Here’s an ethical dilemma: you are called by the police to evaluate a child who has just been arrested for threatening to kill some of his classmates. He is a 14 year old Muslim. They are asking your opinion as a pediatrician – should he be allowed back in school or should he be kept in jail.
You do a little investigating. Here’s what you find out:
Mohamed is a 12 year old boy of South-Asian Muslim descent who was referred by the police to your child psychiatry clinic for evaluation. Mohamed was born in Canada. His parents emigrated from Bangladesh. His family is religious. His mother wears a hijab. The police were called by Mohamed’s school after an incident in which some older boys at his school spat on his mother and called her racial epithets. Mohamad texted his friends “I feel like killing these guys.” One of his classmates told his parents about this. The schoolmate’s parents looked up Mohamed on Facebook. On his home page, he wrote his profession was “serving Allah.” There was a picture of him in a Rambo like pose, holding a rifle. The parents informed school officials who called the police. The police arrested Mohamed outside his home.
In an article released on Sept 18, two international experts discuss the case (10.1542/peds.2017-0685). Dr. Cecille Rousseau is a research and clinical psychiatrist at the Montreal Children's Hospital where she directs the Transcultural Child Psychiatry Clinic. Her clinical work is with refugee children and with torture victims. She also does consultation work for health institutions and school boards on refugee children. She outlines a series of steps that a clinician might take to decide whether, in fact, there is an imminent risk of harm to others.
Dr. B. Heidi Ellis is at Harvard and Boston Children’s Hospital. She studies refugee youth mental health, with a particular emphasis on understanding trauma exposure, violence, and how the social context impacts developmental trajectories. She has investigated the role of discrimination in refugee youth mental health, and developed and evaluated a school-based mental health intervention for Somali refugee youth. She leads the Refugee Trauma and Resilience Center which is dedicated to developing and disseminating refugee child and family interventions.
Read the full article to see what Drs. Rousseau and Ellis recommend.
