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Adolescent health

  • Background

    The World Health Organization defines adolescent as 10–19 years, youth as 15–24 years and young people as 10–24 years.

    Adolescent developmental issues include physical and cognitive transitions, emergent agency, autonomy and independence, personal identity and body image, peer relationships, recreational/educational/vocational goals, and sexuality. Adolescents of refugee-like background experience all these transitions in addition to the transitions of resettlement. They face balancing the values/expectations of their parents/cultural background with those of their new peers, while developing their own identity and learning a new language, in a new schooling system, in a new country.


    Please see the adolescent health clinical practice guideline and the refugee health initial assessment. The following points are useful strategies for working with adolescents who arrived as refugees or seeking asylum.

    • Aim for physical and psychosocial evaluation, with an emphasis on preventative care - healthcare visits may be limited, and adolescents may seek care from a variety of providers.
    • Adolescents should be seen alone at some point during (or soon after) the initial assessment. This may be more acceptable to parents and adolescents if the health provider sees the family initially, and they are aware this will occur in the future.
    • Establish confidentiality for the medical consultation and (separately) for working with interpreters.
    • Adolescents may have an incorrect date of birth recorded - check this in the first visit, clarification is important for consideration of growth, development, learning, and school/vocational placement. See Birth date issues.
    • Clarify access to education, prior schooling experience (including language) and current pathways in Australia - adolescents with interrupted schooling are usually better placed in the older cohort within a classroom year (e.g. 13 yr old could be placed in year 7 where there will be 12 and 13 yr old students). Evidence shows refugee young people have similar education outcomes to their native-born peers - ensure a proactive approach and early paediatric review for learning problems. See education assessment.
    • It takes many years to learn English as an additional language for academic purposes - explaining this is important, and a way to explore schooling and risk/resilience factors.
    • Mental health problems may present in adolescence. Adolescents may make new meaning from past trauma, and present with mental health concerns in relation to early childhood trauma (see WHO fact sheet for useful summary and background, and Mental health).
    • Sexual health is an important area that is often neglected. Many refugee-background young people have low sexual health literacy, and limited opportunities to learn about sexual health. Consider sexually transmitted infections (STIs, including hepatitis B), sexual violence, and female circumcision.
    • Family structures and parenting roles may change with migration, affecting settlement and leading to ‘role reversal’, with adolescents having increased responsibility, or taking on parenting roles.
    • Seek early paediatric review for complex adolescent health issues, including physical health, learning/behavioural concerns, disability, and age assessment. Paediatric review may also help facilitate access to (and acceptance of) mental health services.
    • Unaccompanied or separated minors, and adolescents (and children) on orphan relative visas should have specialist paediatric assessment - these cohorts have increased risk and vulnerability, and require long-term, specialist care.


    Please see initial assessment for initial refugee health screening tests and catch-up immunisation.

    • Pre-arrival immigration medical screening for adolescents includes urinalysis (5 years and older), chest x-ray (11 years and older), HIV screening (15 years and older), and syphilis screening (15 years and older). Unaccompanied minors (all ages) also have screening for HIV and hepatitis B surface antigen (HBsAg); onshore protection visa applicants (15 years and older) also have screening for HBsAg and hepatitis C virus (HCV).
    • IGRA testing is more reliable in adolescents for tuberculosis screening.
    • Catch-up vaccination and vaccine licensing varies with age. Adolescents will generally not need pneumococcal or Hib vaccines, they will need human papillomavirus (HPV) vaccine, and the varicella vaccine schedule changes at 14 years.

    HEADSSS screening

    HEADSSS screening can be used to assess adolescent psychosocial health:

    • H – home
    • E – education/employment (and eating)
    • A – activities
    • D – drug and alcohol use
    • S – sexual activity
    • S – suicide, depression, self-harm
    • S – safety from injury and violence



    Resources are grouped alphabetically by topic area.

    Alcohol and other drugs

    Forced marriage


    Legal and homelessness services

    Mental health and trauma supports

    Sexual health and pregnancy


    • The Huddle: Sport and recreation, AFL Football and study support programs  
    • Welcoming Australia - Sports - Sports and recreational programs promoting inclusion, opportunity and belonging - including for recent arrivals, refugees and people seeking asylum.     

    Immigrant health clinic resources: authors Georgie Paxton, Dan Mason and Karen Kiang, last update June 2020. Contact: