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Radhamony R, Cross WM, Townsin L, Banik B. Culturally and Linguistically Diverse Community Access and Utilisation of the Mental Health Service: An Explanation Using Andersen's Behavioural Model. Issues Ment Health Nurs 2024; 45:758-765. [PMID: 38954511 DOI: 10.1080/01612840.2024.2359602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/04/2024]
Abstract
Andersen's Behavioural Model of Health Service Use (ABMHSU) is a multilevel model that helps understand the factors influencing health service access and utilisation. This framework is a widely used model for health service use in general, as well as in immigrant populations and vulnerable populations. ABMHSU, in this project, provided a framework to explain how the mental health nurses' cultural competence can influence the Victorian CALD community members' mental health care access and utilisation. A unique model of ABMHSU in the current multiple-method project provided a theoretical framework for examining the factors associated with people from the CALD community accessing mental health services in an Australian context to answer the research questions. The key findings of the research were discussed with reference to the extant literature and with triangulation of research results with the ABMHSU in the context of Victoria. The researchers argue that even though predisposing, enabling, and need factors are necessary to determine whether a person is selected for expert care for mental health issues, these factors alone are insufficient. Ongoing research is essential to ascertain the potential of mental health nurses' cultural competence education and cultural responsiveness in addressing the mental health service access and utilisation of the heterogeneous CALD communities. Additional research is advocated to identify the supplementary factors, as there is a dearth of research exploring the potential of ABMHSU worldwide.
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Affiliation(s)
- Reshmy Radhamony
- Institute of Health and Wellbeing, Federation University, Berwick, Victoria, Australia
| | - Wendy M Cross
- School of Health, Federation University, Ballarat, Australia
| | - Louise Townsin
- School of Health, Federation University, Ballarat, Australia
- Research Office, Torrens University, Adelaide, South Australia, Australia
| | - Biswajit Banik
- Institute of Health and Wellbeing, Federation University, Berwick, Victoria, Australia
- Manna Institute, Regional Australia Mental Health Research and Training Institute, University of New England, Armidale, New South Wales, Australia
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2
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Van Hout MC, Madroumi R, Andrews MD, Arnold R, Hope VD, Taegtmeyer M. The nexus of immigration regulation and health governance: a scoping review of the extent to which right to access healthcare by migrants, refugees and asylum seekers was upheld in the United Kingdom during COVID-19. Public Health 2024; 232:21-29. [PMID: 38728905 DOI: 10.1016/j.puhe.2024.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 03/08/2024] [Accepted: 04/05/2024] [Indexed: 05/12/2024]
Abstract
OBJECTIVES Complementing the well-established evidence base on health inequalities experienced by migrants, refugees and asylum seekers in the UK; we examined the extent to which their right to equal non-discriminatory access to health services (promotive, preventive, curative) was upheld during the COVID-19 pandemic. STUDY DESIGN Arksey and O'Malley's scoping review framework. METHODS A comprehensive search was conducted on Medline, PubMed, and CINAHL using detailed MESH terms, for literature published between 01 January 2020 and 01 January 2024. The process was supported by a ten-page Google search and hand searching of reference lists. 42 records meeting the inclusion criteria were charted, coded inductively and analysed thematically in an integrated team-based approach. RESULTS Dissonance between immigration regulation and health governance is illustrated in four themes: Health systems leveraged to (re)enforce the hostile environment; Dissonance between health rights on paper and in practice; Structural failures to overcome communication and digital exclusion; and COVID-19 vaccine (in)equity exacerbated fear, mistrust and exclusion. Migrants, refugees and asylum seekers encountered substantial individual, structural and policy-level barriers to accessing healthcare in the UK during COVID-19. Insecure immigration status, institutional mistrust, data-sharing and charging fears, communication challenges and digital exclusion impacted heavily on their ability to access healthcare in an equitable non-discriminatory manner. CONCLUSIONS An inclusive and innovative health equity and rights-based responses reaching all migrants, refugees and asylum seekers are warranted if the National Health Service is to live up to its promise of 'leaving no one behind' in post-pandemic and future responses.
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Affiliation(s)
- M C Van Hout
- School of Public and Allied Health, Faculty of Health, Liverpool John Moores University, UK.
| | - R Madroumi
- School of Psychology, Faculty of Health, Liverpool John Moores University, UK.
| | - M D Andrews
- Department of Clinical Sciences, Faculty of Clinical Sciences and International Public Health, Liverpool School of Tropical Medicine, UK.
| | - R Arnold
- Department of Public Health, Policy and Systems, Institute of Population Health, University of Liverpool, UK.
| | - V D Hope
- School of Public and Allied Health, Faculty of Health, Liverpool John Moores University, UK.
| | - M Taegtmeyer
- Department of Clinical Sciences, Faculty of Clinical Sciences and International Public Health, Liverpool School of Tropical Medicine, UK.
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3
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Ruberl A, Geiling A, Böttche M, Knaevelsrud C, Stammel N. [Risk Factors for Secondary Traumatic Stress (STS) and Post-Traumatic Stress Disorder (PTSD) in Interpreters with Personal Trauma Experience]. Psychother Psychosom Med Psychol 2024; 74:232-238. [PMID: 38865999 DOI: 10.1055/a-2311-4665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2024]
Abstract
BACKGROUND Interpreters play a crucial role in the care of refugees. However, little attention has been paid to the mental health of interpreters. Despite increased levels of secondary traumatic stress (STS) and increased prevalence of post-traumatic stress disorder (PTSD) among interpreters in the refugee context, there has been little research on risk factors for STS and PTSD in this population. The aim of this study was to investigate potential risk factors for STS and PTSD symptom severity. METHODS A Germany-wide online survey was conducted among interpreters for refugees in 2019. Only those who stated that they had experienced at least one traumatic event were included in the study. The final sample comprises N=83 interpreters. The examination of the potential risk factors (primary traumatic events, traumatic content, and personal refugee background) as well as the interaction between primary traumatic events and traumatic content was carried out using moderated multiple regression. RESULTS There was exclusively found a positive association between the number of primary traumatic events for both STS (p=0.003) and PTSD symptom severity (p=0.042). DISCUSSION/CONCLUSION In the present study, the number of primary traumatic events experienced was identified as a potential risk factor for STS and PTSD. The institutionalization of preventive measures such as regular supervision, follow-up talks, and interpreter-specific training could make an important contribution to protecting the mental health of interpreters. Further research is needed to gain a better understanding of risk factors for STS and PTSD in interpreters.
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Affiliation(s)
- Alexander Ruberl
- Klinische Kinder- und Jugendpsychologie und -psychotherapie, Freie Universität Berlin Fachbereich Erziehungswissenschaft und Psychologie, Berlin
| | - Angelika Geiling
- Wissenschaftliche Abteilung, Zentrum ÜBERLEBEN gGmbH, Berlin
- Klinisch-Psychologische Intervention, Freie Universität Berlin Fachbereich Erziehungswissenschaft und Psychologie, Berlin
| | - Maria Böttche
- Klinisch-Psychologische Intervention, Freie Universität Berlin Fachbereich Erziehungswissenschaft und Psychologie, Berlin
| | - Christine Knaevelsrud
- Klinisch-Psychologische Intervention, Freie Universität Berlin Fachbereich Erziehungswissenschaft und Psychologie, Berlin
| | - Nadine Stammel
- Klinisch-Psychologische Intervention, Freie Universität Berlin Fachbereich Erziehungswissenschaft und Psychologie, Berlin
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4
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Sánchez Collado CR, Sequeira-Aymar E, Saperas Pérez C, Barro Lugo S, Gutierrez de Quijano Miceli F, Barlam Torres N. [Primary approach to migrant mental health and female genital mutilation]. Aten Primaria 2024; 56:102957. [PMID: 38820669 PMCID: PMC11170161 DOI: 10.1016/j.aprim.2024.102957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Accepted: 04/18/2024] [Indexed: 06/02/2024] Open
Abstract
Mental Health (MH) and Female Genital Mutilation (FGM) are two aspects of migrant health that should be addressed and screened in primary care. These topics are inherently sensitive, often challenging and difficult to approach in routine consultations. Providing comprehensive care and management needs both knowledge and a careful approach, yet these factors may sometimes result in low screening of both health issues. Migration itself does not inherently lead to MH disorders. However, the various experiences encountered throughout the migration process can contribute to MH challenges. Migrants face the same issues as the rest of the population, but their expressions may differ. Therefore, it is important to understand the cultural contexts and create a supportive environment within healthcare to effectively address both MH and FGM. FGM is a serious health issue for girls and women that should be assessed in primary care. This includes prevention for at-risk girls, support and care for affected women and community initiatives. To engage with individuals from high-risk countries, both men and women is essential to facilitate change and help to end this harmful practice.
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Affiliation(s)
- Consuelo Rou Sánchez Collado
- Centro de Atención Primaria Garrotxa-Olot Nord, Institut Català de la Salut, Olot, Girona, España; Grupo de Trabajo Cooperación y Salud internacional (COCOOPSI), Sociedad Catalana de Medicina Familiar y Comunitaria.
| | - Ethel Sequeira-Aymar
- Grupo de Trabajo Cooperación y Salud internacional (COCOOPSI), Sociedad Catalana de Medicina Familiar y Comunitaria; Consorci d'Atenció Primària de Salut Barcelona Esquerra, Barcelona, España; Instituto de Salud Global (IsGlobal), Barcelona, España; Instituto de Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), Barcelona, España
| | - Carme Saperas Pérez
- Grupo de Trabajo Cooperación y Salud internacional (COCOOPSI), Sociedad Catalana de Medicina Familiar y Comunitaria; Centro de Atención Primaria Larrard, Parc Sanitari Pere Virgili, Barcelona, España
| | - Silvia Barro Lugo
- Grupo de Trabajo Cooperación y Salud internacional (COCOOPSI), Sociedad Catalana de Medicina Familiar y Comunitaria; Equipo de Atención Primaria Centre, Institut Català de Salut, Hospitalet de Llobregat, Barcelona, España
| | - Federica Gutierrez de Quijano Miceli
- Grupo de Trabajo Cooperación y Salud internacional (COCOOPSI), Sociedad Catalana de Medicina Familiar y Comunitaria; Centro de Atención Primaria Plana Lledó, Institut Català de la Salut, Metropolitana Nord, Mollet del Vallès, Barcelona, España
| | - Núria Barlam Torres
- Grupo de Trabajo Cooperación y Salud internacional (COCOOPSI), Sociedad Catalana de Medicina Familiar y Comunitaria; Centro de Atención Primaria Martorelles-St. Fost Institut Català de la Salut, Metropolitana Nord, Sant Fost de Campsentelles, Barcelona, España
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Lee K, Kronick R, Miconi D, Rousseau C. Moving Forward in Mental Health Care for Refugee, Asylum-Seeking, and Undocumented Children: Social Determinants, Phased Approach to Care, and Advocacy. Child Adolesc Psychiatr Clin N Am 2024; 33:237-250. [PMID: 38395508 DOI: 10.1016/j.chc.2023.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/25/2024]
Abstract
Given the current political and climate crisis, the number of forcedly displaced individuals continues to rise, posing new challenges to host societies aiming to support and respond to the needs of those fleeing war or persecution. In this article, we turn our attention to current and historical sociopolitical contexts influencing the mental health of forcedly displaced children (ie, refugee, asylum-seeking, and undocumented) during their resettlement in high-income countries, proposing timely ways to respond to evolving needs and recommendations to redress ubiquitous structural inequities that act as barriers to education and care for the children, youth, and families seeking sanctuary.
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Affiliation(s)
- Keven Lee
- Division of Social and Transcultural Psychiatry, McGill University, 1033 Pine Avenue, Montreal, Quebec, Canada; Lady Davis Institute, 3755 Côte Ste-Catherine Road, Montreal, Quebec.
| | - Rachel Kronick
- Division of Social and Transcultural Psychiatry, McGill University, 1033 Pine Avenue, Montreal, Quebec, Canada; Lady Davis Institute, 3755 Côte Ste-Catherine Road, Montreal, Quebec
| | - Diana Miconi
- Department of Educational Psychology and Adult Education, Université de Montréal, 90 Vincent D'Indy Avenue, Outremont, Montréal, QC, Canada
| | - Cécile Rousseau
- Division of Social and Transcultural Psychiatry, McGill University, 1033 Pine Avenue, Montreal, Quebec, Canada
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Wiessner C, Licaj S, Klein J, Bohn B, Brand T, Castell S, Führer A, Harth V, Heier M, Heise JK, Holleczek B, Jaskulski S, Jochem C, Koch-Gallenkamp L, Krist L, Leitzmann M, Lieb W, Meinke-Franze C, Mikolajczyk R, Moreno Velásquez I, Obi N, Pischon T, Schipf S, Thierry S, Willich SN, Zeeb H, Becher H. Health Service Use Among Migrants in the German National Cohort-The Role of Birth Region and Language Skills. Int J Public Health 2024; 69:1606377. [PMID: 38510525 PMCID: PMC10952844 DOI: 10.3389/ijph.2024.1606377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 02/14/2024] [Indexed: 03/22/2024] Open
Abstract
Objective: To compare health service use (HSU) between migrants and non-migrants in Germany. Methods: Using data from the population-based German National Cohort (NAKO), we compared the HSU of general practitioners, medical specialists, and psychologists/psychiatrists between six migrant groups of different origins with the utilization of non-migrants. A latent profile analysis (LPA) with a subsequent multinomial regression analysis was conducted to characterize the HSU of different groups. Additionally, separate regression models were calculated. Both analyses aimed to estimate the direct effect of migration background on HSU. Results: In the LPA, the migrant groups showed no relevant differences compared to non-migrants regarding HSU. In separate analyses, general practitioners and medical specialists were used comparably to slightly more often by first-generation migrants from Eastern Europe, Turkey, and resettlers. In contrast, the use of psychologists/psychiatrists was substantially lower among those groups. Second-generation migrants and migrants from Western countries showed no differences in their HSU compared to non-migrants. Conclusion: We observed a low mental HSU among specific migrant groups in Germany. This indicates the existence of barriers among those groups that need to be addressed.
