Assessing the Needs of Newcomer Afghan Children and Adolescents: A Qualitative Investigation of Culturally Relevant Mental Health and Emotional Distress Problems.

While numerous studies have found that children affected by war and forced displacement are at increased risk for common mental health problems, research also indicates that experiences of emotional distress and the way it is expressed and understood vary by cultural group and context. In this study, we used previously developed rapid qualitative assessment methods to examine local perceptions of mental health and emotional distress among recently arrived children (7-17 years old) from Afghanistan who were living in the Boston area. We conducted 100 free listing interviews and 40 key informant interviews. The rapid assessment approach worked well as a method for understanding the problems of newcomer communities. Our analysis identified four culturally relevant mental health and emotional distress problems in the Dari and Pashto languages: tashwish (Dari and Pashto, worry and stress); jighar khoon (Dari, deep sorrow) / ghamjan (Pashto, deep sorrow); bi adab (Dari, going astray and mannerless) / bi-adabha (Pashto, going astray and mannerless) and dek shodan (Dari, missing) / yaadidal (Pashto, missing). While some of the findings resemble Western constructs of anxiety, depression, and conduct-related problems, they also highlight grief and adjustment experiences that may be specific to uprooting from home and culturally relevant terms and indicators useful for further assessing mental health and emotional distress in Afghan children and adolescents and areas of focus for culturally appropriate care and support.