from one or both parents can also deprive children of important role models. Parental traumatic experiences can lead to disrupted (i.e., disorganized) attachment relationships with their children, which can severely impair a child's attachment security. As a result, children are exposed to vulnerabilities and poor coping to mental distress. (Ee et al , 2016)

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  Parents with symptoms of PTSD can be less emotionally available to their children, less sensitive and responsive, and more avoidant. These factors can have negative implications for children's behavioural problems. (Ee et al , 2016)

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  The mental health of parents and other family members has a bearing on children's mental health. Stressors experienced by parents, such as unemployment, put considerable pressure on families and leave parents less able to care for their children appropriately, affecting newcomer children's mental health (Khanlou & Crawford, 2006). Witnessing parents panic or show helplessness is also a risk factor for poor mental health outcomes for children. (Crowley, 2009)

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  As children naturally tend to try to conform to a new environment, they may learn English and acculturate faster than their parents. This difference in the rate of adapting can lead to changes in family roles, which may cause a loss of parental authority and lead to intergenerational conflicts. In addition, cultural differences between parents and children may develop, becoming a stressor between them and affecting children's mental health. (Islam, 2015)

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  Differing attitudes and behaviours toward maintaining the values and beliefs of the parents versus adopting of those of the host country can be a source of conflict between immigrant children and their parents, resulting in a loss of resilience for children. (Tardiff & Geva, 2006)

Community factors

In the post-migration phase, the level of acceptance and social support that refugee children perceive in their host community play an important role in their psychological adjustment and well-being.

Higher levels of social support are linked to fewer mental health problems, while lack of support is related to PTSD, depression and other mental health problems and illnesses (Betancourt & Khan, 2008). Experiences of racism and discrimination pose additional risks to the mental health and well-being of refugee children and youth.

Another risk factor is the lack of connection children may feel with members of their own ethnocultural communities. As discussed regarding adaptation and cultural identity, developing a “balanced” identity within multiple cultures may be beneficial; creating social connections or embracing cultural practices within an individual's own ethnic community can reinforce positive acculturation (Ontario Centre of Excellence for Child and Youth Mental Health [OCECYMH], 2015).

Undergoing many changes in residence during post-migration can also be a risk factor as it can be destabilizing for children (OCECYMH, 2015).

Protective factors at the community level are children's involvement in community activities, access to social and community resources, and participation in volunteer work and leadership roles within the community (OCECYMH, 2015).