scholarly journals Head injury in asylum seekers and refugees referred with psychological trauma

2016 ◽  
Vol 3 ◽  
Author(s):  
S. M. Doherty ◽  
R. Craig ◽  
M. Gardani ◽  
T. M. McMillan
Keyword(s):  
Mental Health ◽  
Head Injury ◽  
Asylum Seekers ◽  
Mental Health Problems ◽  
Psychological Trauma ◽  
Mental Health Clinicians ◽  
Trauma Service ◽  
History Of ◽  
Preliminary Study ◽  
Asylum Seekers And Refugees

Objective.Individuals who seek asylum are frequently fleeing violent persecution and may experience head injury (HI). However, little is known about the prevalence of HI in asylum seekers and refugees (ASR) despite the potential for HI to significantly affect cognitive and emotional functioning and to compromise asylum outcomes. This preliminary study investigates the prevalence of HI in ASR referred to a complex psychological trauma service.Method.Participants were 115 adult ASR referred to a community psychological trauma service with moderate to severe mental health problems associated with psychological trauma. They were screened for a history of HI using a questionnaire developed for the study. Interpreters were used when required.Results.The overall prevalence of HI was 51%. At least 38% of those with HI had a moderate–severe HI that could cause persisting disability. In 53% of those with HI, the cause was torture, human trafficking or domestic violence. Repeat HI can have cumulative effects on function; it was common, and was reported in 68% of those with HI. An injury to the head was not known to mental health clinicians prior to screening in 64% of cases.Conclusion.The emotional and cognitive consequences of HI in ASR may increase the vulnerability of this disadvantaged group, and can be associated with neurobehavioural problems affecting daily life and may compromise asylum outcomes. Routine screening for HI in ASR is needed, as are links to neuropsychology and brain injury services for advice, assessment and intervention.

scholarly journals A brief transdiagnostic psychological intervention for Afghan asylum seekers and refugees in Austria: a randomized controlled trial

Trials ◽  
2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Matthias Knefel ◽  
Viktoria Kantor ◽  
Andrew A. Nicholson ◽  
Jennifer Schiess-Jokanovic ◽  
Dina Weindl ◽  
...  
Keyword(s):  
Mental Health ◽  
Asylum Seekers ◽  
Mental Health Problems ◽  
Psychological Intervention ◽  
Health Problems ◽  
Immigrant Integration ◽  
World Health ◽  
Afghan Refugees ◽  
Link Type ◽  
Asylum Seekers And Refugees

Abstract Background Asylum seekers and refugees are at great risk for developing mental disorders. Afghan refugees are a particularly vulnerable group with a low average education and mental health literacy level. Traumatic experiences and hardship before and during migration are predictive of mental health problems. However, post-migration living difficulties (PMLDs) also account for a large proportion of mental distress in such populations, which, critically, are not sufficiently considered in treatment protocols and research investigations. Indeed, the evidence base for the treatment of refugees and asylum seekers is sparse and limited mainly to trauma-specific treatments, where refugees may likely suffer from other mental health problems such as depression or anxiety. Methods/design This trial is the first evaluation of a short-term, transdiagnostic treatment protocol for treatment-seeking Afghan refugees which addresses mental health problems and PMLDs while using an adapted version of the Problem Management Plus (PM+) protocol. Here, we will investigate the efficacy of an intervention manual with a prospective, single-center, randomized, assessor-blind, two-group trial among refugees who are on a waiting list for professional mental health treatment. Furthermore, we will investigate participants’ subjective experiences with the intervention manual via in-depth interviews. One hundred twenty people will be assessed and randomly allocated to either the intervention arm or a treatment-as-usual arm. Clinical psychologists will conduct the treatment, and the sessions will take place with a Dari interpreter. The protocol consists of six 90-min sessions. The primary endpoint is the general symptom distress measure, assessed with the General Health Questionnaire 28 (GHQ-28). Secondary endpoints are the Post-Migration Living Difficulties Checklist (PMLDC), the International Trauma Questionnaire (ITQ), the World Health Organization Quality of Life Questionnaire (WHOQOL-BREF), the Psychological Outcome Profile (PSYCHLOPS), service and health care use (assessed with several items), and the Immigrant Integration Index (IPL-12). Discussion This trial may provide substantial evidence for a brief transdiagnostic psychological intervention. Here, we intend to contribute to the treatment of mental health problems among Afghan refugees. The assessment of subjective experience with this treatment manual, as well as the evaluation of its clinical applicability, may optimize treatment acceptance and outcomes across a wide range of mental health problems among refugees. Trial registration German Clinical Trials Register (DRKS) registration number: DRKS00016538. Universal Trial Number: U1111-1226-3285. Registered on January 7, 2019. https://www.drks.de/drks_web/setLocale_EN.do

