Suicide Risk in Refugees and Asylum Seekers

2017 ◽  
Vol 41 (S1) ◽  
pp. S35-S36 ◽  
Author(s):  
D. Wasserman
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Disorder ◽  
Mental Health Care ◽  
Asylum Seekers ◽  
Suicide Ideation ◽  
Cultural Beliefs ◽  
Small Scale ◽  
Care Providers ◽  
Refugees And Asylum Seekers

Increasing numbers of individuals forced to leave their home countries in areas of war, conflict, human rights violations and persecution pose a challenge for host countries to meet the mental-health care needs of these individuals. Refugees and asylum-seekers may face unique risk factors for mental disorder before, during, and after their migration leading to suicidality. Experiences of family withdrawal, integration difficulties, and perceived lack of care may contribute to suicide within the refugee populations. Identifying effective treatments and support to minimize the risk especially once the individuals arrive in their new country is key to providing appropriate care. Barriers to mental-health care including lack of knowledge about available resources, communication or language barriers, cultural beliefs about origins and treatment of mental disease, as well as a lack of trust in authority, pose a challenge for health care providers and policy makers.Research has been inconsistent in the findings for the prevalence of mental disorders, suicidal behaviours, and suicide ideation among refugees and asylum seekers. Thus far, research has been limited to small scale, non-randomised, often qualitative analysis. Several studies have found higher rates of mental disorder, whereas others have found a similar prevalence as in the general population, although, Post-Traumatic Stress Disorder has more consistently been found to have a higher prevalence among migrants. The lack of early and thorough exploration of suicidal intent in this population requires large-scale quantitative studies to evaluate the effectiveness and feasibility of current practices in mental-health care and suicide prevention.Disclosure of interestThe author has not supplied his declaration of competing interest.

scholarly journals Mental health care utilisation and access among refugees and asylum seekers in Europe: A systematic review

Health Policy ◽  
2019 ◽  
Vol 123 (9) ◽  
pp. 851-863 ◽  
Author(s):  
Emily Satinsky ◽  
Daniela C. Fuhr ◽  
Aniek Woodward ◽  
Egbert Sondorp ◽  
Bayard Roberts
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Health Care ◽  
Mental Health Care ◽  
Asylum Seekers ◽  
Health Care Utilisation ◽  
Care Utilisation ◽  
Refugees And Asylum Seekers

754 Insomnia and Depression Symptoms in Primary Care Patients Referred for Mental Health Care

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A294-A294
Author(s):  
Ivan Vargas ◽  
Alexandria Muench ◽  
Mark Seewald ◽  
Cecilia Livesey ◽  
Matthew Press ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Mental Health Care ◽  
Primary Care Providers ◽  
Depression Symptoms ◽  
Care Providers ◽  
Mild Depression ◽  
Significant Depression ◽  
Clinically Significant

Abstract Introduction Past epidemiological research indicates that insomnia and depression are both highly prevalent and tend to co-occur in the general population. The present study further assesses this association by estimating: (1) the concurrence rates of insomnia and depression in outpatients referred by their primary care providers for mental health care; and (2) whether the association between depression and insomnia varies by insomnia subtype (initial, middle, and late). Methods Data were collected from 3,174 patients (mean age=42.7; 74% women; 50% Black) who were referred to the integrated care program for assessment of mental health symptoms (2018–2020). All patients completed an Insomnia Severity Index (ISI) and a Patient Health Questionnaire (PHQ-9) during their evaluations. Total scores for the ISI and PHQ-9 were computed. These scores were used to categorize patients into diagnostic groups for insomnia (no-insomnia [ISI < 8], subthreshold-insomnia [ISI 8–14], and clinically-significant-insomnia [ISI>14]) and depression (no-depression [PHQ-914]). Items 1–3 of the ISI were also used to assess the association between depression and subtypes of insomnia. Results Rates of insomnia were as follows: 34.6% for subthreshold-insomnia, 35.5% for clinically-significant insomnia, and 28.9% for mild-depression and 26.9% for clinically-significant-depression. 92% of patients with clinically significant depression reported at least subthreshold levels of insomnia. While the majority of patients with clinical depression reported having insomnia, the proportion of patients that endorsed these symptoms were comparable across insomnia subtypes (percent by subtype: initial insomnia 63%; middle insomnia 61%; late insomnia 59%). Conclusion According to these data, the proportion of outpatients referred for mental health evaluations that endorse treatable levels of insomnia is very high (approximately 70%). This naturally gives rise to at least two questions: how will such symptomatology be addressed (within primary or specialty care) and what affect might targeted treatment for insomnia have on health were it a focus of treatment in general? Support (if any) Vargas: K23HL141581; Perlis: K24AG055602