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Affiliation(s)
- Christian Wiessner
- Institute of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Sara Licaj
- Institute of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jens Klein
- Institute of Medical Sociology, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | - Tilman Brand
- Leibniz Institute for Prevention Research and Epidemiology—BIPS, Bremen, Germany
| | - Stefanie Castell
- Department of Epidemiology, Helmholtz Center for Infection Research, Brunswick, Germany
| | - Amand Führer
- Institute of Medical Epidemiology, Biostatistics, and Informatics, Interdisciplinary Center for Health Sciences, Medical School of the Martin Luther University Halle-Wittenberg, Halle, Germany
| | - Volker Harth
- Institute for Occupational and Maritime Medicine Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Margit Heier
- Institute of Epidemiology, Helmholtz Zentrum München—German Research Center for Environmental Health (GmbH), Neuherberg, Germany
- KORA Study Centre, University Hospital Augsburg, Augsburg, Germany
| | - Jana-Kristin Heise
- Department of Epidemiology, Helmholtz Center for Infection Research, Brunswick, Germany
| | | | - Stefanie Jaskulski
- Institute for Prevention and Cancer Epidemiology, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Carmen Jochem
- Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | - Lena Koch-Gallenkamp
- Department of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Lilian Krist
- Institute of Social Medicine, Epidemiology and Health Economics, Charité University Medicine Berlin, Berlin, Germany
| | - Michael Leitzmann
- Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | - Wolfgang Lieb
- Institute of Epidemiology, Faculty of Medicine, University of Kiel, Kiel, Germany
| | - Claudia Meinke-Franze
- Institute for Community Medicine, University Medical Center Greifswald, Greifswald, Germany
| | - Rafael Mikolajczyk
- Institute of Medical Epidemiology, Biostatistics, and Informatics, Interdisciplinary Center for Health Sciences, Medical School of the Martin Luther University Halle-Wittenberg, Halle, Germany
| | - Ilais Moreno Velásquez
- Max-Delbrueck-Center for Molecular Medicine in the Helmholtz Association (MDC), Molecular Epidemiology Research Group, Berlin, Germany
| | - Nadia Obi
- Institute of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Institute for Occupational and Maritime Medicine Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Tobias Pischon
- Max-Delbrueck-Center for Molecular Medicine in the Helmholtz Association (MDC), Molecular Epidemiology Research Group, Berlin, Germany
- Max-Delbrueck-Center for Molecular Medicine in the Helmholtz Association (MDC), Biobank Technology Platform, Berlin, Germany
- Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Sabine Schipf
- Institute for Community Medicine, University Medical Center Greifswald, Greifswald, Germany
| | - Sigrid Thierry
- Institute of Epidemiology, Helmholtz Zentrum München—German Research Center for Environmental Health (GmbH), Neuherberg, Germany
- Augsburg University Hospital, Augsburg, Germany
| | - Stefan N. Willich
- Institute of Social Medicine, Epidemiology and Health Economics, Charité University Medicine Berlin, Berlin, Germany
| | - Hajo Zeeb
- Leibniz Institute for Prevention Research and Epidemiology—BIPS, Bremen, Germany
| | - Heiko Becher
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg, Germany
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Lerigoleur M, Urena-Dores A, Gérard B, Jaume C, Minet M, Million É, Clary B, Oude Engberink A, Lognos Folco B. [Obstacles and practical perspectives of the consultation in general medicine of migrants with psychological disorders. Qualitative study among French general practitioners]. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2024; 69:207-216. [PMID: 37743560 PMCID: PMC10874601 DOI: 10.1177/07067437231200842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/26/2023]
Abstract
OBJECTIVE The aim of this study is to understand the problems of managing psychological disorders in migrant populations, based on the experience of general practitioners. METHOD A qualitative study was carried out with general practitioners interviewed in a semi-directive mode. We chose the continuous comparison method and Peirce's pragmatic phenomenological approach to explore the lived experience. RESULTS Thirteen interviews revealed four phenomenological categories: (1) Immigration was an experience of mental suffering from beginning to end at the source of psychological disorder migrant population (PDMPs) with the need for specialized follow-up. (2) Inadequate support on arrival, with complicated administrative procedures and insecure societal and environmental conditions, exacerbated the precariousness of migrants, making follow-up difficult. (3) Immigration was a transcultural journey in which the language, attitudes and perceptions of each individual blurred understanding of symptoms and care, and thus professional communication. (4) Unprepared general practitioners found counselling migrants to be difficult, time-consuming and complex. They pointed to the need for a coordinated system with comprehensive multidisciplinary care.Data saturation was reached. Three researchers were brought together. CONCLUSION This study highlights the difficulties encountered by general practitioner (GPs) dealing with migrant patients in France. They feel helpless in the face of the nature of the disorders encountered and experience a disparity between the connections that are difficult to establish and those in their usual practice, even when professional experience with this population is acquired. They point to the need for coordinated models of care, financed by public policy.
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Affiliation(s)
- Marie Lerigoleur
- University of Montpellier Faculty of Medicine Montpellier-Nimes, Montpellier, France
| | - Aurélie Urena-Dores
- University of Montpellier Faculty of Medicine Montpellier-Nimes, Montpellier, France
| | - Bourrel Gérard
- INSERM-Université de Montpellier IDESP, Montpellier, France
| | | | - Mathilde Minet
- University of Montpellier Faculty of Medicine Montpellier-Nimes, Montpellier, France
| | - Élodie Million
- INSERM-Université de Montpellier IDESP, Montpellier, France
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8
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Pang M, Wang J, Zhao M, Chen R, Liu H, Xu X, Li S, Kong F. The Migrant-Local Difference in the Relationship Between Social Support, Sleep Disturbance, and Loneliness Among Older Adults in China: Cross-Sectional Study. JMIR Public Health Surveill 2024; 10:e49253. [PMID: 38194253 PMCID: PMC10806446 DOI: 10.2196/49253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 10/05/2023] [Accepted: 11/02/2023] [Indexed: 01/10/2024] Open
Abstract
BACKGROUND Driven by the accelerated aging of the population of China, the number of older adults has increased rapidly in the country. Meanwhile, following children, migrant older adults (MOA) have emerged as a vulnerable group in the process of fast urbanization. Existed studies have illustrated the association between social support and loneliness and the relationship between sleep disturbance and loneliness; however, the underlying mechanisms and the migrant-local difference in the association between social support, sleep disturbance, and loneliness have not been identified. OBJECTIVE This study aimed to clarify the migrant-local difference in the relationship between social support, sleep disturbance, and loneliness in older adults in China. METHODS Multistage cluster random sampling was used to select participants: 1205 older adults (n=613, 50.9%, MOA and n=592, 49.1%, local older adults [LOA]) were selected in Weifang City, China, in August 2021. Loneliness was assessed with the 6-item short-form University of California, Los Angeles Loneliness Scale, social support was evaluated with the Social Support Rating Scale, and sleep disturbance was measured with the Pittsburgh Sleep Quality Index. The chi-square test, t test, and structural equation modeling (SEM) were adopted to explore the migrant-local difference between social support, sleep disturbance, and loneliness among the MOA and LOA. RESULTS The mean score of loneliness was 8.58 (SD 3.03) for the MOA and 8.00 (SD 2.79) for the LOA. SEM analysis showed that social support exerts a direct negative effect on both sleep disturbance (standardized coefficient=-0.24 in the MOA and -0.20 in the LOA) and loneliness (standardized coefficient=-0.44 in the MOA and -0.40 in the LOA), while sleep disturbance generates a direct positive effect on loneliness (standardized coefficient=0.13 in the MOA and 0.22 in the LOA). CONCLUSIONS Both MOA and LOA have a low level of loneliness, but the MOA show higher loneliness than the LOA. There is a negative correlation between social support and loneliness as well as between social support and sleep disturbance among the MOA and LOA (MOA>LOA), while loneliness is positively associated with sleep disturbance in both populations (MOA
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Affiliation(s)
- Mingli Pang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
- Institute of Health and Elderly Care, Shandong University, Jinan, China
| | - Jieru Wang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
- Institute of Health and Elderly Care, Shandong University, Jinan, China
| | - Mingyue Zhao
- Human Resource Department, The Second Hospital of Shandong University, Jinan, China
| | - Rui Chen
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
- Institute of Health and Elderly Care, Shandong University, Jinan, China
| | - Hui Liu
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
- Institute of Health and Elderly Care, Shandong University, Jinan, China
| | - Xixing Xu
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
- Institute of Health and Elderly Care, Shandong University, Jinan, China
| | - Shixue Li
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
- Institute of Health and Elderly Care, Shandong University, Jinan, China
| | - Fanlei Kong
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
- Institute of Health and Elderly Care, Shandong University, Jinan, China
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GIRTAIN KATELYN, SHAH SURAL, MONTERREY ANAC, GUTIERREZ JRAUL, KUCZEWSKI MARK, LINTON JULIEM. Moving Toward Inclusion: Access to Care Models for Uninsured Immigrant Children. Milbank Q 2023; 101:1009-1032. [PMID: 37494705 PMCID: PMC10726766 DOI: 10.1111/1468-0009.12665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 05/31/2023] [Accepted: 06/29/2023] [Indexed: 07/28/2023] Open
Abstract
Policy Points Models for access to care for uninsured immigrant children that mitigate structural and sociopolitical barriers to inclusive health care include funding structures (e.g., state-sponsored coverage) and care delivery systems (e.g., federally qualified health centers,). Although the quintessential model of access to care necessitates health coverage for all children regardless of immigration status or date of United States entry, incremental policy change may more realistically and efficiently advance equitable access to high-quality health care. Intentional advocacy efforts should prioritize achievable goals that are grounded in data, are attentive to the sociopolitical milieu, are inclusive of diverse perspectives, and would meaningfully impact health care access and outcomes.
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Affiliation(s)
| | - SURAL SHAH
- Olive ViewUCLA Medical Center
- Division of Internal Medicine‐PediatricsDavid Geffen School of MedicineUCLA
| | | | | | | | - JULIE M. LINTON
- University of South Carolina School of Medicine Greenville
- Prisma Health Children's Hospital Upstate
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10
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Spaas C, Said-Metwaly S, Skovdal M, Primdahl NL, Jervelund SS, Hilden PK, Andersen AJ, Opaas M, Soye E, Watters C, Verelst A, Derluyn I, Colpin H, Haene LD. School-based Psychosocial Interventions' Effectiveness in Strengthening Refugee and Migrant Adolescents' Mental Health, Resilience, and Social Relations: A Four-country Cluster Randomized Study. PSYCHOSOCIAL INTERVENTION 2023; 32:177-189. [PMID: 37691715 PMCID: PMC10484026 DOI: 10.5093/pi2023a12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 05/30/2023] [Indexed: 09/12/2023]
Abstract
School-based psychosocial interventions are increasingly put forward as a way to support young refugees' and migrants' well-being and mental health in resettlement. However, the evidence on these interventions' effectiveness remains scarce and scholars denounce particular gaps in the evidence to date, pointing to a lack of large-scale, controlled studies and studies including social outcome measures. This cluster randomized study aims to strengthen the evidence base on school-based psychosocial interventions for refugee and migrant youth by assessing the effect of two interventions, Classroom Drama and Welcome to School, on youth's mental health, resilience, and social relations in Belgium, Denmark, Norway, and the United Kingdom. Multilevel analyses were conducted separately for the two interventions (Classroom Drama, n = 307, ages 11-19; Welcome to School, n = 251, ages 11-23), using separate no-treatment control groups. Our analyses indicated a significant main, positive effect of Classroom Drama on perceived family support, and an effect on perceived support from friends that was moderated by country: in the United Kingdom, the intervention group reported an increase in perceived friend support, whereas the control group reported a decrease. Furthermore, baseline resilience moderated the effect of the Classroom Drama intervention on behavioral difficulties and well-being. No effects of Welcome to School on any of the outcome variables were found. Overall, this study provides novel, nuanced evidence on school-based psychosocial interventions for refugee and migrant adolescents.
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Affiliation(s)
- Caroline Spaas
- KU Leuven UniversityBelgiumKU Leuven University, Belgium;
| | - Sameh Said-Metwaly
- KU Leuven UniversityBelgiumKU Leuven University, Belgium;
- Damanhour UniversityEgyptDamanhour University, Egypt;
| | - Morten Skovdal
- University of CopenhagenDenmarkUniversity of Copenhagen, Denmark;
| | | | | | - Per Kristian Hilden
- Norwegian Centre for Violence and Traumatic Stress StudiesOsloNorwayNorwegian Centre for Violence and Traumatic Stress Studies, NKVTS, Oslo, Norway;
| | - Arnfinn J. Andersen
- Norwegian Centre for Violence and Traumatic Stress StudiesOsloNorwayNorwegian Centre for Violence and Traumatic Stress Studies, NKVTS, Oslo, Norway;
| | - Marianne Opaas
- Norwegian Centre for Violence and Traumatic Stress StudiesOsloNorwayNorwegian Centre for Violence and Traumatic Stress Studies, NKVTS, Oslo, Norway;
| | - Emma Soye
- University of SussexSchool of Education and Social WorkUKSchool of Education and Social Work, University of Sussex, UK;
| | - Charles Watters
- University of SussexSchool of Education and Social WorkUKSchool of Education and Social Work, University of Sussex, UK;
| | - An Verelst
- Ghent UniversityBelgiumGhent University, Belgium
| | - Ilse Derluyn
- Ghent UniversityBelgiumGhent University, Belgium
| | - Hilde Colpin
- KU Leuven UniversityBelgiumKU Leuven University, Belgium;
| | - Lucia De Haene
- KU Leuven UniversityBelgiumKU Leuven University, Belgium;
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Rees SJ, Mohsin M, Kuowei Tay A, Moussa B, Klein L, Nadar N, Hussain F, Krishna Y, Khalil B, Yousif M, Silove D, Fisher J. COVID-19 stressors and mental health problems amongst women who arrived as refugees and those born in Australia. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0002073. [PMID: 37399172 PMCID: PMC10317230 DOI: 10.1371/journal.pgph.0002073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 05/23/2023] [Indexed: 07/05/2023]
Abstract
Women from refugee background residing in high income countries are at greater mental health risk during the COVID-19 pandemic given their higher baseline prevalence of mental disorders, trauma exposures and social adversities. During the COVID-19 pandemic we drew on data from wave-4 of the WATCH cohort study, collected between October 2019 and June 2021. We conducted a cross-sectional analysis to compare the prevalence of common mental disorders (CMDs) from the sample of 650 consecutively recruited women, 339 (52.2%) from the refugee-background who were resettled in Australia and 311 (48.8%) randomly and contemporaneously selected Australian born women. We assessed COVID-19 psychosocial stressors: 1. COVID-related material hardship and 2. COVID-related fear and stress. We examined for associations between scores on these two items and CMDs in each group respectively. Compared to Australian-born woman, women from refugee background recorded a significantly higher prevalence of Major Depressive Disorder (MDD) (19.8% vs 13.5%), PTSD (9.7% vs 5.1%), Separation Anxiety Disorder (SEPAD) (19.8% vs 13.5%) and Persistent Complicated Bereavement Disorder (PCBD) (6.5% vs 2.9%). In refugee women, associations were found between COVID-related material hardship and CMDs [MDD, Relative Risk (RR) = 1.39, 95%CI: 1.02-1.89, p = 0.02] as well as between COVID-related fear and stress and CMDs (MDD, RR = 1.74, 95%CI: 1.04-2.90, p = 0.02 p = 0.02). For Australian-born women, associations were more commonly found between CMDs and material hardship. Our study demonstrates that both women from refugee background and those born in Australia are experiencing significant rates of CMD during the pandemic and that material hardship is an associated factor. We found that women from refugee background are at greater risk for mental health problems and are more likely to report an association of those problems with fear and stress related to COVID_19. All women, and particularly those from refugee background, require urgent and specialised attention to their mental health and psychosocial problems during this pandemic.
