Abstract
Background:
Forced displacement and migration are on the rise worldwide. Asylum seeking and refugee minors (ASRM) are particularly exposed to risk factors for mental health problems. Yet, there is a lack of comprehensive data on the prevalence of specific mental health problems as well as applied screening and follow-up care in Germany.
Methods
Using the online platform REDCap, we conducted the cross-sectional SAVE-KID survey among health and social care professionals (HSCP) working with ASRM in Germany (n = 201; 44% medical doctors, 38% social workers) to assess the estimated mental health burden among ASRM, the conducted screening measures, and provided mental health care as well as the extent to which communication problems affect care for ASRM.
Results
Here we show, that on average, 21% of ASRM are reported with one or more listed mental health problem. Only 37% receive follow-up. Less than 24% of participants conduct mental health screening by informal questions, interviews, trained staff or questionnaires. 84% of participants report frequent communication problems. Most used aids are online tools or relatives’ translations.
Conclusions
SAVE-KID describes an imbalance between the occurrence of and screening for mental health problems among ASRM. Comprehensive, systematic detection of mental health problems remains challenging due to communication problems, lack of specialized staff and diagnostic tools as well as follow-up care structures.
Plain Language Summary
Children and adolescents who apply for asylum or refugee status in Germany are exposed to numerous mental health risks. We conducted an online survey called SAVE-KID, in which 201 health and social care professionals participated. Respondents reported that about one in five minors had a mental health problem, but only one-third of them received follow-up care. Less than a quarter of professionals used structured mental health screening methods. Most professionals reported serious communication difficulties and often had to rely on online tools or family members for translations. These findings show that mental health problems are widespread among underage asylum seekers and refugees, but effective screening and care are hampered by communication barriers, a lack of trained staff, and inadequate diagnosis and support structures.
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Data availability
The de-identified dataset generated and analyzed during the current study is made available as dataset in the supplements.
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Acknowledgements
The authors want to acknowledge the contribution of Dr. C. Adam, Dr. R. Fressle, Dr. A. Krieg, Dr. V. Boda and Dr. K. Kneser for reviewing the questionnaire and to thank Ayfer Sen from the Ombudsstelle für Flüchtlingserstaufnahme Baden-Württemberg for distributing the questionnaire and supporting the study team. We thank the Pediatric Healthcare Research Group as platform for discussion and for their valuable feedback at different stages of the study. This research was funded by the Theodor-Escherich-Prize 2023 of the German Society for Pediatric Infectious Diseases (DGPI) granted to B.S.
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A.E., B.S., and J.W. conceived and designed the study. B.S. and J.W. conducted the recruitment and data collection. A.E. and J.W. analysed the data. A.E. and B.S. interpreted the results. A.E. wrote the initial manuscript draft. M.K., T.L., and M.H. contributed across all stages of the study by discussion and content-related input. All authors commented on, reviewed, and approved the final manuscript.
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Esser, A.J., Willems, J., Klein, M. et al. Cross-sectional survey among professionals on communication and mental health care for asylum seeking and refugee minors in Germany. Commun Med (2026). https://doi.org/10.1038/s43856-026-01415-x
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DOI: https://doi.org/10.1038/s43856-026-01415-x
