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Abstract Iris Tijssen (2020)

Background
Unaccompanied minors are refugees who are under the age of 18 years old when they arrive in the Netherlands. They arrive without parent(s) or another person who has the legal authority. Unaccompanied minor migrants (UMM) are more likely to suffer from psychological problems compared to other refugees. There is still a lack of knowledge about the process of help-seeking behaviour in UMM, as well as before as after their 18th birthday. Also, their experiences with the care and support in the Netherlands is not well known. Furthermore, their needs and wishes regarding (professional, voluntary, or self-management) support for physical, sexual, and mental health issues are unclear. Increased insight could lead to better understanding, support, and professional care for these problems.

Methods
For this qualitative study, semi-structured interviews were conducted with 10 adults from Eritrea, Syria, Afghanistan, and Sudan, who came to the Netherlands as UMM. The interviews were transcribed and thematic analysis was led by an inductive coding process.

Results
Turning 18 meant a big change in the lives of the UMM and the support they received. When they were underage, they were always surrounded by supervisors who arranged help when they had a problem and accompanied them to the GP. After the age of 18, they had to rely on their own and their social network. For some of them, this was difficult. Furthermore, the participants reported malcontent with the Dutch organisation of healthcare, and especially with the GP. They did not feel taken seriously. Unmet expectations due to differences with the organisation of healthcare in their country of origin were mentioned as an explanation for their lack of confidence. However, some respondents mentioned sufficient help. Most of the ex-UMM reported no received mental health care, their native culture causes a barrier to seeking help.

Conclusion
UMM are discontented with Dutch (mental) healthcare. They experience an enormous change in support after turning 18 years old. Education on the Dutch healthcare system to adjust their expectations and a more person-centred, cultural sensitive healthcare provision could improve the help-seeking behaviour and satisfaction regarding the GP.

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