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Affiliation(s)
- Susan J. Rees
- Faculty of Medicine, Discipline of Psychiatry, School of Clinical Medicine, University of New South Wales, Sydney, Australia
| | - Mohammed Mohsin
- Faculty of Medicine, Discipline of Psychiatry, School of Clinical Medicine, University of New South Wales, Sydney, Australia
- Mental Health Research Unit, Liverpool Hospital, SWSLHD, New South Wales Health, Liverpool, Australia
| | - Alvin Kuowei Tay
- Faculty of Medicine, Discipline of Psychiatry, School of Clinical Medicine, University of New South Wales, Sydney, Australia
| | - Batool Moussa
- Faculty of Medicine, Discipline of Psychiatry, School of Clinical Medicine, University of New South Wales, Sydney, Australia
| | - Louis Klein
- Faculty of Medicine, Discipline of Psychiatry, School of Clinical Medicine, University of New South Wales, Sydney, Australia
| | - Nawal Nadar
- Faculty of Medicine, Discipline of Psychiatry, School of Clinical Medicine, University of New South Wales, Sydney, Australia
| | - Fatima Hussain
- Faculty of Medicine, Discipline of Psychiatry, School of Clinical Medicine, University of New South Wales, Sydney, Australia
| | - Yalini Krishna
- Faculty of Medicine, Discipline of Psychiatry, School of Clinical Medicine, University of New South Wales, Sydney, Australia
| | - Batoul Khalil
- Faculty of Medicine, Discipline of Psychiatry, School of Clinical Medicine, University of New South Wales, Sydney, Australia
| | - Mariam Yousif
- Faculty of Medicine, Discipline of Psychiatry, School of Clinical Medicine, University of New South Wales, Sydney, Australia
| | - Derrick Silove
- Faculty of Medicine, Discipline of Psychiatry, School of Clinical Medicine, University of New South Wales, Sydney, Australia
| | - Jane Fisher
- Division of Social Sciences in Public Health and Preventive Medicine, Global and Women’s Health, Monash University, Melbourne, Victoria, Australia
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Sturm G, Zoldan Y. Reconfiguring Health: The Importance of Recognizing Embodied Subjectivity and Social Dynamics in Health. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2023; 23:112-114. [PMID: 37339301 DOI: 10.1080/15265161.2023.2218063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/22/2023]
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13
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Patterns of Suicide and Suicidal Ideation in Relation to Social Isolation and Loneliness in Newcomer Populations: A Review. J Immigr Minor Health 2023; 25:415-426. [PMID: 36348251 PMCID: PMC9643969 DOI: 10.1007/s10903-022-01422-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/18/2022] [Indexed: 11/09/2022]
Abstract
The purpose of this systematic review was to locate and synthesise existing peer-reviewed quantitative and qualitative evidence regarding the relationship between social connection and suicide among newcomers, immigrants, and asylum seekers. Systematic searches were conducted according to PRISMA guidelines using Web of Science and Pubmed. Search terms included those related to (1) social isolation and loneliness, (2) suicide and suicidal ideation, and (3) newcomer, immigrant, and asylum-seeking populations. Inclusion was limited to studies that were published in English and conducted between January 2001 and July 2021 in core anglosphere countries (Canada, United States, Australia, United Kingdom, Scotland, Wales, and Ireland). All potentially eligible articles were screened at two stages: First, we reviewed title and abstracts to omit obviously irrelevant studies and second, we reviewed the full text of each candidate article. Our initial search yielded 136 results. A total of 108 unique results were included for screening; 12 of which were eligible for inclusion in this review. Studies were categorized into 2 themes based on the methodologies of the articles found: qualitative perspectives of immigrants and newcomers; quantitative assessment of the risk of suicide burden and impact of social support and engagement on health and wellbeing of newcomers. Both types of studies highlight a social (dis)connection as an important determinant of mental health and suicide risk among immigrant populations in core anglo-sphere countries, highlighting the continued importance of community programs and funding to support inclusion and community-development among newcomer, immigrant, and asylum-seeking populations.
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Radhamony R, Cross WM, Townsin L, Banik B. Perspectives of culturally and linguistically diverse (CALD) community members regarding mental health services: A qualitative analysis. J Psychiatr Ment Health Nurs 2023. [PMID: 36947100 DOI: 10.1111/jpm.12919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 02/14/2023] [Accepted: 02/28/2023] [Indexed: 03/23/2023]
Abstract
WHAT IS KNOWN ABOUT THE SUBJECT?: Immigrant, refugee and asylum seeker populations worldwide are at high risk of mental health issues National mental health policies call for recognising Australian society's multicultural characteristics to ensure adequate mental health services to CALD communities Several barriers exist for people from CALD communities in Victoria to access and utilise mental health services Improving mental health professionals' knowledge of mental health service provision and cultural responsiveness can enhance CALD community access to services. WHAT DOES THIS PAPER ADD TO EXISTING KNOWLEDGE?: We analysed the perspectives of people from CALD communities in Victoria regarding their needs and experiences with mental health services. Participants reported diverse perceptions and understanding of mental health issues and services Various challenges were identified regarding health service utilisation for the CALD community in Victoria, including language barriers, stigma towards mental health issues, mental health illiteracy, distrust and lack of familiarity with mainstream mental health services. These challenges were acknowledged by community members even after a long residence in Australia The data generated on the beliefs about mental health issues and consequent help-seeking behaviours highlight the importance of culturally sensitive targeted prevention and early intervention strategies and ongoing commitment to building mental health literacy in the wider community WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The information from the study can be adapted for quality improvement and culturally responsive practices The strategies for effective service delivery drawn by this paper can be a comprehensive resource tool for mental health professionals, organisations and policymakers The findings imply that CALD mental health service users and their families will likely benefit from improved service assessment and quality of mental health care and equity when MHNs undertake cultural competence training and bring that into their practice. ABSTRACT INTRODUCTION: Victoria is one of the most multicultural states in Australia. Many CALD communities in Victoria may have encountered complicated migration journeys and complex life stressors during their initial settlement, leading to adverse mental health concerns. This diversity necessitates public policy settings to ensure equity and access in health services planning and delivery. While the MH policies and services take cultural diversity into account, there needs to be more implementation of those components of MH policies that relate to the particular needs of various CALD communities in Victoria. Even though mental health services prevent and address mental health issues, many barriers can impair CALD community access and utilisation of mental health services. Furthermore, the recent Royal Commission inquiry into the Victorian Mental Health system drives a renewed policy imperative to ensure meaningful engagement and cultural safety of all people accessing and utilising mental health services (Department of Health, 2023). AIM This study focused on the perspectives of people from CALD communities in Victoria regarding their mental health service needs, understandings of and experiences with mental health services to prepare an education package for mental health nurses as part of a larger multi-method research project. METHOD A qualitative descriptive design was used to collect and analyse the perspectives of 21 participants in Victoria, using telephone interviews, followed by thematic analysis. RESULTS The themes and sub-themes identified were: Settling issues; Perceptions of understanding of mental health issues (help-seeking attitudes toward mental health issues; the need for CALD community education); perceived barriers to accessing and utilising mental health services in Victoria (socio-cultural and language barriers; stigma, labelling and discrimination; knowledge and experience of accessing health facilities); experience with mental health services and professionals. DISCUSSION Community participation, mental health professional education and robust research regarding the mental health needs of CALD people are some of the recommended strategies to improve access and utilisation of mental health services in Victoria. IMPLICATIONS FOR PRACTICE The current study can contribute to the existing knowledge, understanding, practice and quality improvement as it vividly portrays the issues of various CALD communities in Victoria. The findings of this study imply that CALD MH service users and their families are likely to benefit in terms of improved service assessment and quality of MH care and equity when MHNs undertake CC training and bring that into their practice.
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Affiliation(s)
- Reshmy Radhamony
- Institute of Health and Wellbeing, Federation University, Berwick, Australia
| | | | - Louise Townsin
- Federation University, Berwick, Australia
- Torrens University, Adelaide, South Australia
| | - Biswajit Banik
- Institute of Health and Wellbeing, Federation University, Berwick, Australia
- Manna Institute, Regional Australia Mental Health Research and Training Institute, A project of Regional University Network (RUN), led by the University of New England, Armidale, NSW, Australia
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Garcia de Blakeley M, Stuart J, Sheeran N. Development and initial validation of a measure of cross-lingual practice among mental health practitioners. Psychother Res 2023; 33:251-263. [PMID: 35759688 DOI: 10.1080/10503307.2022.2090300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Abstract
OBJECTIVE Despite the importance of spoken language in psychotherapy processes with clients whose native language is distinct from the language of therapy, there is a dearth of research on mental health practitioners (MHPs) language competence. This research aimed to develop the Perceptions of Cross-lingual Practice (PCLP) scale designed to aid MHPs' cross-lingual practice. METHOD Study 1 developed items and collected data from Australian MHPs (n = 155) to test the scale's factor structure through exploratory factor analysis. Study 2 (n = 257) confirmed the emergent factor structure of the scale through confirmatory factor analysis and further assessed its reliability and convergent validity. RESULTS The final 23-item measure had good reliability and validity. Three factors emerged; MHPs' perceptions of self-competence, MHPs' perceptions of difficulties faced by clients, and MHPs' perceptions of barriers for themselves imposed by language. The perceptions of self-competence subscale was weakly related to the other subscales highlighting a disconnect between MHPs' self-perceptions and perceptions of contextual factors. CONCLUSION The PCLP is a reliable and valid measure of MHPs' perceptions of cross-lingual practice composed of three subscales each with good psychometric properties that can be used for various purposes in the evaluation and development of MHPs in post-graduate and professional settings.
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Affiliation(s)
| | - Jaimee Stuart
- School of Applied Psychology, Griffith University, Brisbane, Australia
| | - Nicola Sheeran
- School of Applied Psychology, Griffith University, Brisbane, Australia
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A Qualitative Systematic Review of Experiences and Barriers Faced by Migrant Women with Perinatal Depression in Canada. WOMEN 2022. [DOI: 10.3390/women3010001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Perinatal depression is the onset of depressive symptoms during pregnancy and up to one year after childbirth. Migrant women are at higher risk of experiencing perinatal depression due to numerous psychosocial stressors related to their experiences. This qualitative review aims to aggregate the experiences and barriers to care faced by immigrant and refugee women in Canada who have perinatal depression. Qualitative research can elucidate the barriers to treatment and culturally-impacted experiences of Canadian migrant women with perinatal depression. Following PRISMA and Joanna Briggs Institute (JBI) guidelines for conducting qualitative systematic reviews, 13 eligible studies representing 10 samples (N = 262 participants) were identified and included in this review. Participants included service providers, immigrant women, and refugee women. Three synthesized themes were identified by this review using the JBI meta-aggregative approach: (1) culture-related challenges; (2) migration-related challenges; and (3) service accessibility and quality. Within these themes were experiences of migrant women that encompass six categories: (1) conceptualization of perinatal depression; (2) childbirth-specific challenges; (3) migration-related challenges; (4) social isolation; (5) accessibility of services; and (6) quality of care. The role of family, cultural differences, financial challenges, and the effects of these on service accessibility are impactful in the experiences of migrant women. A greater understanding of the role of both culture and migration in the delivery of care, especially regarding service provider attitudes in more representative samples, is recommended.
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Bayes-Marin I, Roura-Adserias M, Giné-Vázquez I, Villalobos F, Franch-Roca M, Lloret-Pineda A, Gabarrell-Pascuet A, He Y, Hafi RE, Butt FMA, Mellor-Marsá B, Alós MC, Sainz-Elías H, Ayad-Ahmed W, Aparicio L, Cabeza ME, Bobo ÓÁ, López YO, Haro JM, Cristóbal-Narváez P. Factors Associated with Depression and Anxiety Symptoms among Migrant Population in Spain during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15646. [PMID: 36497721 PMCID: PMC9736595 DOI: 10.3390/ijerph192315646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Revised: 11/04/2022] [Accepted: 11/18/2022] [Indexed: 06/17/2023]
Abstract
Migrants are likely to experience mental health conditions, being one of the most vulnerable groups during the COVID-19 pandemic. The present study aims to: (1) estimate the prevalence of depressive and anxious symptoms and (2) examine the impact of risk and protective factors on this symptomatology. A sample of 129 migrants living in Spain during the COVID-19 pandemic completed an anonymous online survey, including information on sociodemographic and individual characteristics, migration, basic needs, social environment and perceived health domains. Multiple Poisson regression models analysed the effects of risk and protective factors on depression and anxiety symptoms. The prevalence of depressive and anxiety symptoms was 22.3% and 21.4%, respectively. Risk factors such as living in a rented house and previous mental health conditions were associated with higher depression symptoms, whereas unemployment was related to anxiety symptoms. Conversely, older age, better self-esteem, and higher levels of social support were associated with fewer depression symptoms. Older age and better quality of life were related to fewer anxiety symptoms. These findings addressing risk and protective factors (e.g., social support, self-esteem) help to design culturally effective programs, particularly in migrants with pre-existing mental health conditions, adjusting the organisation of mental healthcare services in difficult times in Spain.
