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.

scholarly journals Addressing the gaps in mental health care for internally displaced persons

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Sandeep R Sabhlok ◽  
Vivian Pender ◽  
Elizabeth Mauer ◽  
Michael S Lipnick ◽  
Gunisha Kaur
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Internally Displaced Persons ◽  
Displaced Persons ◽  
Internally Displaced

scholarly journals Psychotherapy in the Kurdistan region of Iraq (KRI): Preferences and expectations of the Kurdish host community, internally displaced- and Syrian refugee community

2021 ◽  
pp. 002076402199521
Author(s):  
Kerem Böge ◽  
Eric Hahn ◽  
Judith Strasser ◽  
Stephanie Schweininger ◽  
Malek Bajbouj ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Patient Satisfaction ◽  
Mental Health Care ◽  
Host Community ◽  
Internally Displaced Persons ◽  
Syrian Refugees ◽  
Displaced Persons ◽  
Internally Displaced ◽  
Satisfaction With Services

Background and Aim: The Kurdish Region of Iraq (KRI) is home to Kurds, internally displaced persons, and Syrian refugees. In the last decades, its inhabitants have witnessed a great deal of political instability, which has led to increased rates of psychological distress. Mental illness contrasts with limited access to and availability of mental health services – and so the treatment gap remains high. This study aims to investigate the perspectives, perceptions, and expectations of Syrian refugees, internally displaced persons and KRI host community members concerning mental health care in the governorate of Duhok. Attitudes and perspectives regarding psychotherapy, such as satisfaction with services, effects of therapy, bias toward therapy, and stigma, are explored. Methods: One hundred one participants were recruited from hospitals, clinical settings, and institutions from the governorate of Duhok in the KRI. Participants received the Patient Satisfaction Questionnaire (PSQ) and were asked to evaluate services through four subscales: patient satisfaction, effects of therapy, bias toward therapy, and stigma. Results: Results revealed overall high satisfaction with services and effects of therapy. In contrast, both bias and stigma subscales were rated more ambivalently. Conclusion: Patient satisfaction is key for assessing health care quality, understanding attitudes toward therapy, and help-seeking behavior. Results offer insight for stakeholders in the psychosocial field allowing for a better understanding and improvement of availability and access to quality-driven mental health care services

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.

Access to Mental Health Services Among Internally Displaced Persons in Ukraine: Results from a Nationwide Survey

2017 ◽  
Vol 41 (S1) ◽  
pp. S614-S614 ◽  
Author(s):  
B. Roberts ◽  
N. Makhashvili ◽  
J. Javakhishvili
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Health Services ◽  
Health Care Providers ◽  
Psychosocial Support ◽  
Emotional Problem ◽  
Internally Displaced Persons ◽  
Displaced Persons ◽  
Care Providers ◽  
Internally Displaced

BackgroundThere are an estimated 1.4 million internally displaced persons (IDPs) in Ukraine as a result of the armed conflict in Ukraine.Objectives(i) Measure the burden of key mental disorders (PTSD, depression and anxiety); (ii) examine rates of utilization of health and psychosocial support services; (iii) examine the patterns of utilisation of services.MethodsThe study used a cross-sectional survey design and was conducted throughout Ukraine between March and May 2016 with 2203 IDPs aged 18 years and over. Time-location sampling was chosen as a probabilistic sampling method. Outcome measures were the PCL-5 for PTSD, the PHQ-9 for depression and the GAD-7 for anxiety. Descriptive and multivariate regression analyses were used.ResultsOf the 2203 respondents, 703 reported experiencing a mental health or emotional problem over the previous 12 months and were also screened positive with PTSD, depression or anxiety. Of these 703, 180 had sought care (with sources of care to be given in the presentation). Therefore, 523 respondents did not seek care, equating to an overall treatment gap of 74%, (74% for PTSD, 71% for depression and 70% for anxiety). Key reasons for not utilising treatment included preferring to use their own medications (n = 176); unaffordability of health services (n = 118) or medications (n = 140); poor understanding by health care providers (n = 123); poor quality of services (n = 78) and stigma/embarrassment (n = 41).ConclusionsThe findings support the need for a scaled-up, comprehensive and trauma informed response to provision of the mental health care of IDPs in Ukraine.Disclosure of interestThe authors have not supplied their 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

Pathways to Mental Health Services and Perceptions about the Effectiveness of Treatment

2018 ◽  
Vol 9 (3) ◽  
pp. 388-407 ◽  
Author(s):  
Sirry M. Alang ◽  
Donna D. McAlpine
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Mental Health Problems ◽  
Severity Of Illness ◽  
Mental Illnesses ◽  
Social Characteristics ◽  
Treatment Gap ◽  
Quality Outcomes ◽  
Effectiveness Of Care

The gap between need and effective treatment for mental health problems continues to be a challenge for researchers and policymakers. Much of the attention has been on differences in treatment rates, with insufficient attention to variation in pathways that people take into treatment. Individuals may choose to seek help but may also be substantially influenced by others or coerced into care. The chances of each type of pathway are influenced by social characteristics and may shape perceptions of effectiveness of care. This paper investigates variation in pathways into care and perceived effectiveness of care. We also examine whether choice or coercion into care are associated with whether individuals perceive care as effective and if severity of illness moderates this relationship. We use data from the 2010–2014 National Survey on Drug Use and Health (N = 10,020). Persons who independently sought mental health care were more likely to rate treatment as effective compared to persons ordered into care. Among people with severe mental illnesses, the probability of rating treatment as effective is lowest among those who were ordered into care. Entry into mental health care is not sufficient for closing the treatment gap if coerced care leads to poorer quality outcomes.

scholarly journals The Use of Antidepressants, Anxiolytics, Sedatives and Hypnotics in Europe: Focusing on Mental Health Care in Portugal and Prescribing in Older Patients

2020 ◽  
Vol 17 (22) ◽  
pp. 8612
Author(s):  
Marta Estrela ◽  
Maria Teresa Herdeiro ◽  
Pedro Lopes Ferreira ◽  
Fátima Roque
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Disorders ◽  
Mental Health Care ◽  
Older Patients ◽  
Common Mental Disorders ◽  
Health Policies ◽  
Depression And Anxiety ◽  
Treatment Gap ◽  
Mental Health Policies

(1) Background: Mental disorders are a growing concern in the 21st century. The most prevalent common mental disorders include depression and anxiety. It is predicted that half of the population will at some point in their lives experience one or more mental disorders. Although common mental disorders are highly prevalent, some of the most significant related problems are the wide treatment gap and the excessive use of antidepressants, anxiolytics and sedatives/hypnotics, especially among older patients. (2) Methods: This study aimed to analyze mental health care in Portugal, with a focus on the consumption of antidepressants, anxiolytics, sedatives and hypnotics among older patients. (3) Results: The use of antidepressants, anxiolytics, sedatives and hypnotics has increased overall across Europe. In Portugal, a downward trend of sedatives and hypnotics consumption can be observed. Anxiolytics and antidepressants, on the other hand, have been increasing. Patients aged ≥60 years old consume more than half of the aforementioned drugs. (4) Conclusions: Mental health policies should be designed to improve the conscientious use of antidepressants, anxiolytics, sedatives and hypnotics, particularly among older adults.

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