The notion of professional identity among practitioners working with asylum seekers. A discursive analysis of practitioners’ experience of clinical supervision and working context in work with asylum seekers

Mental health training programs for non-health professionals and volunteers working with asylum-seekers and refugees: scoping review

OBJECTIVE

To identify and describe the mental health training programs for non-health professionals and volunteers who work, have worked, or would work with asylum seekers and/or refugees.

METHOD

Scoping review following JBI methodology. Search carried out in MEDLINE, CINAHL, ERIC, SCOPUS, PsycINFO, Psychology & Behavioral Sciences Collection, RCAAP, ProQuest, and websites of Clinical Trials, UNHCR, International Organization for Migration, WHO, Save the Children, International Migration, Integration and Social Cohesion in Europe, and International Federation of Red Cross and Red Crescent Societies. Studies written in English, Portuguese, French, Spanish and Swedish.

RESULTS

Of the 8954 articles identified, 16 were included reporting on 11 training programs: Mind-Spring, PM+, MHFA, Cognitive-Behavioral Training for Community and Religious Leaders, EmpaTeach, Suicide Prevention Education Program, Teaching Recovery Techniques, Handbook for Teachers of Vietnamese Refugee Students, PFA, Psychosocial support of volunteers and CBP&MHPSS.

CONCLUSION

Training programs from scientific literature focus on mental health disorders, while non-governmental organizations' documents focus on resilience and self-care. The current mental health training programs might be insufficient.

Exploring job demands and resources in psychotherapists treating displaced people-A scoping review

Objective: Little is known about the occupational health of psychotherapists treating displaced people. Therefore, the literature was explored regarding job demands, job resources, as well as work- and health-related outcomes. The Job Demands-Job Resources model (JD-R model) according to Bakker and Demerouti served as theoretical framework. Method: This scoping review followed the methodological framework provided by the Joanna Briggs Institute (JBI). Six databases were searched for qualitative, quantitative and mixed methods studies. Results: Based on 15 included articles, the emotional impact of work, cultural or language barriers, and administrative obstacles were identified as major job demands. Important job resources were related to a politicized conceptualization of the professional identity. Health-related outcomes could mainly be ascribed to empathy-based strain, while work-related outcomes were associated with discrepancies between personal values and asylum regulations. Conclusion: Despite the emotional impact of work, psychotherapists seem to benefit from work engagement arising out of socio-political conviction and the ability to help suffering people. Practitioners need more environmental support like professional networks. Further research is required, as current findings are predominantly based on qualitative and cross-sectional studies.

Health professionals' experiences of and attitudes towards mental healthcare for migrants and refugees in Europe: A qualitative systematic review

Migrants living in Europe constitute over half of the world's international migrants and are at higher risk of poor mental health than non-migrants, yet also face more barriers in accessing and engaging with services. Furthermore, the quality of care received is shaped by the experiences and attitudes of health professionals. The aim of this review was to identify professionals' attitudes towards migrants receiving mental healthcare and their perceptions of barriers and facilitators to service provision. Four electronic databases were searched, and 23 studies met the inclusion criteria. Using thematic synthesis, we identified three themes: 1) the management of multifaceted and complex challenges associated with the migrant status; 2) professionals' emotional responses to working with migrants; and 3) delivering care in the context of cultural difference. Professionals employed multiple strategies to overcome challenges in providing care yet attitudes towards this patient group were polarized. Professionals described mental health issues as being inseparable from material and social disadvantage, highlighting a need for effective collaboration between health services and voluntary organizations, and partnerships with migrant communities. Specialist supervision, reflective practice, increased training for professionals, and the adoption of a person-centered approach are also needed to overcome the current challenges in meeting migrants' needs. The challenges experienced by health professionals in attempting to meet migrant needs reflect frustrations in being part of a system with insufficient resources and without universal access to care that effectively stigmatizes the migrant status.

The Prevalence of Burnout and Secondary Traumatic Stress in Professionals and Volunteers Working With Forcibly Displaced People: A Systematic Review and Two Meta-Analyses

Research suggests that professionals and volunteers who work with forcibly displaced people (FDP) experience burnout and secondary traumatic stress (STS) as a result of working with such a highly traumatized population. In the present systematic review and meta-analyses, we report the pooled prevalence rates of burnout and STS in individuals working both professionally and voluntarily with FDP. The CINAHL Complete, E-Journals, ERIC, MEDLINE Complete, OpenDissertations, PsycARTICLES, and PsycINFO databases were searched for articles published historically to September 2019. Studies (N = 15) were included and assessed for quality if (a) their sample comprised individuals working in a professional or voluntary capacity with refugees, asylum seekers, forced migrants, or displaced persons and (b) reported on an outcome of STS or burnout. Two meta-analyses were conducted using random-effects models to assess the prevalence of (a) burnout and (b) STS. The pooled prevalence of high-level burnout was 29.7%, 95% CI [13.8%, 45.6%], with considerable heterogeneity between studies, Q(5) = 112.42, p < .001, I² = 95.6%. The pooled prevalence of moderate, high, and severe STS was 45.7%, 95% CI [26.1%, 65.2%] with considerable heterogeneity between studies, Q(12) = 1,079.37, p < .001, I² = 98.9%. Significant differences were observed in reported prevalence depending on the measure administered. This review highlights the high prevalence of high-level burnout and moderate-to-severe STS reported by individuals working with FDP. The results have implications for future research, employment support for individuals working with FDP, and measure selection for assessing STS.