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Affiliation(s)
- Ivet Bayes-Marin
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut—Campus Clínic, Universitat de Barcelona, 08036 Barcelona, Spain
- Centre for Biomedical Research on Mental Health (CIBERSAM), 28029 Madrid, Spain
| | - Maria Roura-Adserias
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, 08950 Barcelona, Spain
| | - Iago Giné-Vázquez
- Centre for Biomedical Research on Mental Health (CIBERSAM), 28029 Madrid, Spain
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, 08950 Barcelona, Spain
| | - Felipe Villalobos
- Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), 08007 Barcelona, Spain
| | - Marta Franch-Roca
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, 08950 Barcelona, Spain
| | - Amanda Lloret-Pineda
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, 08950 Barcelona, Spain
| | - Aina Gabarrell-Pascuet
- Centre for Biomedical Research on Mental Health (CIBERSAM), 28029 Madrid, Spain
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, 08950 Barcelona, Spain
| | - Yuelu He
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, 08950 Barcelona, Spain
- Department of Sociology, University of Barcelona, 08036 Barcelona, Spain
| | - Rachid El Hafi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, 08950 Barcelona, Spain
| | | | - Blanca Mellor-Marsá
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, 08950 Barcelona, Spain
| | - M. Carmen Alós
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, 08950 Barcelona, Spain
| | - Helena Sainz-Elías
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, 08950 Barcelona, Spain
| | - Wala Ayad-Ahmed
- Departamento de Medicina Legal, Psiquiatría y Patología, Facultad de Medicina, Universidad Complutense de Madrid, 28040 Madrid, Spain
- Fundación de Investigación Hospital Clínico San Carlos, 28040 Madrid, Spain
| | - Lola Aparicio
- Servicio de Atención a la Migración en Salud Mental (SATMI), Parc Sanitari Sant Joan de Déu, Avenida Drassanes 19, 08003 Barcelona, Spain
| | - Mercedes Espinal Cabeza
- Servicio de Atención a la Migración en Salud Mental (SATMI), Parc Sanitari Sant Joan de Déu, Avenida Drassanes 19, 08003 Barcelona, Spain
| | - Óscar Álvarez Bobo
- Servicio de Atención a la Migración en Salud Mental (SATMI), Parc Sanitari Sant Joan de Déu, Avenida Drassanes 19, 08003 Barcelona, Spain
| | - Yolanda Osorio López
- Servicio de Atención a la Migración en Salud Mental (SATMI), Parc Sanitari Sant Joan de Déu, Avenida Drassanes 19, 08003 Barcelona, Spain
| | - Josep Maria Haro
- Centre for Biomedical Research on Mental Health (CIBERSAM), 28029 Madrid, Spain
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, 08950 Barcelona, Spain
- Instituto de Investigación Sanitaria Princesa (IP), 28006 Madrid, Spain
| | - Paula Cristóbal-Narváez
- Centre for Biomedical Research on Mental Health (CIBERSAM), 28029 Madrid, Spain
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, 08950 Barcelona, Spain
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Gonçalves AQ, Sequeira-Aymar E, Aguilar Martín C, Dalmau RM, Cruz A, Evangelidou S, Hargreaves S, Requena-Mendez A, Jacques-Aviñó C. Usefulness and practicality of a multidisease screening programme targeting migrant patients in primary care in Spain: a qualitative study of general practitioners. BMJ Open 2022; 12:e065645. [PMID: 36385020 PMCID: PMC9670956 DOI: 10.1136/bmjopen-2022-065645] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES Some migrant groups are disproportionately affected by key infectious diseases in European countries. These pose a challenge for healthcare systems providing care to these groups. We aimed to explore the views of general practitioners (GPs) on the acceptability, adaptability and feasibility of a multidisease screening programme based on an innovative clinical decision-support system for migrants (the ISMiHealth tool), by examining the current gaps in healthcare provision and areas of good practice and the usefulness and limitations of training in the health needs of migrants. METHODS We undertook a qualitative descriptive study and carried out a series of focus groups (FGs) taking a pragmatic utilitarian approach. Participants were GPs from the four primary healthcare (PHC) centres in Catalonia, Spain, that piloted an intervention of the ISMiHealth tool. GPs were recruited using purposive and convenience sampling. FG discussions were transcribed and analysed using thematic content analysis. RESULTS A total of 29 GPs participated in four FGs. Key themes identified were: (1) GPs found the ISMiHealth tool to be very useful for helping to identify specific health problems in migrants, although there are several additional barriers to screening as part of PHC, (2) the importance of considering cultural perspectives when caring for migrants, and of the impact of migration on mental health, (3) the important role of PHC in healthcare provision for migrants and (4) key proposals to improve screening of migrant populations. GPs also highlighted the urgent need, to shift to a more holistic and adequately resourced approach to healthcare in PHC. CONCLUSIONS GPs supported a multidisease screening programme for migrant populations using the ISMiHealth tool, which aided clinical decision-making. However, intercultural participatory approaches will need to be adopted to address linguistic and cultural barriers to healthcare access that exist in migrant communities.
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Affiliation(s)
- Alessandra Queiroga Gonçalves
- Unitat de Suport a la Recerca Terres de l'Ebre, Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Tortosa, Spain
- Unitat Docent de Medicina de Família i Comunitària Tortosa-Terres de L'Ebre, Institut Català de la Salut, Tortosa, Spain
| | - Ethel Sequeira-Aymar
- Consorci d'Atenció Primària de Salut Barcelona Esquerra (CAPSBE) Casanova, Barcelona, Spain
- August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Carina Aguilar Martín
- Unitat de Suport a la Recerca Terres de l'Ebre, Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Tortosa, Spain
- Unitat d'Avaluació, Direcció d'Atenció Primària Terres de l'Ebre, Institut Català de la Salut, Tortosa, Spain
| | - Rosa Maria Dalmau
- Equip d'Atenció Primària Tortosa Oest, Institut Català de la Salut, Tortosa, Spain
- Campus Terres de l'Ebre, Universitat Rovira i Virgili, Tortosa, Spain
| | - Angeline Cruz
- Barcelona Institute for Global Health (ISGlobal, Hospital Clínic-Universitat de Barcelona), Barcelona, Spain
| | - Stella Evangelidou
- Barcelona Institute for Global Health (ISGlobal, Hospital Clínic-Universitat de Barcelona), Barcelona, Spain
| | - Sally Hargreaves
- Migrant Health Research Group, Institute for Infection and Immunity, St. George's, University of London, London, UK
| | - Ana Requena-Mendez
- Barcelona Institute for Global Health (ISGlobal, Hospital Clínic-Universitat de Barcelona), Barcelona, Spain
- Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
- Department of Infectious Disease, Karolinska University Hospital, Solna, Stockholm, Sweden
- CIBERINFEC, ISCIII - CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Enfermedades Infecciosas, Madrid, Madrid, Spain
| | - Constanza Jacques-Aviñó
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Barcelona, Spain
- Campus Bellaterra, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Barcelona, Spain
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Frounfelker RL, Mishra T, Carroll A, Brennan RT, Gautam B, Ali EAA, Betancourt TS. Past trauma, resettlement stress, and mental health of older Bhutanese with a refugee life experience. Aging Ment Health 2022; 26:2149-2158. [PMID: 34396853 PMCID: PMC9386683 DOI: 10.1080/13607863.2021.1963947] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 07/30/2021] [Indexed: 01/25/2023]
Abstract
OBJECTIVES Older displaced persons often receive limited attention from aid organizations, policy-makers and service providers in countries of resettlement. The objective of this study is to identify the relationship between experiencing traumatic events and stressors prior to resettlement, current resettlement stressors, social support, and mental health of older Bhutanese with a refugee life experience. METHOD Study participants were 190 older Bhutanese with a refugee life experience living in a metropolitan area in New England (US) and Ontario (Canada). We used structural equation modeling to determine the association between traumatic and stressful events in Bhutan and Nepal, current resettlement stressors, and symptoms of anxiety and depression, as measured by the GAD-7 and PHQ-9. We assessed the role of social support as an effect modifier in the relationship between these variables. RESULTS Surviving torture was associated with anxiety (p=.006), and experiencing threats to physical wellbeing in Nepal was associated with both anxiety (p=.003) and depression (p=.002). The relationship between physical threats in Nepal and current mental health were partially mediated by resettlement stressors. Social support moderated the relationship between trauma, stress, and mental health. CONCLUSION Both past traumas and current resettlement stressors contribute to the current psychosocial functioning of older Bhutanese with a refugee life experience. Based on our findings, social support is critical in promoting mental health in this population.
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Affiliation(s)
- Rochelle L Frounfelker
- Division of Social and Transcultural Psychiatry, Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Tej Mishra
- Research Program on Children and Adversity, Boston College School of Social Work, Chestnut Hill, MA, USA
| | - Alexa Carroll
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Robert T Brennan
- Research Program on Children and Adversity, Boston College School of Social Work, Chestnut Hill, MA, USA
- Women's Study Research Center, Brandeis University, Waltham, MA, USA
| | - Bhuwan Gautam
- Bhutanese Society of Western Massachusetts, Inc., Springfield, MA, USA
| | - Eman Abdullahi Alas Ali
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Theresa S Betancourt
- Research Program on Children and Adversity, Boston College School of Social Work, Chestnut Hill, MA, USA
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20
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Chandra A, Ashley L, Arthur MY. Climate Change, Migration, and Health: Strategic Opportunities for Health Security. Health Secur 2022; 20:440-444. [PMID: 36126319 DOI: 10.1089/hs.2022.0052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Amit Chandra
- Amit Chandra, MD, MSc, Senior Emerging Health Challenges Advisor, Bureau for Asia United States Agency for International Development, Washington, DC. The views and opinions expressed in this commentary are those of the authors and not necessarily the views and opinions of the United States Agency for International Development
| | - Laurie Ashley
- Laurie Ashley, MS, Climate Adaptation and Resilience Advisor, Center for Resilience, Bureau for Resilience and Food Security United States Agency for International Development, Washington, DC. The views and opinions expressed in this commentary are those of the authors and not necessarily the views and opinions of the United States Agency for International Development
| | - Micaela Y Arthur
- Micaela Y. Arthur, MPH, Senior Health Advisor, Bureau for Asia United States Agency for International Development, Washington, DC. The views and opinions expressed in this commentary are those of the authors and not necessarily the views and opinions of the United States Agency for International Development
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21
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Arora AK, Engler K, Lessard D, Kronfli N, Rodriguez-Cruz A, Huerta E, Lemire B, Routy JP, Wittmer R, Cox J, de Pokomandy A, Del Balso L, Klein M, Sebastiani G, Vedel I, Quesnel-Vallée A, Lebouché B. Experiences of Migrant People Living with HIV in a Multidisciplinary HIV Care Setting with Rapid B/F/TAF Initiation and Cost-Covered Treatment: The 'ASAP' Study. J Pers Med 2022; 12:1497. [PMID: 36143282 PMCID: PMC9503330 DOI: 10.3390/jpm12091497] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Revised: 09/02/2022] [Accepted: 09/09/2022] [Indexed: 11/21/2022] Open
Abstract
This study aimed to explore the experiences of migrant people living with HIV (MLWH) enrolled in a Montreal-based multidisciplinary HIV care clinic with rapid antiretroviral treatment (ART) initiation and cost-covered ART. Between February 2020 and March 2022, 32 interviews were conducted with 16 MLWH at three time-points (16 after 1 week of ART initiation, 8 after 24 weeks, 8 after 48 weeks). Interviews were analyzed via the Framework Method. Thirty categories were identified, capturing experiences across the HIV care cascade. At diagnosis, most MLWH described "initially experiencing distress". At linkage, almost all MLWH discussed "navigating the health system with difficulty". At treatment initiation, almost all MLWH expressed "being satisfied with treatment", particularly due to a lack of side effects. Regarding care retention, all MLWH noted "facing psychosocial or health-related challenges beyond HIV". Regarding ART adherence, most MLWH expressed "being satisfied with treatment" with emphasis on their taking control of HIV. At viral suppression, MLWH mentioned "finding more peace of mind since becoming undetectable". Regarding their perceived health-related quality of life, most MLWH indicated "being helped by a supportive social network". Efficient, humanizing, and holistic approaches to care in a multidisciplinary setting, coupled with rapid and free ART initiation, seemed to help alleviate patients' concerns, address their bio-psycho-social challenges, encourage their initial and sustained engagement with HIV care and treatment, and ultimately contribute to positive experiences.