Head injury and neuropsychiatric sequelae in asylum seekers

Neurology ◽  
2020 ◽  
Vol 95 (19) ◽  
pp. e2605-e2609 ◽  
Author(s):  
Hannah S. McMurry ◽  
Darren C. Tsang ◽  
Nicole Lin ◽  
Stephen N. Symes ◽  
Chuanhui Dong ◽  
...  
Keyword(s):  
Head Injury ◽  
Asylum Seekers ◽  
Clinical Characteristics ◽  
Psychological Trauma ◽  
Cross Sectional Study ◽  
Primary Study ◽  
Cross Sectional ◽  
Physical Trauma ◽  
History Of ◽  
Neuropsychiatric Comorbidities

ObjectiveAsylum seekers experience a high burden of physical and psychological trauma, yet there is a scarcity of literature regarding the epidemiology and sequelae of head injury (HI) in asylum seekers. We examined HI prevalence and association with neuropsychiatric comorbidities in asylum seekers.MethodsA retrospective cross-sectional study was performed through review of 139 medical affidavits from an affidavit database. Affidavits written from 2010 to 2018 were included. Demographic and case-related data were collected and classified based on the presence of HI. For neuropsychiatric sequelae, the primary study outcome was headache and the secondary outcomes were depression, posttraumatic stress disorder, and anxiety. Multivariable logistic regression was performed to examine the association between HI and neuropsychiatric sequelae, adjusted for demographic and clinical characteristics.ResultsA total of 139 medical affidavits of asylum seekers were included. The mean age was 27.4 ± 12.1 years, 56.8% were female, and 38.8% were <19 years. Almost half (42.5%) explicitly self-reported history of HI. Compared to clients who did not report HI, clients with HI were older and more likely to report a history of headache, physical abuse, physical trauma, concussion, and loss of consciousness. After adjustment for demographic and clinical characteristics, clients with HI had greater odds for neuropsychological sequelae such as headache (odds ratio [OR] 4.2, 95% confidence interval [CI] 2.0–8.7) and depression (OR 2.5, 95% CI 1.1–5.7).ConclusionsWe observed a high prevalence of HI in asylum seekers. Comprehensive screening for HI and neuropsychiatric comorbidities is encouraged when evaluating asylum seekers.

The mental health needs of asylum seekers and refugees in Ireland

2011 ◽  
Vol 26 (S2) ◽  
pp. 452-452
Author(s):  
A. Datta ◽  
J. Frewen
Keyword(s):  
Mental Health ◽  
Health Risks ◽  
Asylum Seekers ◽  
English Language ◽  
Mental Health Problems ◽  
Outcome Expectations ◽  
Cultural Integration ◽  
Economic Sectors ◽  
Psychiatric Problems ◽  
Asylum Seekers And Refugees

IntroductionAsylum seekers and refugees (ASR) are commonly portrayed as opportunists who came to Ireland to fraudulently scrounge off the Irish public. Such views and the consequent exclusion and discrimination they experience can aggravate their mental health risks and reduce their willingness to seek professional help.ObjectivesTo identify the mental health risks faced by ASR and outline specific measures to improve their situation.AimsThrough available hardcopy and online literature1/Assess and evaluate impact of asylum seeking and refugee integration process on ASR psychiatric problems in Ireland.2/Assess and evaluate knowledge and understanding of ASR mental health status; effects of segregation from local communities due to living in isolated ‘centres’ and no employment entitlement; communication and cultural integration difficulties; impact of exclusion and/or (racial) discrimination; apprehension of alien mental health system and treatment process; differing outcome expectations held by ASR and mental health specialists; and fear of being stigmatised by peers.MethodsRigorous review of relevant and applicable hardcopy and internet literature in English language since 2000.ResultsASR mental health problems associated are generally multi-dimensional. In addition to ‘normal’ stresses, many ASR are haunted by past hardships, experience exclusion and integration difficulties and endure a highly stressful asylum process.ConclusionASR require additional, specifically targeted mental health assistance and services that respect and understand their particular needs. Mental health services should work with the asylum process and other relevant socio-economic sectors to develop programmes to tackle potential ASR mental health concerns.