Organisational impact of the National Disability Insurance Scheme transition on mental health care providers: the experience in the Australian Capital Territory

2018 ◽  
Vol 26 (6) ◽  
pp. 590-594 ◽  
Author(s):  
Mary Anne Furst ◽  
Jose A Salinas-Perez ◽  
Luis Salvador-Carulla
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Health Care Providers ◽  
Service Provision ◽  
Care Providers ◽  
Australian Capital Territory ◽  
Insurance Scheme ◽  
Mental Health Care Providers ◽  
The Impact

Objectives: Concerns raised about the appropriateness of the National Disability Insurance Scheme (NDIS) in Australia for people with mental illness have not been given full weight due to a perceived lack of available evidence. In the Australian Capital Territory (ACT), one of the pilot sites of the Scheme, mental health care providers across all relevant sectors who were interviewed for a local Atlas of Mental Health Care described the impact of the scheme on their service provision. Methods: All mental health care providers from every sector in the ACT were contacted. The participation rate was 92%. We used the Description and Evaluation of Services and Directories for Long Term Care to assess all service provision at the local level. Results: Around one-third of services interviewed lacked funding stability for longer than 12 months. Nine of the 12 services who commented on the impact of the NDIS expressed deep concern over problems in planning and other issues. Conclusions: The transition to NDIS has had a major impact on ACT service providers. The ACT was a best-case scenario as it was one of the NDIS pilot sites.

scholarly journals Cross-Sectional Study of Mental Health Related Knowledge and Attitudes Among Care Assistant Workers in Guangzhou, China

2020 ◽  
Author(s):  
Jie Li ◽  
Xiao-Ling Duan ◽  
Hua-Qing Zhong ◽  
Wen Chen ◽  
Sara Evans‑Lacko ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Disorders ◽  
Linear Regression ◽  
Mental Health Care ◽  
Health Staff ◽  
Care Providers ◽  
Knowledge And Attitudes ◽  
Additional Item ◽  
Health Related

Abstract Background: Care assistant workers (CAWs) are a part of a new pattern of mental health care providers in China and play a significant role in bridging the human resource shortage. CAWs in China mainly include community cadres, community mental health staff and community policemen. The mental health related knowledge and attitudes of CAWs could influence their mental health care delivery. This study aimed to assess the mental health related knowledge and attitudes of CAWs in Guangzhou, China. Methods: In November 2017, a study was conducted among 381 CAWs from four districts of Guangzhou, China. Participants were assessed using the Perceived Devaluation and Discrimination Scale (PDD), the Mental Health Knowledge Schedule (MAKS), and the Mental illness: Clinicians’ Attitudes (MICA). Data were analyzed by descriptive statistics, ANOVA, Bonferroni corrections and multivariable linear regression. Results: The mean scores (standard deviation) of PDD, MAKS and MICA were 36.45 (6.54), 22.72 (2.56), 51.67 (7.88), respectively. Univariate analyses showed that the older CAWs, community policemen and those who were less willing to deliver care had significant higher MICA scores when compared with other staff (P < 0.001). However, participants who disagreed additional item 1（views towards inpatients) and additional item 2 (affiliate stigma) had a significant lower MICA scores when compared with those who agreed (P < 0.001). Multivariable linear regression showed that after controlling some variables, care willingness and PDD total score were significantly positively associated with the MICA total score (all P < 0.05), while attitudes on additional items were significantly negatively associated with the MICA total score (all P < 0.01).Conclusion: These findings suggest negative attitudes towards people with mental disorders among CAWs are common, especially among older staff. Community policemen suggest that they applied stereotypes of ‘violent mentally ill’ people to all people they deal with who have mental disorders. The results also indicate human rights are being paid attention to now, but need to be improved in the future. Strategies to improve attitudes and to reduce stigma and discrimination should be conducted with particular staff groups.

scholarly journals Integration of mental health care in private not-for-profit health centres in Guinea, West Africa: a systemic entry point towards the delivery of more patient-centred care?

