War trauma experience and behavioral screening of Bosnian refugee childrenresettled in Massachusetts

The authors assessed war violence exposure and behavioral symptoms in Bosni an refugee children in Massachusetts and the utility of behavioral screenin g of refugees during the Refugee Health Assessment (RHA), required of newly arrived refugees. The study was a survey of 31 Bosnian refugee children in 1996 at the International Clinic of Boston Medical Center, the state's lar gest contracted provider of the RHA, Subjects were also offered referrals t o appropriate mental health services. Sixty-eight percent experienced long- term separation from a parent. Eighty-one percent were directly exposed to armed combat. Seventy-one percent experienced the death of a close friend o r relative. Fifty-two percent experienced economic deprivation. Families re ported behavioral symptoms for 77% of children. Only one family expressed i nterest in psychosocial services of any kind. Large numbers of Bosnian refu gees are likely to have experienced traumatic war violence and are at risk of behavioral symptoms. The RHA affords opportunities to screen for behavio ral problems but not to intervene. Primary care providers and other clinici ans should be aware of likely recurrences of symptoms in high-risk children such as these. J Dev Behav Pediatr 21:255-261, 2000. Index terms: refugees , war trauma, mental health, Bosnia, children.