scholarly journals A brief transdiagnostic psychological intervention for Afghan asylum seekers and refugees in Austria: A Randomized Controlled Trial

2019 ◽  
Author(s):  
Matthias Knefel ◽  
Viktoria Kantor ◽  
Andrew A. Nicholson ◽  
Jennifer Schieß-Jokanovic ◽  
Dina Weindl ◽  
...  
Keyword(s):  
Mental Health ◽  
Asylum Seekers ◽  
Mental Health Problems ◽  
Psychological Intervention ◽  
Health Problems ◽  
Immigrant Integration ◽  
Life Questionnaire ◽  
Afghan Refugees ◽  
Wide Range ◽  
Asylum Seekers And Refugees

Abstract Background Asylum seekers and refugees are at great risk for developing mental disorders. Afghan refugees are a particularly vulnerable group with a low average educational and mental health literacy level. Traumatic experiences and hardship pre- and during migration are predictive of mental health problems. However, post-migration living difficulties (PMLDs) also account for a large proportion of mental distress in such populations, which critically are not sufficiently considered in treatment protocols and research investigations. Indeed, the evidence base for the treatment of refugees and asylum seekers is sparse and mainly limited to trauma-specific treatments, where refugees may likely suffer from other mental health problems such as depression or anxiety as well. Methods/design This trial is the first evaluation of the efficacy of a short-term, transdiagnostic treatment protocol adapted to address mental health problems and PMLDs for treatment seeking Afghan refugees using an adapted version of the Problem Management Plus (PM+) protocol. We investigate the efficacy of an intervention manual with a prospective, single-center, randomized, assessor blind, two-group trial. Furthermore we investigate participants’ subjective experiences with the intervention manual with in-depth interviews. One-hundred-twenty people will be assessed and randomly allocated to either the intervention arm or a TAU arm. Clinical psychologists will conduct the treatment and the sessions will take place with a Dari interpreter. The protocol includes six 90-minute sessions. The primary endpoint is the general symptom distress measure, assessed with the General Health Questionnaire 28 (GHQ-28). Secondary endpoints include the Post-Migration Living Difficulties Checklist (PMLDC), the International Trauma Questionnaire (ITQ), the WHO Quality of Life Questionnaire (WHOQOL-BREF), the Psychological Outcome Profile (PSYCHLOPS), service and health care use (assessed with several items), and the Immigrant Integration Index (IPL-12). Discussion This trial may provide substantial evidence for a brief transdiagnostic psychological intervention. Here, we intend to contribute to the treatment of mental health problems among Afghan refugees. The assessment of subjective experience with this treatment manual, as well as the evaluation of its clinical applicability, may optimize treatment acceptance and outcomes across a wide range of mental health problems among refugees.

scholarly journals Mental Health and Traumatization of Newly Arrived Asylum Seeker Adults in Finland: A Population-Based Study

2021 ◽  
Vol 18 (13) ◽  
pp. 7160
Author(s):  
Ferdinand Garoff ◽  
Natalia Skogberg ◽  
Antti Klemettilä ◽  
Eero Lilja ◽  
Awa Ahmed Haji Omar ◽  
...  
Keyword(s):  
Mental Health ◽  
North Africa ◽  
Asylum Seekers ◽  
Mental Health Problems ◽  
Significant Risk ◽  
Cumulative Effect ◽  
Participation Rate ◽  
Psychological Trauma ◽  
Population Based ◽  
Screening Tools

Asylum seekers frequently experience potentially traumatic events (PTEs), but the type and frequency vary depending on the country of origin. The cumulative effect of multiple PTEs and other stressors expose asylum seekers to a significant risk of mental ill health. The aim of the study was to examine the prevalence of PTEs, depression and anxiety symptoms, risk for psychological trauma, psychotropic medication use and previous mental health diagnoses among adult asylum seekers in the Asylum Seekers Health and Wellbeing (TERTTU) Survey (n = 784 respondents, participation rate 78.6%). A substantial majority (88.7%, 95% CI 86.9–90.3) of asylum seekers reported one or more PTEs before arriving to Finland. PTEs during the asylum-seeking journey were reported at 12.0% (95% CI 10.7–13.4), however, when examined by region of origin, the proportion was 34.5% (95% CI 29.5–39.8) for asylum seekers from Africa (excluding North Africa). Significant symptoms of depression were reported by 41.7% (95% CI 39.6–43.9) of asylum seekers and symptoms of anxiety by 34.2% (95% CI 32.1–36.2). Half of the asylum seekers were assessed as having at least a medium-risk for psychological trauma. Prevalence rates were higher among females and asylum seekers from Africa. This study highlights the importance of using screening tools to identify asylum seekers with severe mental health problems that may need referral to further assessment and treatment. Asylum seekers from Africa (excluding North Africa) should be given additional attention in initial health screenings and examinations.