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Affiliation(s)
- Anish K. Arora
- Department of Family Medicine, Faculty of Medicine & Health Sciences, McGill University, Montréal, QC H3S 1Z1, Canada
- Centre for Outcomes Research & Evaluation, Research Institute of the McGill University Health Centre, Montréal, QC H4A 3S5, Canada
- Infectious Diseases and Immunity in Global Health Program, Research Institute of the McGill University Health Centre, Montréal, QC H4A 3S5, Canada
- Canadian Institutes of Health Research Strategy for Patient-Oriented Research (CIHR/SPOR) Mentorship Chair in Innovative Clinical Trials in HIV Care, Montréal, QC H4A 3S5, Canada
| | - Kim Engler
- Centre for Outcomes Research & Evaluation, Research Institute of the McGill University Health Centre, Montréal, QC H4A 3S5, Canada
- Canadian Institutes of Health Research Strategy for Patient-Oriented Research (CIHR/SPOR) Mentorship Chair in Innovative Clinical Trials in HIV Care, Montréal, QC H4A 3S5, Canada
| | - David Lessard
- Centre for Outcomes Research & Evaluation, Research Institute of the McGill University Health Centre, Montréal, QC H4A 3S5, Canada
- Canadian Institutes of Health Research Strategy for Patient-Oriented Research (CIHR/SPOR) Mentorship Chair in Innovative Clinical Trials in HIV Care, Montréal, QC H4A 3S5, Canada
| | - Nadine Kronfli
- Centre for Outcomes Research & Evaluation, Research Institute of the McGill University Health Centre, Montréal, QC H4A 3S5, Canada
- Department of Medicine, Chronic Viral Illness Service, Division of Infectious Diseases, McGill University Health Centre, Montréal, QC H4A 3J1, Canada
| | - Adriana Rodriguez-Cruz
- Department of Family Medicine, Faculty of Medicine & Health Sciences, McGill University, Montréal, QC H3S 1Z1, Canada
- Centre for Outcomes Research & Evaluation, Research Institute of the McGill University Health Centre, Montréal, QC H4A 3S5, Canada
- Infectious Diseases and Immunity in Global Health Program, Research Institute of the McGill University Health Centre, Montréal, QC H4A 3S5, Canada
- Canadian Institutes of Health Research Strategy for Patient-Oriented Research (CIHR/SPOR) Mentorship Chair in Innovative Clinical Trials in HIV Care, Montréal, QC H4A 3S5, Canada
| | - Edmundo Huerta
- Centre for Outcomes Research & Evaluation, Research Institute of the McGill University Health Centre, Montréal, QC H4A 3S5, Canada
- Canadian Institutes of Health Research Strategy for Patient-Oriented Research (CIHR/SPOR) Mentorship Chair in Innovative Clinical Trials in HIV Care, Montréal, QC H4A 3S5, Canada
| | - Benoit Lemire
- Pharmacy Department, McGill University Health Centre, Montréal, QC H4A 3J1, Canada
| | - Jean-Pierre Routy
- Department of Medicine, Chronic Viral Illness Service, Division of Infectious Diseases, McGill University Health Centre, Montréal, QC H4A 3J1, Canada
| | - René Wittmer
- Department of Family Medicine and Emergency Medicine, Université de Montréal, Montréal, QC H3C 3J7, Canada
| | - Joseph Cox
- Department of Medicine, Chronic Viral Illness Service, Division of Infectious Diseases, McGill University Health Centre, Montréal, QC H4A 3J1, Canada
- Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine & Health Sciences, McGill University, Montréal, QC H3A 1A2, Canada
| | - Alexandra de Pokomandy
- Department of Family Medicine, Faculty of Medicine & Health Sciences, McGill University, Montréal, QC H3S 1Z1, Canada
- Department of Medicine, Chronic Viral Illness Service, Division of Infectious Diseases, McGill University Health Centre, Montréal, QC H4A 3J1, Canada
| | - Lina Del Balso
- Department of Medicine, Chronic Viral Illness Service, Division of Infectious Diseases, McGill University Health Centre, Montréal, QC H4A 3J1, Canada
| | - Marina Klein
- Department of Medicine, Chronic Viral Illness Service, Division of Infectious Diseases, McGill University Health Centre, Montréal, QC H4A 3J1, Canada
| | - Giada Sebastiani
- Department of Medicine, Chronic Viral Illness Service, Division of Infectious Diseases, McGill University Health Centre, Montréal, QC H4A 3J1, Canada
| | - Isabelle Vedel
- Department of Family Medicine, Faculty of Medicine & Health Sciences, McGill University, Montréal, QC H3S 1Z1, Canada
| | - Amélie Quesnel-Vallée
- Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine & Health Sciences, McGill University, Montréal, QC H3A 1A2, Canada
- Department of Sociology, Faculty of Arts, McGill University, Montréal, QC H3A 0G5, Canada
| | - ASAP Migrant Advisory Committee
- Centre for Outcomes Research & Evaluation, Research Institute of the McGill University Health Centre, Montréal, QC H4A 3S5, Canada
- Department of Medicine, Chronic Viral Illness Service, Division of Infectious Diseases, McGill University Health Centre, Montréal, QC H4A 3J1, Canada
| | - Bertrand Lebouché
- Department of Family Medicine, Faculty of Medicine & Health Sciences, McGill University, Montréal, QC H3S 1Z1, Canada
- Centre for Outcomes Research & Evaluation, Research Institute of the McGill University Health Centre, Montréal, QC H4A 3S5, Canada
- Infectious Diseases and Immunity in Global Health Program, Research Institute of the McGill University Health Centre, Montréal, QC H4A 3S5, Canada
- Canadian Institutes of Health Research Strategy for Patient-Oriented Research (CIHR/SPOR) Mentorship Chair in Innovative Clinical Trials in HIV Care, Montréal, QC H4A 3S5, Canada
- Department of Medicine, Chronic Viral Illness Service, Division of Infectious Diseases, McGill University Health Centre, Montréal, QC H4A 3J1, Canada
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22
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Sánchez-Teruel D, Robles-Bello MA. Predictive variables of resilience in young Moroccan immigrant. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-020-01126-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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23
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Barriers to Accessing Mental Health Services by Migrant Youth. Community Ment Health J 2022; 58:1101-1111. [PMID: 34799773 DOI: 10.1007/s10597-021-00919-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 11/11/2021] [Indexed: 10/19/2022]
Abstract
The purpose of the study was to identify barriers to accessing mental health services by migrant youth in a middle-sized central Canadian city. We asked participants, "What would stop you from talking to someone about mental health stress?". We interviewed 30 youth aged 16 to 22 who migrated from 10 different countries and lived in Canada for an average of 29 months. The data was analyzed using group concept mapping. The participants identified five concepts: fear of being misunderstood or ignored, desire for confidentiality, lack of trust and understanding, talking about it as not appropriate, and fear of the disclosure process. We compare these results with the literature.
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24
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Orang TM, Missmahl I, Thoele AM, Valensise L, Brenner A, Gardisi M, Peter H, Kluge U. New directions in the mental health care of migrants, including refugees-A randomized controlled trial investigating the efficacy of value-based counselling. Clin Psychol Psychother 2022; 29:1433-1446. [PMID: 35199419 DOI: 10.1002/cpp.2728] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 02/21/2022] [Accepted: 02/22/2022] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Specialized literature has identified a need for evidence-based, low-threshold, short-term, and intracultural psychological interventions that can be made available to migrants, including refugees, who suffer from psychological symptoms in host countries. The objective of the present study is to measure the efficacy of value-based counselling (VBC) as such an intervention. METHOD We conducted a pragmatic, rater-blinded randomized controlled trial employing a pre-post control group design to assess the efficacy of VBC based on a study sample of 103 migrants, including refugees, who resided in Germany at the time. A set of instruments was used to evaluate primary outcome measures of depression, posttraumatic stress disorder (PTSD) symptoms, perceived stress, generalized anxiety, and somatic complaints. RESULTS Per protocol analysis included 42 participants in the VBC group, and 43 in the waiting list. Compared with participants in the waiting-list group, the VBC group, following an average of four counselling sessions, experienced a clinically meaningful reduction of depression (adjusted difference 7.06, 95% CI [4.86, 9.26], effect size 0.68, p < .001), PTSD (adjusted difference 17.15, 95% CI [10.49, 23.81], effect size 0.76, p < .001), perceived stress (adjusted difference 9.25, 95% CI [6.23, 12.27], effect size 0.75, p < .001), anxiety (adjusted difference 5.34, 95% CI [3.47, 7.20], effect size 0.70, p < .001), and somatic complaints (adjusted difference 5.52, 95% CI [3.30, 7.74], effect size 0.72, p < .001). The positive outcomes were maintained at 3-month follow-up. Utilization of mental health services was significantly reduced at the 3-month follow-up conducted with participants of the VBC group. CONCLUSIONS VBC, a culturally sensitive and strength-based mental health service, is an effective short-term intervention which meets the specific mental health needs of migrants, including refugees.
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Affiliation(s)
- Tahereh Mina Orang
- Ipso gGmbH - International Psychosocial Organisation, Berlin, Germany.,Klinik für Psychiatrie und Psychotherapie, Charité Universitätsmedizin Berlin Campus Mitte, Berlin, Germany
| | - Inge Missmahl
- Ipso gGmbH - International Psychosocial Organisation, Berlin, Germany
| | - Anna-Maria Thoele
- Klinik für Psychiatrie und Psychotherapie, Charité Universitätsmedizin Berlin Campus Mitte, Berlin, Germany
| | - Livia Valensise
- Klinik für Psychiatrie und Psychotherapie, Charité Universitätsmedizin Berlin Campus Mitte, Berlin, Germany
| | - Anna Brenner
- Klinik für Psychiatrie und Psychotherapie, Charité Universitätsmedizin Berlin Campus Mitte, Berlin, Germany
| | - Maryam Gardisi
- Ipso gGmbH - International Psychosocial Organisation, Berlin, Germany
| | - Helmut Peter
- Medizinisches Versorgungszentrum Falkenried, Hamburg, Germany
| | - Ulrike Kluge
- Klinik für Psychiatrie und Psychotherapie, Charité Universitätsmedizin Berlin Campus Mitte, Berlin, Germany.,Berliner Institut für empirische Integrations- und Migrationsforschung (BIM), Humboldt Universität zu Berlin, Berlin, Germany
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25
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Hamid AARM. Psychological Distress and Homesickness Among Sudanese Migrants in the United Arab Emirates. Front Psychol 2022; 12:710115. [PMID: 35222134 PMCID: PMC8866835 DOI: 10.3389/fpsyg.2021.710115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Accepted: 12/10/2021] [Indexed: 11/29/2022] Open
Abstract
Migration is a global phenomenon growing in scope, and it can be associated with negative emotions such as sense of impending loss, fear of the unknown, and anxiety about those left at home. The objective of this exploratory study was to examine psychological distress and homesickness among Sudanese migrants in the United Arab Emirates (UAE). Participants were 1444 Sudanese migrants (Mage = 40.20; SD = 10.98). The Second Version of the Dundee Relocation Inventory was used to assess homesickness, and the 28-item General Health Questionnaire was used to measure psychological distress, depressive and anxiety symptoms, somatic symptoms, and social dysfunction. The results showed that older age and longer duration of residence in the UAE were associated with lower levels of homesickness, psychological distress, and depressive and anxiety symptoms. Further, homesickness was associated with higher psychological distress, somatic symptoms, and depressive and anxiety symptoms. Women and unemployed migrants had higher psychological distress, somatic symptoms, and depressive and anxiety symptoms compared with men and those employed, respectively. Being unmarried was associated with higher levels of depressive symptoms and homesickness, while those married or divorced/widowed showed lower levels of depressive symptoms and homesickness. It was concluded that there is a need to tackle unemployment among migrants in the UAE and address family reunion issues.
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26
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Rodriguez V, Furmli H, Green ME, Griffiths R, Pudwell J, Velez MP. Infertility Consults in Immigrant and Refugee Women in Ontario: Population-Based Cohort Study. Reprod Sci 2022; 29:1661-1665. [PMID: 35122219 DOI: 10.1007/s43032-022-00871-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 01/29/2022] [Indexed: 12/01/2022]
Abstract
Though immigrant women comprise a growing portion of the Canadian population, there remains a lack of information on the rates of infertility diagnosis in this group. Our study aimed to investigate the differences in rates of infertility consults between refugee, non-refugee immigrant, and Canadian-born women. We conducted a population-based matched cohort study in women 15-45 years of age in Ontario. Immigration status was defined as refugee, non-refugee immigrant, and Canadian-born woman. Refugee and non-refugee immigrant women were matched by age and residence in the same Local Health Integration Network (LHIN) to two Canadian-born women. The cohort was followed for 2 years for occurrence of infertility consult. Proportion of infertility consults by immigration status was calculated and differences between groups were assessed using standardized differences (SD). Modified Poisson regression was used to calculate the relative risk (RR) for infertility consults by immigration status after adjusting for confounding variables. Our results showed an increased proportion of infertility consults among both refugees (4.7%) and non-refugee immigrant women (5.8%) compared to their Canadian-born matches (2.8% and 3.2%, respectively), with SD ≧ 0.1 in most stratified age groups, denoting a meaningful statistical difference. In the multivariable analysis, relative to Canadian-born women, the RR for fertility consults was increased in refugee women (RR 1.66, CI 95% 1.58-1.75), and non-refugee immigrants (RR 1.77, 95% CI 1.74-1.80). These findings may be explained by immigrant women originating from areas with higher infertility rates, or their experience of higher than average stress levels, a known risk factor for infertility.
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Affiliation(s)
- Valeria Rodriguez
- Undergraduate Medicine, Queen's University, Kingston, ON, Canada.,Department of Obstetrics and Gynecology, Queen's University, Kingston, ON, Canada
| | - Hossai Furmli
- Department of Family Medicine, Queen's University, Kingston, ON, Canada
| | - Michael E Green
- Department of Family Medicine, Queen's University, Kingston, ON, Canada.,ICES, Queen's University, Kingston, ON, Canada
| | | | - Jessica Pudwell
- Department of Obstetrics and Gynecology, Queen's University, Kingston, ON, Canada
| | - Maria P Velez
- Department of Obstetrics and Gynecology, Queen's University, Kingston, ON, Canada. .,ICES, Queen's University, Kingston, ON, Canada.
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27
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Peñuela-O'Brien E, Wan MW, Edge D, Berry K. Health professionals' experiences of and attitudes towards mental healthcare for migrants and refugees in Europe: A qualitative systematic review. Transcult Psychiatry 2022; 60:176-198. [PMID: 34986056 PMCID: PMC10074763 DOI: 10.1177/13634615211067360] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
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.
