This article follows recent publications regarding the conceptualization of refugees’ trauma (Transcultural Psychiatry, 2000, Vol. 37, No. 3), and describes the neglected and misunderstood perspective of child and adolescent psychiatry. The first issues concern the validity, social impairment and multiaxial understanding of psychiatric disorders such as post-traumatic stress disorder and depression that occur in young refugees. Second, aspects of the variability in risk and resilience of young refugees are discussed. Third, it is suggested that the psychiatric perspective is compatible with the tiering of mental health services, with accessible community-based services for many children, and specialist clinic-based services for those whose problems are more complex and associated with greater impairment. These issues are illustrated by a brief account of a school-based refugee mental health service. © 2002, Sage Publications. All rights reserved.

disorders and impairment risk and resilience tiered services Refugees Child and adolescent psychiatry

depression publication refugee mental health service human risk assessment psychiatrist validation process population risk Adolescent health services research Review adaptive behavior Child Welfare health care quality health care access posttraumatic stress disorder medical specialist good clinical practice social disability medical decision making psychotrauma health care delivery Child