scholarly journals A brief transdiagnostic psychological intervention for Afghan asylum seekers and refugees in Austria: A Randomized Controlled Trial

2019 ◽  
Author(s):  
Matthias Knefel ◽  
Viktoria Kantor ◽  
Andrew A. Nicholson ◽  
Jennifer Schieß-Jokanovic ◽  
Dina Weindl ◽  
...  
Keyword(s):  
Mental Health ◽  
Asylum Seekers ◽  
Mental Health Problems ◽  
Psychological Intervention ◽  
Health Problems ◽  
Immigrant Integration ◽  
Life Questionnaire ◽  
Afghan Refugees ◽  
Wide Range ◽  
Asylum Seekers And Refugees

Abstract Background: Asylum seekers and refugees are at great risk for developing mental disorders. Afghan refugees are a particularly vulnerable group with a low average education and mental health literacy level. Traumatic experiences and hardship before and during migration are predictive of mental health problems. However, post-migration living difficulties (PMLDs) also account for a large proportion of mental distress in such populations, which critically, are not sufficiently considered in treatment protocols and research investigations. Indeed, the evidence base for the treatment of refugees and asylum seekers is sparse and mainly limited to trauma-specific treatments, where refugees may likely suffer from other mental health problems such as depression or anxiety. Methods/design: This trial is the first evaluation of a short-term, transdiagnostic treatment protocol to address mental health problems and PMLDs for treatment seeking Afghan refugees using an adapted version of the Problem Management Plus (PM+) protocol. Here, we will investigate the efficacy of an intervention manual with a prospective, single-center, randomized, assessor blind, two-group trial among refugees who are on a waiting list for professional mental health treatment. Further, we will investigate participants’ subjective experiences with the intervention manual via in-depth interviews. One-hundred-twenty people will be assessed and randomly allocated to either the intervention arm or a TAU arm. Clinical psychologists will conduct the treatment and the sessions will take place with a Dari interpreter. The protocol includes six 90-minute sessions. The primary endpoint is the general symptom distress measure, assessed with the General Health Questionnaire 28 (GHQ-28). Secondary endpoints include the Post-Migration Living Difficulties Checklist (PMLDC), the International Trauma Questionnaire (ITQ), the WHO Quality of Life Questionnaire (WHOQOL-BREF), the Psychological Outcome Profile (PSYCHLOPS), service and health care use (assessed with several items), and the Immigrant Integration Index (IPL-12). Discussion: This trial may provide substantial evidence for a brief transdiagnostic psychological intervention. Here, we intend to contribute to the treatment of mental health problems among Afghan refugees. The assessment of subjective experience with this treatment manual, as well as the evaluation of its clinical applicability, may optimize treatment acceptance and outcomes across a wide range of mental health problems among refugees.

scholarly journals Effects of Pregnancy Loss on Subsequent Postpartum Mental Health: A Prospective Longitudinal Cohort Study

2021 ◽  
Vol 18 (4) ◽  
pp. 2179
Author(s):  
David C. Reardon ◽  
Christopher Craver
Keyword(s):  
Mental Health ◽  
Risk Factor ◽  
Live Birth ◽  
Pregnancy Loss ◽  
Mental Health Problems ◽  
Psychiatric Treatment ◽  
Reproductive Services ◽  
History Of ◽  
Mental Health Treatments ◽  
Prospective Longitudinal

Pregnancy loss, natural or induced, is linked to higher rates of mental health problems, but little is known about its effects during the postpartum period. This study identifies the percentages of women receiving at least one postpartum psychiatric treatment (PPT), defined as any psychiatric treatment (ICD-9 290-316) within six months of their first live birth, relative to their history of pregnancy loss, history of prior mental health treatments, age, and race. The population consists of young women eligible for Medicaid in states that covered all reproductive services between 1999–2012. Of 1,939,078 Medicaid beneficiaries with a first live birth, 207,654 (10.7%) experienced at least one PPT, and 216,828 (11.2%) had at least one prior pregnancy loss. A history of prior mental health treatments (MHTs) was the strongest predictor of PPT, but a history of pregnancy loss is also another important risk factor. Overall, women with a prior pregnancy loss were 35% more likely to require a PPT. When the interactions of prior mental health and prior pregnancy loss are examined in greater detail, important effects of these combinations were revealed. About 58% of those whose first MHT was after a pregnancy loss required PPT. In addition, over 99% of women with a history of MHT one year prior to their first pregnancy loss required PPT after their first live births. These findings reveal that pregnancy loss (natural or induced) is a risk factor for PPT, and that the timing of events and the time span for considering prior mental health in research on pregnancy loss can significantly change observed effects. Clinicians should screen for a convergence of a history of MHT and prior pregnancy loss when evaluating pregnant women, in order to make appropriate referrals for counseling.

