Reflections on the risks of alcohol and substance abuse among young refugees and migrants in Serbia

In Serbia, the co-funded EU ‘RM Child-Health Initiative’ supports cutting-edge research by UNICEF’s partner, the Institute of Mental Health

Jelena Vasic, MD, trainee in child psychiatry, Institute of Mental Health
Adolescent boys at a refugee centre on the outskirts of Belgrade
19 May 2021

In Serbia, the co-funded EU Refugee and Migrant Child Health Initiative (RM Child-Health Initiative) supports work by UNICEF that both encompasses and looks beyond the provision of basic healthcare to safeguard the mental health of children and youth. The RM Child-Health Initiative is enabling the Institute of Mental Health, with UNICEF support, to assess the risks, scale and nature of substance use among children and youth from refugee and migrant communities to inform future prevention efforts.

This cutting-edge field research is a response to concerns about the health status of youth living in refugee and migrant centres, as reported by the Serbian authorities. It aims to explore the nature of their vulnerability and their strategies to deal with their problems, and help professionals support young refugees and migrants who use – and abuse – alcohol and drugs. The research will guide the development of materials and capacity building for health and community workers who are in regular contact with young refugees and migrants, helping them to identify and tackle the risks of substance abuse and connect children and youth to support services.

One researcher, Jelena Vasic, shares her impressions of the work so far, with the final report expected at the end of 2021.

Let me try to describe our experience and challenges in preparing and conducting research about the prevalence of alcohol and substance use, and the psychological impact this has had among young refugees and migrants in Serbia.

Our first step – and first major challenge – was to review existing literature on this topic. We were faced with a lack of data on prevention measures or interventions to tackle alcohol and substance abuse among young refugees and migrants. It was clear that we would have a hard time finding standardized instruments to assess this specific problem. So, we had to use instruments that were standardized for the general population of children and adolescents, and we tried to adapt them for refugee and migrant children as much as possible.

The fieldwork was the second challenge, given the vast diversity of languages spoken by the children and adolescents among the refugee and migrant population. In all, 184 children and adolescents aged 11- 18 years of age were surveyed, of whom 155 (around 84 per cent) were male, in two refugee/migrant centres in Bogovadja in central Serbia and Krnjaca in Belgrade. While most of them were from Afghanistan, they spoke different dialects, so we had to find a way to adapt the survey for to reach everyone. Translators and cultural mediators helped us to adapt the survey successfully, so that it would work for children who spoke in different dialects.

Because we were focusing on children aged between 11 and 18, we tried hard to motivate them to take part in our survey, which combined the filling in of a questionnaire with an interview. Again, the cultural mediators were vital, explaining to parents and children the purpose and meaning of this survey. Then we had to find a way to make it possible for participants to actually take part, despite the high rates of illiteracy in this population. That’s why we organized simultaneous translation, with participants filling in the questionnaire with the assistance of translators and interpreters. This approach allowed the interviewers to answer any questions or clarify any topic as needed. What’s more, we were very aware that questions related to mental health problems and traumatic experiences could possibly trigger some kind of reaction in children. To minimize any potential risks, the interviewers were all residents in psychiatry, who were able to pause the survey and provide psychological interventions if they could see this was necessary.

Given that members of the refugee and migrant population are at times interviewed by police, and because there are certain restrictions and taboos about alcohol and substance use in their culture, we assumed that it could be challenging for children and adolescents from these families to answer our questions. So, we assured them that their answers would be anonymous. Even so, we had to deal with some resistance to a certain extent.

Overall, this experience was unique and so valuable. It required us to become far more sensitized to the cultural and social norms of young refugees and migrants. The greatest challenges in this survey were related to finding the most efficient methodological approach. Hopefully, our experience will be helpful to future researchers in this field.

Now we face yet another challenge: to bring all of the research together, analyse the findings, and develop workable, practical recommendations to help these highly vulnerable children avoid the dangers and damage caused by alcohol and substance abuse.

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This story is part of the Project Strengthening Refugee and Migrant Children’s Health Status in Southern and South Eastern Europe, co-funded by the Health Programme of the European Union (the ‘RM Child-Health’ initiative). The content of this story represents the views of the author only and is her sole responsibility; it cannot be considered to reflect the views of the European Commission and/or the European Health and Digital Executive Agency or any other body of the European Union. The European Commission and the Agency do not accept any responsibility for use that may be made of the information it contains.