Mental distress is a normal reaction to upsetting and stressful events. When distress is due to circumstances such as forced displacement and difficult living circumstances, it is not a mental disorder (Hassan, et al., 2015). It is important to differentiate mental distress from a mental disorder, or a level of distress that interferes with a child's or youth's daily activities.

When differentiating between expected mental distress in response to a stressor and the possibility of a mental disorder, it is important to pay attention to the child's level of functioning in their significant relationships, school and play.

The decision to refer to a mental health professional such as a psychiatrist is an important one. Not all refugee children and youth experiencing mental health problems or illnesses require this level of assessment and intervention. In the next section, Dr. Debra Stein discusses the warning signs that indicate that children might have a mental health condition requiring referral to a psychiatrist.

To avoid over-diagnosis in refugee populations, evidence of impaired social functioning and/or a high level or long duration of suffering are necessary for the diagnosis of mental disorders such as PTSD or depression (Pottie et al., 2016).