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

scholarly journals Rates and Associated Factors of Secondary Mental Health Care Utilisation among Ex-Military Personnel in the United States: A Narrative Review

Healthcare ◽  
2019 ◽  
Vol 7 (1) ◽  
pp. 18 ◽  
Author(s):  
Katharine Mark ◽  
Dominic Murphy ◽  
Sharon Stevelink ◽  
Nicola Fear
Keyword(s):  
Mental Health ◽  
United States ◽  
Health Care ◽  
Mental Health Care ◽  
Military Personnel ◽  
Mental Health Problems ◽  
The United States ◽  
Health Care Utilisation ◽  
Narrative Review ◽  
Care Utilisation

Little is known about ex-serving military personnel who access secondary mental health care. This narrative review focuses on studies that quantitatively measure secondary mental health care utilisation in ex-serving personnel from the United States. The review aimed to identify rates of mental health care utilisation, as well as the factors associated with it. The electronic bibliographic databases OVID Medline, PsycInfo, PsycArticles, and Embase were searched for studies published between January 2001 and September 2018. Papers were retained if they included ex-serving personnel, where the majority of the sample had deployed to the recent conflicts in Iraq or Afghanistan. Fifteen studies were included. Modest rates of secondary mental health care utilisation were found in former military members—for mean percentage prevalence rates, values ranged from 12.5% for at least one psychiatric inpatient episode, to 63.2% for at least one outpatient mental health appointment. Individuals engaged in outpatient care visits most often, most likely because these appointments are the most commonly offered source of support. Post-traumatic stress disorder, particularly re-experiencing symptoms, and comorbid mental health problems were most consistently associated with higher mental health care utilisation. Easily accessible interventions aimed at facilitating higher rates of help seeking in ex-serving personnel are recommended.

scholarly journals Mental health care utilisation among internally displaced persons in Ukraine: results from a nation-wide survey

2017 ◽  
Vol 28 (1) ◽  
pp. 100-111 ◽  
Author(s):  
B. Roberts ◽  
N. Makhashvili ◽  
J. Javakhishvili ◽  
A. Karachevskyy ◽  
N. Kharchenko ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Multivariate Regression ◽  
Health Care Utilisation ◽  
Internally Displaced Persons ◽  
Displaced Persons ◽  
Treatment Gap ◽  
Internally Displaced ◽  
Care Utilisation

AimsThere are an estimated 1.5 million internally displaced persons (IDPs) in Ukraine because of the armed conflict in the east of the country. The aim of this paper is to examine utilisation patterns of mental health and psychosocial support (MHPSS) care among IDPs in Ukraine.MethodsA cross-sectional survey design was used. Data were collected from 2203 adult IDPs throughout Ukraine between March and May 2016. Data on mental health care utilisation were collected, along with outcomes including post-traumatic stress disorder (PTSD), depression and anxiety. Descriptive and multivariate regression analyses were used.ResultsPTSD prevalence was 32%, depression prevalence was 22%, and anxiety prevalence was 17%. Among those that likely required care (screened positive with one of the three disorders, and also self-reporting a problem) there was a large treatment gap, with 74% of respondents who likely required MHPSS care over the past 12 months not receiving it. For the 26% (N = 180) that had sought care, the most common sources of services/support were pharmacies, family or district doctor/paramedic (feldsher), neurologist at a polyclinic, internist/neurologist at a general hospital, psychologists visiting communities, and non-governmental organisations/volunteer mental health/psychosocial centres. Of the 180 respondents who did seek care, 163 could recall whether they had to pay for their care. Of these 163 respondents, 72 (44%) recalled paying for the care they received despite government care officially being free in Ukraine. The average costs they paid for care was US$107 over the previous 12 months. All 180 respondents reported having to pay for medicines and the average costs for medicines was US$109 over the previous 12 months. Among the 74% had not sought care despite likely needing it; the principal reasons for not seeking care were: thought that they would get better by using their own medications, could not afford to pay for health services or medications, no awareness of where to receive help, poor understanding by health care providers, poor quality of services, and stigma/embarrassment. The findings from multivariate regression analysis show the significant influence of a poor household economic situation on not accessing care.ConclusionsThe study highlights a high burden of mental disorders and large MHPSS treatment gap among IDPs in Ukraine. The findings support the need for a scaled-up, comprehensive and trauma-informed response to provision of MHPSS care of IDPs in Ukraine alongside broader health system strengthening.

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 Psychological therapy for inpatients receiving acute mental health care: A systematic review and meta-analysis of controlled trials

2018 ◽  
Vol 57 (4) ◽  
pp. 453-472 ◽  
Author(s):  
Charlotte Paterson ◽  
Thanos Karatzias ◽  
Adele Dickson ◽  
Sean Harper ◽  
Nadine Dougall ◽  
...  
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Health Care ◽  
Mental Health Care ◽  
Meta Analysis ◽  
Psychological Therapy ◽  
Controlled Trials

scholarly journals Mental Health and Service Use of Migrants in Contact with the Public Psychiatry System in Paris

2020 ◽  
Vol 17 (24) ◽  
pp. 9397
Author(s):  
Andrea Tortelli ◽  
Florence Perquier ◽  
Maria Melchior ◽  
François Lair ◽  
Fabien Encatassamy ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Asylum Seekers ◽  
Service Use ◽  
Pathways To Care ◽  
Treatment Level ◽  
Stable Housing ◽  
Increased Risk ◽  
Provision Of Care

Background: Migrants, and particularly asylum seekers, are at increased risk of psychiatric disorders in comparison with natives. At the same time, inequalities in access to mental health care are observed. Methods: In order to evaluate whether the Parisian public psychiatric system is optimally structured to meet the needs of this population, we examined data on mental health and service use considering three different levels: the global system treatment level, a psychiatric reception center, and mobile teams specializing in access to psychiatric care for asylum seekers. Results: We found higher treatment rates among migrants than among natives (p < 0.001) but inequalities in pathways to care: more mandatory admissions (OR = 1.36, 95% CI: 1.02–1.80) and fewer specialized consultations (OR = 0.56, 95% CI: 0.38–0.81). We observed a mismatch between increased need and provision of care among migrants without stable housing or seeking asylum. Conclusions: Inequalities in the provision of care for migrants are observed in the Parisian public psychiatric system, particularly for those experiencing poor social and economic conditions. There is a need to facilitate access to mental health care and develop more tailored interventions to reduce discontinuity of care.

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