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Affiliation(s)
- E Peñuela-O'Brien
- Division of Psychology and Mental Health, School of Health Sciences, 5292University of Manchester.,9022Greater Manchester Mental Health NHS Foundation Trust
| | - M W Wan
- Division of Psychology and Mental Health, School of Health Sciences, 5292University of Manchester
| | - D Edge
- Division of Psychology and Mental Health, School of Health Sciences, 5292University of Manchester.,9022Greater Manchester Mental Health NHS Foundation Trust
| | - K Berry
- Division of Psychology and Mental Health, School of Health Sciences, 5292University of Manchester.,9022Greater Manchester Mental Health NHS Foundation Trust
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Zotova N, Agadjanian V, Isaeva J, Kalandarov T. Worry, work, discrimination: Socioecological model of psychological distress among Central Asian immigrant women in Russia. SSM - MENTAL HEALTH 2021; 1:100011. [PMID: 38075982 PMCID: PMC10705018 DOI: 10.1016/j.ssmmh.2021.100011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The Russian Federation is a major immigrant-receiving nation and hosts large immigrant populations from post-Soviet countries including Central Asia. However, there is yet little research on their health needs, and especially on mental health of immigrant women. This study uses qualitative data from 72 interviews with women from Kyrgyzstan, Tajikistan, and Uzbekistan conducted in two large cities in Central Russia, Kazan and Nizhny Novgorod, from April 2014 to February 2017. This study examines psychological distress among immigrant women and applies a gendered socioecological lens to understand its causes. We have identified intersecting factors that operate at different levels and cause distress in Central Asian immigrant women in Russia. Gendered vulnerabilities, persistent worry about their families' well-being, separation from loved ones, and limited sources of social support are key individual and interpersonal level of distress factors. Poor working and housing conditions along with economic hardships and concerns over their ability to reach the goals that guided their decisions to move to Russia reinforce experienced distress among immigrant women. Discrimination against Central Asian nationals and structural racism amplify challenges for immigrants' psychological well-being and mental health in Russia. By investigating underlying factors of psychological distress among an understudied immigrant population, this study defines configurations of Russia's risk environment and contributes to an understanding of migration as an important determinant of mental health.
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Affiliation(s)
| | | | - Julia Isaeva
- Privolzhsky Research Medical University, Nizhniy Novgorod, Russia
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29
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Sick and Tired-Sociodemographic and Psychosocial Characteristics of Asylum Seekers Awaiting an Appointment for Psychotherapy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182211850. [PMID: 34831606 PMCID: PMC8619663 DOI: 10.3390/ijerph182211850] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 11/04/2021] [Accepted: 11/08/2021] [Indexed: 12/02/2022]
Abstract
Background: An EU directive holds the EU member states responsible for implementing the provision of health care for asylum seekers. However, current literature indicates insufficient care for asylum seekers in the German health system. This article aims to characterize the situation of the client population on the waiting list of a psychosocial center (PSZ). Methods: We conducted a retrospective observational study based on client files in Halle (Saale), Germany. We included 437 adults who were on the PSZ waiting list between 2016 and 2019. Questionnaires that collected information on the clientele at two different times were analyzed. Results: The average waiting time for psychotherapy was 50 weeks. In total, 85.6% of the 188 respondents reported sleep disorders (n = 161), 65.4% of clients reported pain (n = 123) and 54.8% suicide attempts/suicidal thoughts (n = 54). In the 16-week waiting period in which the clients waited for an initial appointment with a psychologist, the residence status deteriorated in 21.3% (n = 40). Conclusion: Improving asylum seekers’ access to the German health system is urgently needed in order to prevent unnecessary suffering in the future and to comply with EU law.
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30
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Sheth N, Patel S, O’Connor S, Dutton MA. Working Towards Collaborative, Migrant-Centered, and Trauma-Informed Care: a Mental Health Needs Assessment for Forced Migrant Communities in the DC Metropolitan Area of the United States. JOURNAL OF INTERNATIONAL MIGRATION AND INTEGRATION 2021. [DOI: 10.1007/s12134-021-00884-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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31
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Habtamu K, Desie Y, Asnake M, Lera EG, Mequanint T. Psychological distress among Ethiopian migrant returnees who were in quarantine in the context of COVID-19: institution-based cross-sectional study. BMC Psychiatry 2021; 21:424. [PMID: 34433430 PMCID: PMC8385266 DOI: 10.1186/s12888-021-03429-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 06/21/2021] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND In association with the novel coronavirus (SARS-CoV-2) disease 2019 (COVID-19) pandemic, many numbers of Ethiopian migrants are returning to their home country, and they are required to stay in mandatory quarantine centers. This results in severe disruptions of life routines, social isolation, and loss of freedom. Studies on psychological distress among Ethiopian migrant returnees in the context of COVID-19 are scarce. This study aimed to investigate the prevalence of psychological distress and associated factors among migrant returnees who were in quarantine during the time of COVID-19. METHODS A cross-sectional study was conducted with 405 migrant returnees recruited from quarantine centers in Addis Ababa. We developed a structured questionnaire to collect data on sociodemographic, migration related, quarantine related and COVID-19 related characteristics of participants. We used the 21 item Depression, Anxiety and Stress Scale to assess psychological distress. Univariate and multivariable negative binomial regression models were fitted to assess the association between exposure variables with depression, anxiety and stress separately. RESULTS A little more than half of the participants (55%) had depressive symptoms; around half had anxiety symptoms (48.9%) and more than a third (35.6%) experienced symptoms of stress. We found significantly higher prevalence of anxiety (ARR = 0.59; 95% CI = 0.39, 0.91) and depressive symptoms (ARR = 0.56; 95% CI = 0.39, 0.81) among women than men. Fear of discrimination after the quarantine was significantly associated with depressive (ARR = 0.76; 95% CI = 0.63, 0.92) and anxiety symptoms (ARR = 0.77; 95% CI = 0.62, 0.97). Experiencing COVID-19 like symptoms is associated with depressive (ARR = 0.40; 95% CI = 0.25, 0.65), anxiety (ARR = 0.35; 95% CI = 0.20, 0.62) and stress symptoms (ARR = 0.43; 95% CI = 0.28, 0.66). Have no a plan of what to do after the quarantine (ARR = 1.30; 95% CI = 1.09, 1.54) was significantly associated with increasing stress scores. CONCLUSIONS We found a very high prevalence of depressive, anxiety and stress symptoms among Ethiopian migrant returnees who were in quarantine due to the COVID-19 pandemic. Screening, integration of mental health services with other socioeconomic and psychosocial services, and effective and efficient referral may be useful to address the burden of psychological distress in this group.
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Affiliation(s)
- Kassahun Habtamu
- School of Psychology, College of Education and Behavioral Studies, Addis Ababa University, P.O.BOX: 1176, Addis Ababa, Ethiopia.
| | - Yekoyealem Desie
- grid.7123.70000 0001 1250 5688School of Psychology, College of Education and Behavioral Studies, Addis Ababa University, P.O.BOX: 1176, Addis Ababa, Ethiopia
| | - Mulat Asnake
- grid.7123.70000 0001 1250 5688School of Psychology, College of Education and Behavioral Studies, Addis Ababa University, P.O.BOX: 1176, Addis Ababa, Ethiopia
| | - Endirias Gina Lera
- Research, Consultancy and Community Service Department, Ethiopian Police University, Sendafa, Ethiopia
| | - Temesgen Mequanint
- Research, Consultancy and Community Service Department, Ethiopian Police University, Sendafa, Ethiopia
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Costa D, Biddle L, Mühling C, Bozorgmehr K. Subjective social status mobility and mental health of asylum seekers and refugees: Population-based, cross-sectional study in a German federal state. J Migr Health 2021; 1-2:100020. [PMID: 34405172 PMCID: PMC8352208 DOI: 10.1016/j.jmh.2020.100020] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 12/01/2020] [Accepted: 12/01/2020] [Indexed: 11/25/2022] Open
Abstract
Asylum seekers and refugees experience changes in subjective social status. Downward mobility in subjective social status is associated with poor mental health. Intersectoral measures to minimise the effect of downward social mobility are needed.
Background Asylum seekers and refugees (ASR) experience substantial changes in subjective social status (SSS), pre and post migration, which may affect their mental health. However, the effect of SSS mobility on mental health among ASR has been underexplored so far. Methods Population-based cross-sectional study among a random sample of 560 adult ASR living in 64 collective accommodation centres in Baden-Wurttemberg, Germany. SSS in the country of origin before emigration and in Germany was assessed with a multi-lingual, adapted version of the MacArthur social ladder. Health-related quality of life (HRQoL), anxiety and depressive symptoms were measured as mental health outcomes. Generalized linear regression models were fitted to estimate associations between changes in SSS and each outcome. Results A perceived loss of three or more steps in SSS from origin to Germany (compared to no change) was associated with poorer scores in HRQoL (B, standardized coefficient = -2.679, standard error, se = 1.351, p = 0.047), with more depressive symptoms (B = 1.156, se = 0.389, p = 0.003) and anxiety (B = 0.971, se = 0.432, p = 0.025), in models adjusted for SSS in country of origin. The strength and direction of associations remained after adjusting for sex, age, education and time since arrival (HRQoL: B = -2.494, se = 1.351, p = 0.066; depression: B = 1.048, se = 0.393, p = 0.008; anxiety: B = 1.006, se = 0.438, p = 0.022). Conclusion ASR experiencing downward SSS mobility present poorer mental health compared to those experiencing no change in SSS. Early integration efforts and intersectoral measures to counter social downward mobility could prevent poor mental health among ASR.
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Affiliation(s)
- Diogo Costa
- Department of Population Medicine and Health Services Research, School of Public Health, Bielefeld University, 33501 Bielefeld, Germany
- Corresponding author.
| | - Louise Biddle
- Section for Health Equity Studies and Migration, Department of General Practice and Health Services Research, University Hospital Heidelberg, Im Neuenheimer Feld 130.3, 69120 Heidelberg, Germany
| | - Catharina Mühling
- Department of Population Medicine and Health Services Research, School of Public Health, Bielefeld University, 33501 Bielefeld, Germany
| | - Kayvan Bozorgmehr
- Department of Population Medicine and Health Services Research, School of Public Health, Bielefeld University, 33501 Bielefeld, Germany
- Section for Health Equity Studies and Migration, Department of General Practice and Health Services Research, University Hospital Heidelberg, Im Neuenheimer Feld 130.3, 69120 Heidelberg, Germany
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Liem A, Renzaho AMN, Hannam K, Lam AIF, Hall BJ. Acculturative stress and coping among migrant workers: A global mixed-methods systematic review. Appl Psychol Health Well Being 2021; 13:491-517. [PMID: 33811751 DOI: 10.1111/aphw.12271] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 02/03/2021] [Accepted: 03/13/2021] [Indexed: 02/02/2023]
Abstract
No existing review has synthesized key questions about acculturation experiences among international migrant workers. This review aimed to explore (1) What are global migrant workers' experiences with acculturation and acculturative stress? (2) What are acculturative stress coping strategies used by migrant workers? And (3) how effective are these strategies for migrant workers in assisting their acculturation in the host countries? Peer-reviewed and gray literature, without time limitation, were searched in six databases and included if the study: focused on acculturative stress and coping strategies; was conducted with international migrant workers; was published in English; and was empirical. Eleven studies met the inclusion criteria. Three-layered themes of acculturation process and acculturative stress were identified as: individual layer; work-related layer; and social layer. Three key coping strategies were identified: emotion-focused; problem-focused; and appraisal-focused. These coping strategies were used flexibly to increase coping effectiveness and evidence emerged that a particular type of acculturative stress might be solved more effectively by a specific coping strategy. Migrant workers faced numerous challenges in their acculturative process. Understanding this process and their coping strategies could be used in developing research and interventions to improve the well-being of migrant workers.
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Affiliation(s)
- Andrian Liem
- Department of Communication, Centre for Macau Studies, University of Macau, Macau, China
| | - Andre M N Renzaho
- School of Social Sciences, Western Sydney University, Penrith South, NSW, Australia
- Translational Health Research Institute, Western Sydney University, Penrith South, NSW, Australia
- Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, Vic, Australia
| | - Kevin Hannam
- University of Saint Joseph, Macau, China
- University of Johannesburg, Johannesbuurg, South Africa
- Nebrija University, Madrid, Spain
- Technological Higher Education Institute, Hong Kong, China
| | - Agnes I F Lam
- Department of Communication, Centre for Macau Studies, University of Macau, Macau, China
| | - Brian J Hall
- NYU Shanghai, Shanghai, China
- School of Global Public Health, New York University, New York, NY, USA
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Mental Health of Refugees and Migrants during the COVID-19 Pandemic: The Role of Experienced Discrimination and Daily Stressors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18126354. [PMID: 34208243 PMCID: PMC8296172 DOI: 10.3390/ijerph18126354] [Citation(s) in RCA: 52] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 06/03/2021] [Accepted: 06/08/2021] [Indexed: 02/03/2023]
Abstract
The COVID-19 pandemic is a defining global health crisis of our time. While the impact of COVID-19, including its mental health impact, is increasingly being documented, there remain important gaps regarding the specific consequences of the pandemic on particular population groups, including refugees and migrants. This study aims to uncover the impact of the COVID-19 pandemic on the mental health of refugees and migrants worldwide, disentangling the possible role of social and daily stressors, i.e., experiences of discrimination and daily living conditions. Descriptive analysis and structural equation modeling were used to analyze the responses of N = 20,742 refugees and migrants on the self-reporting global ApartTogether survey. Survey findings indicated that the mental health of refugees and migrants during the COVID-19 pandemic was significantly impacted, particularly for certain subgroups, (i.e., insecure housing situation and residence status, older respondents, and females) who reported experiencing higher levels of increased discrimination and increases in daily life stressors. There is a need to recognize the detrimental mental health impact of the COVID-19 pandemic on particular refugee and migrant groups and to develop interventions that target their unique needs.
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Cohen JH, Zotova N. Rethinking remittance: The socioeconomic dynamics of giving for migrants and nonmigrants. ECONOMIC ANTHROPOLOGY 2021. [DOI: 10.1002/sea2.12215] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Jeffrey H. Cohen
- Department of Anthropology The Ohio State University Columbus OH 43210 USA
| | - Natalia Zotova
- The Albert Einstein College of Medicine Bronx NY 10461 USA
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BeLue R, Barnes A, Manu S, Luckett C, Adam B. Culturally Responsive Psychiatric Services for Refugee and Immigrant Adolescents: Are Child and Adolescent Psychiatrists Prepared to Serve Refugee Children? A Focus on African Refugee Families. Health Equity 2021; 5:306-309. [PMID: 34036213 PMCID: PMC8139254 DOI: 10.1089/heq.2020.0117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/09/2021] [Indexed: 11/21/2022] Open
Abstract
The arrival of sub-Saharan African immigrants and refugees (AIRs) to the United States has been steadily increasing for the past several decades. Not only are AIR adolescents directly affected by previous migration processes, but they are also impacted by stress and the mental health of their parents, even if they were born in the United States to immigrant/refugee parents. Immigrant and refugee parents concerned with their child's behavior and emotions should be evaluated by a qualified mental health professional, including licensed counselors, psychologists, and child and adolescent psychiatrists. However, access to culturally responsive psychiatric care for youth is limited. African adolescents are additionally burdened by their own acculturation process, balancing multiple cultural expectations as well as feelings of social isolation resulting from perceived racism and discrimination.
