Augments previous research reviews on the mental health status of refugee children and adolescents, with an emphasis on the distinct stressors and coping strategies associated with the separate phases of preflight, flight, and resettlement. The article summarizes research that addresses the stressors affecting refugee children, including (1) preflight stress occasioned by witnessing violence, enduring work camps and extended periods of deprivation, and being forced combatants, (2) flight stress triggered by the traumas of life in refugee camps and detention centers, and (3) resettlement stress accentuated by cultural bereavement; intentional, cognitive, and emotional coping modes across all 3 phases of the refugee experience. Stress reactions arise from exposure to violence and life in refugee camps while persistent psychiatric symptoms occur in resettlement. Health risks and health conditions present ongoing problems, especially when the children’s culture creates barriers to effective interventions and service utilization. Traditional healing practices, different cultural norms for emotional expression and manifestation of psychological distress, and lack of resources to pay for services all interfere with obtaining mental health services. Protective factors for children and adolescents include parental well-being and appropriate contact with the native culture. Clinical research and implementation of clinical services must account for cultural variations in symptom expression, diagnosis, and treatment-seeking behaviors.
