Systematic review of former unaccompanied immigrant minors’ access to healthcare services in the United States

Abstract

Abstract Aim Former unaccompanied immigrant minors (UMs) now living in the USA are a uniquely vulnerable population. The US Office of Refugee Resettlement shelters provide health services, but most are discontinued once UMs leave the shelters. A systematic review was therefore designed to quantify access to medical, mental, and dental healthcare services by former UMs living in the USA. Subject and methods The study protocol was registered with PROSPERO. A search was made in Ovid MEDLINE, Embase, Scopus, and Academic Search Complete in June 2020. Full-text review, data extraction, and data analysis were completed by all authors. Results Searches returned a total of 2646 studies, of which 15 met all eligibility criteria. There was an overlap in the services investigated in the studies — 13 assessed mental health, ten assessed medical, and four included dental care. Sample sizes ranged from one to 4809, and there was a wide range of study designs. Some studies included multiple locations. Nine studies demonstrated success in community-based clinics or programs; one in a hospital, four in schools, three in group living settings, and one in U.S. Customs Border Patrol (CBP) custody. Three studies explored access to services post-release from shelters. Conclusions Healthcare programs at shelters, schools, and in the community have provided some screening and diagnosis of medical, mental health, and dental conditions for UMs, but multiple financial and cultural barriers make ongoing treatment difficult to access. Long-term studies following UMs in shelters and post-release through adulthood are needed to help create new, or modify existing, programs, to adequately support UMs now living in the USA.