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Affiliation(s)
- Rhonda BeLue
- Department of Health Management and Policy, College of Public Health and Social Justice, Saint Louis University, St. Louis, Missouri, USA
| | - Alicia Barnes
- Department of Psychiatry and Behavioral Neuroscience, Saint Louis University, St Louis, Missouri, USA
| | - Sunita Manu
- Department of Health Management and Policy, College of Public Health and Social Justice, Saint Louis University, St. Louis, Missouri, USA
| | - Camille Luckett
- Department of Health Management and Policy, College of Public Health and Social Justice, Saint Louis University, St. Louis, Missouri, USA
| | - Balkozar Adam
- Department of Psychiatry, University of Missouri-Columbia, Columbia, Missouri, USA
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Ke P, Ke L, Liu B, Liu X. The Relationship Between Mental Health and Psychosocial Stress of Reservoir Migrants in the Middle Route of China's South-to-North Water Diversion Project (SNWDP): The Mediating Role of Social Support. Psychol Res Behav Manag 2021; 14:299-306. [PMID: 33727870 PMCID: PMC7955681 DOI: 10.2147/prbm.s297416] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 02/22/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND South-North Water Diversion Project (SNWDP) migrants were vulnerable to developing mental health problems due to post-migration stresses and lack of social support. However, the evidence on the mental health, psychosocial stress and social support of SNWDP migrants and their interrelationships are limited and inconclusive. We aimed to explore the mechanism of influence of social support on the relationship between mental health and social psychosocial stress of SNWDP migrants. METHODS We performed a cross-sectional analysis of the data of 983 SNWDP migrants. The mental health status, psychosocial stress and social support of the participants were evaluated by Symptom Checklist-90-Revised (SCL-90-R), Psychosocial Stress Survey for Groups (PSSG) and Social Support Rating Scale (SSRS). Multiple stepwise regression model was used to analyze the data. RESULTS Among the 983 individuals, the average SCL-90-R score was 1.47, the PSSG score was 30.50, and the SSRS score was 40.30. The SCL-90-R was positively correlated with PSSG (r=0.483, P<0.001) and negatively correlated with SSRS (r=-0.257, P<0.001), PSSG was negatively correlated with SSRS (r=-0.516, P<0.001). Multiple regression analysis showed that PSSG and SSRS had significant effects on SCL-90-R prediction and that SSRS played a partial intermediary role in SCL-90-R and PSSG (46.87%). CONCLUSION The SNWDP migrants performed a strong correlation between social support, mental health and psychosocial stress. Social support plays a part role in mediating mental health and psychosocial stress.
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Affiliation(s)
- Pan Ke
- School of Public Health (SPH), Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, 430040, People’s Republic of China
| | - Li Ke
- School of Nursing, Hubei University of Medicine, Shiyan, 442000, People’s Republic of China
| | - Bing Liu
- School of Public Health, Hubei University of Medicine, Shiyan, 442000, People’s Republic of China
| | - Xiang Liu
- Health Management Center, Shiyan People’s Hospital, Affiliated Hubei University of Medicine, Shiyan, 442000, People’s Republic of China
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Vasic J, Grujicic R, Toskovic O, Pejovic Milovancevic M. Mental Health, Alcohol and Substance Use of Refugee Youth. Front Psychiatry 2021; 12:713152. [PMID: 34867512 PMCID: PMC8639593 DOI: 10.3389/fpsyt.2021.713152] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 10/28/2021] [Indexed: 11/13/2022] Open
Abstract
This study aims to explore the prevalence of alcohol and substance use among young refugees along with the indicators of experienced psychological difficulties. It is based on a sample of 184 children and adolescents aged 11-18 years old, residing at two refugee centers in the Republic of Serbia. Out of 184 participants, the majority was male (N = 155; 84.29%). More than a half of participants (53.3%) displayed significant symptoms of PTSD. 50% consume energy drinks, 28% use tobacco; 13% use alcohol; 4.6% use marijuana; 1.7% use LSD, amphetamines, glue, tranquilizers and cocaine. Female respondents were more frequently expressing emotional difficulties (p < 0.05) while male participants were more frequent users of alcohol or substances (p < 0.01). Younger children were more frequently expressing symptoms of hyperactivity and prosocial behavior, while they were less frequently using substances. There is also a significant negative correlation between the years of education and individual proneness to substance use. Furthermore, those who resided in a greater number of refugee camps were found to experience greater levels of emotional and behavioral difficulties and face a greater risk of physical abuse. The burden of migration increases proneness to substance use, as a consequence of scarce coping resources and the stress of adjusting. Migrants are vulnerable to substance use, since some of them have commonly witnessed and/or personally experienced pre-and post-migration stress and trauma, including loss of homes and livelihoods, violence, torture and family separation. Preventive programs need to focus on the problem of alcohol and substance use among this vulnerable population.
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Affiliation(s)
- Jelena Vasic
- Clinic for Children and Adolescents, Institute of Mental Health, Belgrade, Serbia
| | - Roberto Grujicic
- Clinic for Children and Adolescents, Institute of Mental Health, Belgrade, Serbia
| | - Oliver Toskovic
- Laboratory for Experimental Psychology, Department of Psychology, Faculty of Philosophy, University of Belgrade, Belgrade, Serbia
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Abstract
Circumstances forcing individuals and families to flee set the stage for disruptions in mental health and forge resilience. Individual characteristics and conditions premigration, perimigration, and postmigration influence health, mental health, care-seeking behavior, and stages of well-being and successful resettlement. Primary care providers have strategies to promote mental well-being, including focusing on resilience and social determinants of health. Integrated or collaborative care models are ideal for delivering optimum care for refugee and immigrant communities. Connecting primary and behavioral care promotes a team approach; provides comprehensive, whole-person care; and relies on participation of patients and families.
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Affiliation(s)
- Kim S Griswold
- Department of Family Medicine, Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, USA.
| | - Dianne M Loomis
- Emeritus, University at Buffalo, School of Nursing, Buffalo, NY, USA
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40
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Asfaw BB, Beiersmann C, Keck V, Nikendei C, Benson-Martin J, Schütt I, Lohmann J. Experiences of psychotherapists working with refugees in Germany: a qualitative study. BMC Psychiatry 2020; 20:588. [PMID: 33308187 PMCID: PMC7733283 DOI: 10.1186/s12888-020-02996-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 12/03/2020] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Despite a high burden of mental health problems among refugees, there is limited knowledge about effective mental health care provision for this group. Although substantial efforts in understanding the complexity of cross-cultural psychotherapy - which in the context of this study we use to refer to therapy with client and therapist of different cultural backgrounds - have been made, there remains a dearth of research exploring barriers for effective cross-cultural psychotherapy. This study aimed at narrowing this gap in knowledge by exploring major challenges encountered by psychotherapists in cross-cultural psychotherapy and strategies which have proven useful in overcoming such challenges. METHODS We employed a qualitative study design, conducting semi-structured in-depth interviews with 10 purposely selected psychotherapists working with refugees in Germany. Respondents were from varying theoretical background and had varying levels of experience. Data were analyzed using a thematic approach, following a mix of deductive and inductive coding. RESULTS Respondents reported three main challenges in their cross-cultural practice: different or unrealistic expectations of clients towards what psychotherapy would offer them; challenges grounded in different illness explanatory models; and communication challenges. In dealing with these challenges, respondents recommended psychoeducation to overcome issues related to problematic expectations towards psychotherapy; "imagining the real", identifying "counter magic" and other client-appropriate resources to deal with issues related to clients' foreign illness attributions; and translators in dealing with communication barriers, though the latter not univocally. CONCLUSIONS Results show that psychotherapy with refugees can be very successful, at least from the psychotherapist perspective, but also poses significant challenges. Our findings underline the importance of developing, testing, and institutionalizing structured and structural approaches to training psychotherapists in cross-cultural therapy at scale, to accommodate the rising mental health care need of refugees as a client group.
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Affiliation(s)
- Baye Berihun Asfaw
- Department of Psychology, College of Social Sciences and Humanities, University of Gonder, P.O. Box: 196, Gonder, Ethiopia.
| | - Claudia Beiersmann
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg, Germany
| | - Verena Keck
- Department of Social and Cultural Anthropology, Goethe University Frankfurt/Main, Frankfurt, Germany
| | - Christoph Nikendei
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany
| | - Janine Benson-Martin
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg, Germany
- Gesundheitsamt Enzkreis, Pforzheim, Germany
| | | | - Julia Lohmann
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg, Germany
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
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41
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Mann EM, Klosovsky A, Yen C, Olson APJ, Hoffman SJ, Mamo B, Frerich EA, Weinberg M, Mayali H, McCoy M, Prasad S, Dunlop SJ, Stauffer WM. Health challenges in refugee resettlement: an innovative multi-sector partnership to improve the continuum of care for resettled refugees. J Travel Med 2020; 27:5861565. [PMID: 32577767 PMCID: PMC7649377 DOI: 10.1093/jtm/taaa103] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 06/09/2020] [Accepted: 06/14/2020] [Indexed: 11/14/2022]
Abstract
Refugee resettlement is a complex process relevant to migration medicine. A partnership between the International Organization for Migration, the US Centers for Disease Control and Prevention, and the University of Minnesota addresses medical needs of refugees and serves as a model for improving the continuum of care delivered to refugees.
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Affiliation(s)
- Erin M Mann
- Center for Global Health and Social Responsibility, University of Minnesota, Minneapolis, MN, USA
- To whom correspondence should be addressed.
| | - Alexander Klosovsky
- Migration Health Division, International Organization for Migration, Washington, DC, USA
| | - Catherine Yen
- Migration Health Division, International Organization for Migration (formerly), Washington, DC, USA
| | - Andrew P J Olson
- Division of Pediatric Hospital Medicine, Department of Pediatrics and Division of General Internal Medicine, Department of Medicine, Medical School, University of Minnesota, Minneapolis, MN, USA
| | - Sarah J Hoffman
- Population Health and Systems Cooperative, School of Nursing, University of Minnesota, Minneapolis, MN, USA
| | - Blain Mamo
- Infectious Disease Epidemiology, Prevention and Control Division, Minnesota Department of Health, Saint Paul, MN, USA
| | - Ellen A Frerich
- Infectious Disease Epidemiology, Prevention and Control Division, Minnesota Department of Health, Saint Paul, MN, USA
| | - Michelle Weinberg
- Immigrant Refugee and Migrant Health Branch, Division of Global Migration and Quarantine, United States Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Harith Mayali
- Migration Health Division, International Organization for Migration, Washington, DC, USA
| | - Molly McCoy
- Center for Global Health and Social Responsibility, University of Minnesota, Minneapolis, MN, USA
| | - Shailendra Prasad
- Center for Global Health and Social Responsibility, University of Minnesota, Minneapolis, MN, USA
| | - Stephen J Dunlop
- Department of Emergency Medicine, Hennepin Healthcare, Minneapolis, MN, USA
| | - William M Stauffer
- Center for Global Health and Social Responsibility, University of Minnesota, Minneapolis, MN, USA
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Oliver-Parra A, Dalmau-Bueno A, Ruiz-Muñoz D, García-Altés A. Relationship between parents' mental disorders and socioeconomic status and offspring's psychopathology: A cross-sectional study. PLoS One 2020; 15:e0240681. [PMID: 33064781 PMCID: PMC7567396 DOI: 10.1371/journal.pone.0240681] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 09/30/2020] [Indexed: 12/31/2022] Open
Abstract
Mental disorders (MD) are one of the main causes of the disease burden worldwide. Associations between socioeconomic status (SES) and presence of MD in parents have been related with increased odds of MD in offspring. However, there is a lack of population-based research in this field. The aim of the present study was to examine together the relationship between the presence of MD in children, and the SES and presence of MD in their parents, in a whole of population data. A gender approach was undertaken aiming to discern how these variables influence children's mental health when related with the father and the mother. Using administrative individual data from the National Health System, a retrospective cross-sectional study was conducted. The entire children population aged 6 to 15 resident in Catalonia in 2017 was examined. A logistic regression model was performed. Low SES was associated with increased odds of children's MD. Offspring of a parent with MD were at more risk of presenting MD than offspring of parents without these problems. Although these associations were consistent for both boys and girls when looking at the father's or mother's SES and MDs, the mother's SES and MDs showed a higher association with the offspring's MDs than the father's. Lowest associations, found for boys when looking at the father's SES and MDs, were: OR of 1.21, 95%CI 1.16 to 1.27 for lowest SES, and OR of 1.66, 95%CI 1.61 to 1.70 for parental MDs. Children's familiar environment, which includes SES and mental health of parents, plays an important role in their mental health. Socially constructed gender roles interfere with SES and parent's MD. These findings support the relevance of examining MD and its risk factors within a gender approach.
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Affiliation(s)
- Alba Oliver-Parra
- Agència de Qualitat i Avaluació Sanitàries de Catalunya (AQuAS), Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
| | - Albert Dalmau-Bueno
- Agència de Qualitat i Avaluació Sanitàries de Catalunya (AQuAS), Barcelona, Spain
| | - Dolores Ruiz-Muñoz
- Agència de Qualitat i Avaluació Sanitàries de Catalunya (AQuAS), Barcelona, Spain
| | - Anna García-Altés
- Agència de Qualitat i Avaluació Sanitàries de Catalunya (AQuAS), Barcelona, Spain
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Caqueo-Urízar A, Atencio D, Flores J, Narea M, Urzúa A, Irarrázaval M. Mental Health in Immigrant Children and Adolescents in Northern Chile Mental Health in Immigrant Children and Adolescents. J Immigr Minor Health 2020; 23:280-288. [PMID: 33021701 DOI: 10.1007/s10903-020-01101-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/01/2020] [Indexed: 11/24/2022]
Abstract
Approximately 1.251.225 foreign-born migrants reside in Chile, including 183.315 children. This study compares mental health indicators in immigrant and non-immigrant children to understand the mental health effects of migration. A cross-sectional study of 634 students from Chilean schools was conducted. Fifty percent of the students were immigrants. The System for the Evaluation of Children and Adolescents was used to evaluate mental health. No significant differences were observed in mental health indicators between immigrant and non-immigrant children. At both elementary and secondary levels, immigrant students had higher rates of contextual problems (family problems and problems with peers) and lower scores in integration and social consequence. Immigrant students in elementary schools scored lower in self-esteem. The higher rates of contextual problems in immigrant children should be addressed through structural changes in migration policies, such as providing support for employment of parents, welfare assistance, and access to health systems.