scholarly journals Subjective social mobility, quality of life and mental health of asylum seekers/refugees in Germany

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
D Costa ◽  
L Biddle ◽  
C Mühling ◽  
K Bozorgmehr
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Social Status ◽  
Social Mobility ◽  
Asylum Seekers ◽  
Country Of Origin ◽  
Subjective Social Status ◽  
Downward Mobility ◽  
Asylum Seekers And Refugees

Abstract Background Changes in the subjective social status (SSS) of migrants, specifically between the pre- and post-migratory movement, can be a relevant determinant of their mental health condition. This study analyzed the effect of downward subjective social mobility to the mental health of asylum seekers and refugees (ASR) in Germany. Methods Through a random sampling procedure, 560 adult ASR (18+ years) were recruited across 58 collective accommodation centers in Germanys' 3rd largest state (2018). SSS was assessed with the MacArthur social ladder (10-rungs), in reference to the participants' position in the country of origin and in Germany. Quality of Life (QoL, measured with EUROHIS-QOL), anxiety (General Anxiety Disorder-2) and depressive symptoms (Patient Health Questionnaire-2), were considered as mental health outcomes. Generalized linear regression models were fitted to measure associations between changes in SSS and each outcome. Results A loss of 3 or more steps in SSS from origin to Germany (compared to no-change) was significantly associated with poorer scores in QoL (B, standardized coefficient= -2.679, standard error, se = 1.351, p = 0.047), with more symptoms of depression (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 the country of origin. The strength and direction of associations was unaltered after further adjusting for sex, age, educational level and time since arrival, although the coefficient for QoL was non-significant for those declaring a 3-step downward mobility (B= -2.494, se = 1.351, p = 0.066 for QoL; B = 1.048, se = 0.393, p = 0.008 for depression; and B = 1.006, se = 0.438, p = 0.022 for anxiety). Discussion The results suggest that interventions should focus on those experiencing social downward mobility and not only prioritize individuals with low social status. Early integration efforts and intersectoral measures to counter social downward mobility could prevent poor mental health among ASR. Key messages We analysed the impact to the quality of life and mental health of asylum seekers and refugees, of a change in subjective social status from country of origin to Germany. Asylum seekers and refugees residing in Germany, who perceived a downward social status mobility following their migration process, are at risk for poorer mental health.

scholarly journals Common Mental Disorders and Substance Use in School Children of Eastern Nepal

2019 ◽  
Vol 8 (1) ◽  
pp. 17-21
Author(s):  
P Sharma ◽  
P Sharma ◽  
N Thakur ◽  
S Sharma ◽  
M Pokharel
Keyword(s):  
Mental Health ◽  
Substance Use ◽  
Mental Disorders ◽  
Mental Health Problems ◽  
Common Mental Disorders ◽  
School Mental Health ◽  
Prevalence Studies ◽  
Common Mental Health Problems ◽  
Current Scenario ◽  
History Of

Introduction: School mental health is one of the important areas where early detection can lead to appropriate early intervention and burden of disease can be minimized. There is dearth of prevalence studies of common mental disorders on school going adolescents in Nepal. Considering this we aimed to study the prevalence of common mental health problems and substance use in school going adolescents. Material And Method: We evaluated 240 students for common mental disorders (depression and anxiety) using translated version of PHQ-4 and substance use single validated question after taking consent from school authorities and assent from students. Results: It was seen that 68.8 % students had psychological distress. 22.9 % and 27.5% of students had anxiety and depression respectively on screener and 23.3% students had use of substance at least once within a year. When compared male had significantly higher number of substance use as compared to female but no difference in PHQ-4 scores were seen when compared between gender and history of substance use. Conclusion: The study shows the current scenario of school going adolescents in Nepal and highlights the need of prevalence data on more generalizable setting.

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