2019 ◽  
Author(s):  
Abdoulaye Sow ◽  
Jeroen De Man ◽  
Myriam De Spiegelaere ◽  
Veerle Vanlerberghe ◽  
Bart Criel
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Patient Participation ◽  
Care Providers ◽  
Patient Centred Care ◽  
For Profit ◽  
Not For Profit ◽  
Health Centres ◽  
Care Package

Abstract Abstract Background Patient-centred care is an essential component of quality of health care. We hypothesize that integration of a mental health care package into versatile first-line health care services can strengthen patient participation, an important dimension of patient-centred care. The objective of this study is to analyse whether consultations conducted by providers in facilities that integrated mental health care score higher in terms of patient participation. Methods This study was conducted in Guinea in 12 not-for-profit health centres, 4 of which had integrated a mental health care package (MH+) and 8 had not (MH-). The study involved 450 general curative consultations (175 in MH+ and 275 in MH- centres), conducted by 18 care providers (7 in MH+ and 11 in MH- centres). Patients were interviewed after the consultation on how they perceived their involvement in the consultation, using the Patient Participation Scale (PPS). The providers completed a self-administered questionnaire on their perception of patient’s involvement in the consultation. We compared scores of the PPS between MH+ and MH- facilities and between patients and providers. Results The mean PPS score was 24.21 and 22.54 in MH+ and MH- health centres, respectively. Participation scores depended on both care providers and the health centres they work in and ranged from 19.12 to 26.96 (p <0.001) for providers and from 20.49 to 26.96 (p <0.001) for the health centres. When adjusting for health providers and the duration of consultation, the patients consulting an MH+ centre were scoring higher on patient participation score than the ones of an MH- centre (adjusted odds ratio of 4.06 with a 95% CI of 1.17-14.10, p = 0.03). All care providers agreed they understood the patients' concerns, and patients shared this view. All patients agreed they wanted to be involved in the decision-making concerning their treatment; providers, however, were reluctant to do so. Conclusion Integrating a mental health care package into versatile first-line health services can promote more positive attitudes of care provider-patient interactions, even though this process by its own is not sufficient.

Primary Care Pediatrics and Child Psychopathology: A Review of Diagnostic, Treatment, and Referral Practices

PEDIATRICS ◽  
1986 ◽  
Vol 78 (6) ◽  
pp. 1044-1051 ◽  
Author(s):  
Elizabeth J. Costello
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Mental Disorder ◽  
Mental Health Care ◽  
Mental Health Problems ◽  
Primary Care Providers ◽  
Health Problems ◽  
Group Practices ◽  
Primary Care Pediatricians

The quality of mental health care for children depends not only on specialist mental health services, but also on how effectively primary care providers identify, treat, and refer children with emotional and behavioral problems. Recent research has shown that primary care practitioners are the sole providers of mental health care to the majority of people with a mental disorder. For example, Regier et al1 calculated that in 1975 54.1% of persons with a mental disorder were treated only in a primary care or outpatient medical setting, with another 6% receiving care from both specialist mental health and primary care medical facilities. An additional 21.5% were not in treatment or received treatment from nonmedical agencies. If the data were extrapolated for all age groups, these rates would imply that only one child in five with a mental disorder is receiving specialist treatment, three are in the care of a pediatrician, and one is receiving no treatment. This would lead to the conclusion that pediatricians are, according to Regier et al,1 the de facto mental health service for most children in need of such care. It would lend support to the drive to increase pediatricians' awareness of, and training for, the mental health component of their work.2 In this paper, we review the published evidence as it applies to children. SCOPE This review includes the published studies of mental health problems diagnosed by primary care pediatricians, family practitioners, or pediatric nurse practitioners working in outpatient settings in the United States. These include private pediatric practices, group practices, health maintenance organizations (HMOs), and other types of prepaid group practices. The questions addressed are: (1) What proportion of the children seen by primary care pediatricians and their colleagues are diagnosed by them as having a mental disorder? (2) What proportion of children are referred for specialist evaluation and treatment? (3) What risk factors are associated with a higher probability of receiving a diagnosis of psychopathology? (4) How accurate are primary care pediatricians' diagnoses of mental health problems?

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