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Affiliation(s)
| | - Diego Atencio
- Escuela de Psicología y Filosofía and Centro de Justicia Educacional, CJE, Universidad de Tarapacá, Arica, Chile
| | - Jerome Flores
- Escuela de Psicología y Filosofía and Centro de Justicia Educacional, CJE, Universidad de Tarapacá, Arica, Chile
| | - Marigen Narea
- Escuela de Psicología and Centro de Justicia Educacional, CJE, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Alfonso Urzúa
- Escuela de Psicología, Universidad Católica del Norte, Antofagasta, Chile
| | - Matías Irarrázaval
- Departamento de Psiquiatría, Facultad de Medicina, Hospital Clínico, Universidad de Chile, Santiago, Chile
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Rometsch C, Denkinger JK, Engelhardt M, Windthorst P, Graf J, Nikendei C, Zipfel S, Junne F. Care providers' views on burden of psychosomatic symptoms of IS-traumatized female refugees participating in a Humanitarian Admission Program in Germany: A qualitative analysis. PLoS One 2020; 15:e0239969. [PMID: 33017408 PMCID: PMC7535032 DOI: 10.1371/journal.pone.0239969] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2019] [Accepted: 09/17/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Traumatized refugees often suffer from diverse psychosomatic symptoms. Female Yazidi refugees from Northern Iraq who survived attacks of the so-called "Islamic State" were brought to Germany to receive special medical and psychotherapeutic treatment in a unique worldwide humanitarian admission program (HAP). Here, we report on their psychosomatic symptoms and helpful strategies from the perspective of care providers. METHODS Care providers (N = 84) in this HAP were interviewed in an individual setting as well as in focus groups to gather information about the HAP beneficiaries' psychosomatic symptoms. Data analysis followed Qualitative Content Analysis by Mayring. RESULTS The care providers reported five main psychological burdens of the Yazidis: 1) insecurity regarding loss, 2) worries about family members, 3) ambivalence about staying in Germany or returning to Iraq, 4) life between two worlds and 5) re-actualization of the traumatic experiences. The predominant psychological symptoms the care providers noticed were fear, depressive symptoms, feelings of guilt, and sleep and eating disorders. Regarding somatic symptoms, the care providers mainly received complaints about pain in the head, back, chest and stomach. Helpful strategies for providing adequate health care were care providers' cooperating with physicians, precise documentation of beneficiaries' symptoms, and additional support in directing the beneficiaries through the health care system. Regarding psychotherapy, interpreters help to overcome language barriers, onsite psychotherapy, flexible therapy appointments, psychoeducational methods, time for stabilization, and support in coping with daily life aspects. In the care providers' experience, psychotherapists have to build a relationship of trust. After grief therapy, a trauma-specific therapy in a culturally adapted way is possible. CONCLUSION The HAP is a unique model health care program to offer highly traumatized refugees medical and psychological help. Care providers reported on several (psycho-)somatic symptoms of the traumatized women. The strategies the HAP care providers perceived as helpful can be recommended for similar projects in the future.
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Affiliation(s)
- Caroline Rometsch
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Tuebingen, Germany
| | - Jana Katharina Denkinger
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Tuebingen, Germany
| | - Martha Engelhardt
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Tuebingen, Germany
| | - Petra Windthorst
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Tuebingen, Germany
| | - Johanna Graf
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Tuebingen, Germany
| | - Christoph Nikendei
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany
| | - Stephan Zipfel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Tuebingen, Germany
| | - Florian Junne
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Tuebingen, Germany
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Determinants of Refugee and Migrant Health Status in 10 European Countries: The Mig-HealthCare Project. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17176353. [PMID: 32878303 PMCID: PMC7503735 DOI: 10.3390/ijerph17176353] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 08/01/2020] [Accepted: 08/26/2020] [Indexed: 01/22/2023]
Abstract
In this study, we collect and synthesize information on the health status of the refugee/migrant population in ten European countries in order to map refugee/migrant health needs. With this information, we identify areas of intervention and healthcare system strengthening to provide the basis for future health planning and effective healthcare provision to migrants, asylum-seekers and refugees in the European Union (EU). Methods: 1407 migrants in ten European Union countries (consortium members of the Mig-HealthCare project) were surveyed on general health, mental health, and specific diseases using an interviewer-administered questionnaire. Descriptive statistics and multivariable linear regression analyses were conducted to investigate the risk factors on general quality of life for migrants and refugees in the EU. Results: Mean age was 31.9 (±11.05) years and 889 (63.1%) participants were males. The majority came from Syria, Afghanistan, Iraq, Nigeria, and Iran. Having a mental health disorder or a chronic disease such as a heart or respiratory disease was associated with worse general health. On the other hand, having permission to stay in the country of interview and being interviewed in the country of final destination was associated with better general health. Access to health care services was fragmented or unavailable for some interviewees because of linguistic, cultural, or administrative barriers. Conclusions: The management of chronic diseases and mental health conditions in European migrants and refugees is a key priority for health service provision. Further efforts should be made to guarantee healthcare access for migrant and refugee populations.
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Banerjee D, Sharma S, Antony S. “Koro and Migration”: Observational Study of an Outbreak of Koro in a Migrant Population Working in South India. JOURNAL OF PSYCHOSEXUAL HEALTH 2020. [DOI: 10.1177/2631831820934988] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Introduction: Koro is a culture-bound syndrome, common in India, characterized by the belief that one’s genitals are shrinking followed by the fear of impending death. Significant social stressors can precipitate this syndrome in vulnerable populations. One such factor is migration which is associated with increased vulnerability to neurosis and poor coping. It has been a less studied factor in the genesis of Koro and the same has been an interesting association in this study. Methods: There was an outbreak of Koro (13 cases: 8 males and 5 females) among a population (n = 52) from east and middle India who had migrated to the south for manual work. These cases presented in clusters to our psychiatry outpatient department within a span of 2 weeks. We did an observational study to explore the sociodemographic and clinical correlates of these patients. Their perceptions and attributions to the illness were also reported. Results: Most patients were married men with lower socioeconomic status and no formal education. More females were however affected than earlier reported data. Most patients knew about the illness and believed that it was contagious. Death anxiety, loss of libido, and insomnia were common associated complaints. Males feared impotence, whereas females feared of “loss of child-bearing” abilities. The major attributing factors to the illness were migration, the stigma of working near a “mental hospital,” and sharing shelter with the affected. Pharmacotherapy and single-session cognitive behavioral therapy were used for treatment. Conclusions: Our study revealed unique clinical correlates and belief-systems of patients affected with Koro. It is time we stop seeing it just as “culture-bound syndrome” and begin seeing it also as a social disorder caused by distortion of body-related beliefs. Migration being a significant environmental stressor can often precipitate such culture-bound syndromes. Further mixed-method studies are warranted.
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Affiliation(s)
- Debanjan Banerjee
- National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Snehal Sharma
- National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Sojan Antony
- National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
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Søegaard EGI, Kan Z, Koirala R, Hauff E, Thapa SB. Variations in psychiatric morbidity between traumatized Norwegian, refugees and other immigrant patients in Oslo. Nord J Psychiatry 2020; 74:390-399. [PMID: 31961250 DOI: 10.1080/08039488.2020.1714724] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Background: There is a lack of clinical studies that focus on different psychiatric disorders after trauma and the relationship with migration status.Purpose: To examine differences in psychiatric morbidity in traumatized patients referred to psychiatric treatment in Southern Oslo.Materials and methods: Hundred and ten patients with trauma background attending an outpatient clinic in Southern Oslo were studied. Forty-four of the participants (40%) were ethnic Norwegians, 25 (22.7%) had refugee background and 41 (37.3%) were first- or second-generation immigrants without refugee background. Thorough diagnostic assessment was done by experienced psychiatrists through several structured clinical interviews and self-report questionnaires.Results: Ninety-eight patients (89%) were diagnosed with at least one Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision (DSM-IV-TR) disorder. There was a clear difference in the presentation of certain psychiatric disorders between the groups. Ethnic Norwegian patients were more likely to have anxiety disorders: agoraphobia, social phobia and panic disorder than non-refugee immigrant patients. They also had higher rates of alcohol abuse/dependence. Somatoform pain disorder was more common in both the refugee and other-immigrant groups than among the ethnic Norwegian patients. The refugee patients had significantly more major depressive disorder, post-traumatic stress disorder (PTSD) and both co-occurring.Conclusion: Trauma is frequently associated with depression, anxiety disorders, somatoform pain disorder and PTSD in a clinical population. The clinical presentation and comorbidity of these disorders seem to vary significantly between traumatized patients with Norwegian, refugee and non-refugee immigrant backgrounds. After a major trauma, refugees may be at greater risk for both PTSD and depression than other immigrants and the native population.
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Affiliation(s)
- Erik Ganesh Iyer Søegaard
- Department of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.,Department of Mental Health and Addiction, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Zhanna Kan
- Department of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Rishav Koirala
- Department of Mental Health and Addiction, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Brain and Neuroscience Center, Kathmandu, Nepal
| | - Edvard Hauff
- Department of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.,Department of Mental Health and Addiction, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Suraj Bahadur Thapa
- Department of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.,Department of Mental Health and Addiction, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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Frounfelker RL, Miconi D, Farrar J, Brooks MA, Rousseau C, Betancourt TS. Mental Health of Refugee Children and Youth: Epidemiology, Interventions, and Future Directions. Annu Rev Public Health 2020; 41:159-176. [PMID: 31910713 PMCID: PMC9307067 DOI: 10.1146/annurev-publhealth-040119-094230] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The number of refugee youth worldwide receives international attention and is a top priority in both academic and political agendas. This article adopts a critical eye in summarizing current epidemiological knowledge of refugee youth mental health as well as interventions aimed to prevent or reduce mental health problems among children and adolescents in both high- and low-to-middle-income countries. We highlight current challenges and limitations of extant literature and present potential opportunities and recommendations in refugee child psychiatric epidemiology and mental health services research for moving forward. In light of the mounting xenophobic sentiments we are presently witnessing across societies, we argue that, as a first step, all epidemiological and intervention research should advocate for social justice to guarantee the safety of and respect for the basic human rights of all refugee populations during their journey and resettlement. A constructive dialogue between scholars and policy makers is warranted.
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Affiliation(s)
| | - Diana Miconi
- Department of Psychiatry, McGill University, Montreal, QC H3A 1A1, Canada; , ,
| | - Jordan Farrar
- Research Program on Children and Adversity, School of Social Work, Boston College, Chestnut Hill, Massachusetts 02467, USA; ,
| | | | - Cécile Rousseau
- Department of Psychiatry, McGill University, Montreal, QC H3A 1A1, Canada; , ,
| | - Theresa S Betancourt
- Research Program on Children and Adversity, School of Social Work, Boston College, Chestnut Hill, Massachusetts 02467, USA; ,
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Björkenstam E, Helgesson M, Norredam M, Sijbrandij M, de Montgomery CJ, Mittendorfer-Rutz E. Common mental disorders among young refugees in Sweden: The role of education and duration of residency. J Affect Disord 2020; 266:563-571. [PMID: 32056927 DOI: 10.1016/j.jad.2020.02.015] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 01/27/2020] [Accepted: 02/01/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Studies investigating risks of common mental disorders (CMDs) in refugee youth are sparse. The current study examined health care use due to CMDs in unaccompanied and accompanied refugee youth and Swedish-born, and the role of education and residency duration. METHODS This longitudinal cohort study included 746,517 individuals (whereof 36,347 refugees) between 19 and 25 years, residing in Sweden in 2009. Refugees were classified as unaccompanied/accompanied. Risk estimates of CMDs, measured as health care use and antidepressant treatment, between 2010-2016 were calculated as adjusted hazard ratios (aHR) with 95% confidence intervals (CI). Highest attained education in 2009, and residency duration were examined as potential modifiers. RESULTS Compared to Swedish-born youth, refugees had a lower risk of treated major depressive and anxiety disorders (aHR): 0.67 (95% CI 0.63-0.72) and 0.67 (95% CI 0.63-0.71) respectively), but a higher risk for posttraumatic stress disorders (PTSD). Compared to Swedish-born, unaccompanied had a nearly 6-fold elevated risk for PTSD (aHR: 5.82, 95% CI 4.60-7.34) and accompanied refugees had a 3-fold risk of PTSD (aHR: 3.08, 95% CI 2.54-3.74). Rates of PTSD decreased with years spent in Sweden. The risk of CMDs decreased with increasing education. LIMITATIONS The study lacked information on pre-migration factors. There may further be a potential misclassification of untreated CMDs. CONCLUSION Refugees had a lower risk of treated depressive and anxiety disorders but a higher risk for PTSD. In refugees, the rates of anxiety disorders increased slightly over time whereas the rates of PTSD decreased. Last, low education was an important predictor for CMDs.
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Affiliation(s)
- Emma Björkenstam
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Neuroscience, Psychiatry, Uppsala University, Uppsala, Sweden.
| | - Magnus Helgesson
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Marie Norredam
- Danish Research Centre for Migration, Ethnicity, and Health (MESU), Section for Health Services Research, Department of Public Health, University of Copenhagen, Copenhagen K, Denmark; Section of Immigrant Medicine, Department of Infectious Diseases, University Hospital Hvidovre, Copenhagen, Denmark
| | - Marit Sijbrandij
- Department of Clinical, Neuro- and Developmental Psychology, Vrije Universiteit, Amsterdam, the Netherlands
| | - Christopher Jamil de Montgomery
- Danish Research Centre for Migration, Ethnicity, and Health (MESU), Section for Health Services Research, Department of Public Health, University of Copenhagen, Copenhagen K, Denmark
| | - Ellenor Mittendorfer-Rutz
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden
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Rousseau C. Un numéro thématique sur la santé mentale des immigrants et réfugiés. SANTE MENTALE AU QUEBEC 2020. [DOI: 10.7202/1075385ar] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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