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We assessed the effects of a stringent reception policy on the mental health of unaccompanied adolescent asylum seekers by comparing the mental health of adolescents in a restricted campus reception setting and in a setting offering more autonomy (numbers [response rates]: 69 [93%] and 53 [69%], respectively; mean age, 16 years). Unaccompanied adolescent asylum seekers in a restricted reception setting reported more emotional problems on the Hopkins Symptom Checklist than their counterparts in the more autonomy group (mean scores [SD]: restricted, 59.3 [13.1]; other, 53.4 [10.5]; p = 0.033, F test). Main effects concerned a rise in anxiety. Girls showed larger differences than boys. A restrictive reception may therefore affect the mental health of minor asylum seekers. Health care workers and policy makers should be aware of this adverse effect.