How GPs can help forcibly displaced young migrants

Liz Hare; Amy Stevens; Jessica Keeble; Christian Harkensee

doi:10.3399/BJGP.2025.0225

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How GPs can help forcibly displaced young migrants
Nathaniel J T Aspray, Victoria R Goodall and Judith Matsiko

Published on: 06 February 2026

Published on: (6 February 2026)
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How GPs can help forcibly displaced young migrants
Nathaniel J T Aspray, GP and NIHR In-Practice Fellow, The Migrant Health Research Group, City St George's, University of London
Other Contributors:
Victoria R Goodall, General Practitioner

Judith Matsiko, General Practitioner and Medico-Legal Report Doctor
As NHS GPs who also have experience providing Initial Health Assessments for Looked After Children - many of whom are forcibly displaced young migrants - we welcome the timely article by Hare et al.¹

We also applaud the balanced and respectful tone in the ABCDEF model recommended by the authors. It is our experience that many displaced young people don’t perceive themselves as ‘children’, and consultation styles need to be accordingly adapted. For a 15-year-old who was married aged 13 and made his own way from a refugee camp in South Sudan to the UK, questioning whether he can talk to his parents if he feels upset at school can be patronising or even completely alienating, leading to one of Berne’s ‘crossed transactions’² and further undermining trust in the system. Consultations with this patient group require careful navigation between infantilising people who may see themselves as adults and ‘adultifying’³ vulnerable children.

Another necessary balance must be struck between encouraging trust and disclosure of challenging subjects such as torture, while recognising the risks of retraumatisation and importance of continuity of care where trauma is disclosed.⁴

Finally, we welcome the November 2025 update to the IHA forms (designed by colleagues in the RCPCH).⁵ The previous iteration’s questions such as “Does the young person have relev...
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As NHS GPs who also have experience providing Initial Health Assessments for Looked After Children - many of whom are forcibly displaced young migrants - we welcome the timely article by Hare et al.¹

We also applaud the balanced and respectful tone in the ABCDEF model recommended by the authors. It is our experience that many displaced young people don’t perceive themselves as ‘children’, and consultation styles need to be accordingly adapted. For a 15-year-old who was married aged 13 and made his own way from a refugee camp in South Sudan to the UK, questioning whether he can talk to his parents if he feels upset at school can be patronising or even completely alienating, leading to one of Berne’s ‘crossed transactions’² and further undermining trust in the system. Consultations with this patient group require careful navigation between infantilising people who may see themselves as adults and ‘adultifying’³ vulnerable children.

Another necessary balance must be struck between encouraging trust and disclosure of challenging subjects such as torture, while recognising the risks of retraumatisation and importance of continuity of care where trauma is disclosed.⁴

Finally, we welcome the November 2025 update to the IHA forms (designed by colleagues in the RCPCH).⁵ The previous iteration’s questions such as “Does the young person have relevant skills for their age, e.g. dressing, personal hygiene, telling time, managing money, including credit, travelling alone, preparing simple food, accessing health services/information?” seemed particularly inappropriate for a people group who have shown resourcefulness and resilience far beyond that of most adults in the UK.

References
1. Hare L, Stevens A, Keeble J, Harkensee C. How GPs can help forcibly displaced young migrants. Br J Gen Pract 2026; 76(762): 41–4. doi:10.3399/BJGP.2025.0225.
2. Berne E. Transactional analysis in psychotherapy: a systematic individual and social psychiatry. New York: Grove Press; 1961.
3. Burton L. Childhood Adultification in Economically Disadvantaged Families: A Conceptual Model. Family Relations 2007; 56(4): 329–45.
4. Schock K, Rosner R, Knaevelsrud C. Impact of asylum interviews on the mental health of traumatized asylum seekers. Eur J Psychotraumatol 2015; 6: 26286. doi:10.3402/ejpt.v6.26286.
5. RCPCH Health Policy team. Initial Health Assessment Delivery Standards. RCPCH. 2025. www.rcpch.ac.uk/resources/initial-health-assessment-delivery-standards (accessed Jan 29, 2026).
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Competing Interests: None declared.