scholarly journals Deterioration of housing environment and mental health of asylum seekers – a multi-level analysis

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
A Mohsenpour ◽  
L Biddle ◽  
K Bozorgmehr
Keyword(s):  
Mental Health ◽  
Internal Consistency ◽  
Odds Ratio ◽  
Asylum Seekers ◽  
Rapid Assessment ◽  
Living Environment ◽  
Generalized Anxiety ◽  
Rater Reliability ◽  
General Anxiety ◽  
Housing Environment

Abstract Background Asylum seekers arriving in Germany are assigned to a local district and an accommodation centre wherein. We developed and validated a six-item questionnaire for rapid assessment of housing deterioration and investigated its association with inhabitant mental health. Methods Using cross-sectional data from a state-wide survey in Germany, we applied a random-effects modelling approach to estimate the exposure effect of housing deterioration on depression and general anxiety among a random sample of asylum seekers, using validated instruments (GAD2/PHQ2) for outcome variables. Housing deterioration was assessed on six items (windows/glass, walls/roof, garbage, graffiti, outside spaces, overall living environment) resulting in a deterioration score as exposure of interest. Additionally, we assessed the instrument’s intra- and inter-rater reliability and internal consistency. Results Of the 412 asylum seekers living in 58 accommodation centres, 45.7% reported symptoms of depression and 45.0% suffered general anxiety. Most centres (76.7%) were based in urban municipalities and 45.7% of inhabitants were living in an accommodation centre hosting ≥51 inhabitants. Preliminary adjusted odds ratio for accommodation centres with highest deterioration (Q 4) was 2.07 (0.67-6.40) for generalized anxiety, compared to 1.17 (0.45-3.08) for centres with lowest deterioration (Q 1). For depression, preliminary odds ratio was 1.92 (0.87-4.27) compared to 1.26 (0.63-2.50). The validation study confirmed inter-/intra-rater reliability (Brennan-Prediger coefficient: 0.81 and 0.92, respectively) and internal consistency (Crohnbach’s α: 0.80). Conclusions There are higher odds ratios for generalized anxiety disorder and depression among asylum seekers based on higher deterioration of housing environment. A questionnaire for rapid deterioration assessment and identification of accommodations needing further evaluation has been developed and successfully validated. Key messages Deterioration of small-scale housing environment is associated with poorer mental health for asylum seekers living in accommodation centres. A highly reliable new tool has been developed for rapid assessment of deterioration status of accommodation centres and identification of those needing further evaluation.

scholarly journals Housing deterioration: a multi-dimensional index and validation in shared refugee accommodation

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
A Mohsenpour ◽  
L Biddle ◽  
K Krug ◽  
K Bozorgmehr
Keyword(s):  
Internal Consistency ◽  
Validation Study ◽  
Convergent Validity ◽  
Small Area ◽  
Living Environment ◽  
Housing Quality ◽  
Health It ◽  
Housing Environment ◽  
Valid Index

Abstract Background Asylum seekers and refugees (ASR) are struggling for residential autonomy while awaiting the results of their asylum case. As housing is a known upstream determinant of and fundamental resource for health, it is important to monitor housing quality of state-provided shared refugee accommodation. We constructed, validated and field-tested a new and quick-to-apply index to measure the degree of Small-area Housing Environment Deterioration (SHED). Methods Conceptualizing housing quality as characteristics and maintenance of physical environment, we developed the SHED based on the “Broken Windows”-index (BWI). We conducted a validation study with seven raters at two time points, assessing measures of inter-/intra-rater reliability and internal consistency, complemented by cognitive interviews. Further, we field-tested the index in a random sample of 58 shared refugee accommodations and assessed its convergent validity against ASR's satisfaction with their living places (EUROHIS QOL). Results SHED assesses five domains (windows/glass, walls/roof, garbage, graffiti, outside spaces), complemented by a rating of the overall living environment. The validation study delivered an 'almost perfect' prevalence- and bias-adjusted Kappa (PABAK) of 0.87 (0.82-0.91) for intra-rater, 'substantial' to 'almost perfect' PABAK's between 0.71 (0.52-0.91) and 0.91 (0.87-0.91) depending on the rater (all p < 0.001), and a Cronbach's α of 0.80. The index's construct validity is based on the BWI and converges with the ASR's subjective satisfaction with their living places. Cognitive interviewees enjoyed the simplicity and speed of the SHED and guided the creation of a manual for future use. Conclusions The index demonstrated high measures on objectivity, reliability, and internal consistency. It proved its applicability in a field-test and showed convergent validity with ASR's satisfaction with their living place within shared refugee accommodation. Key messages We have constructed an objective, reliable, internally consistent and valid index assessing the degree of deterioration of small-area housing environment. SHED offers opportunities for monitoring the physical quality of collective accommodation centres and filling the research gap on associations between housing quality and health.

scholarly journals A Brief Online and Offline (Paper-and-Pencil) Screening Tool for Generalized Anxiety Disorder: The Final Phase in the Development and Validation of the Mental Health Screening Tool for Anxiety Disorders (MHS: A)

2021 ◽  
Vol 12 ◽  
Author(s):  
Shin-Hyang Kim ◽  
Kiho Park ◽  
Seowon Yoon ◽  
Younyoung Choi ◽  
Seung-Hwan Lee ◽  
...  
Keyword(s):  
Mental Health ◽  
Anxiety Disorder ◽  
Anxiety Disorders ◽  
Generalized Anxiety Disorder ◽  
Internal Consistency ◽  
Screening Tool ◽  
Health Screening ◽  
Mental Health Screening ◽  
Generalized Anxiety ◽  
Paper And Pencil

Generalized anxiety disorder (GAD) can cause significant socioeconomic burden and daily life dysfunction; hence, therapeutic intervention through early detection is important. This study was the final stage of a 3-year anxiety screening tool development project that evaluated the psychometric properties and diagnostic screening utility of the Mental Health Screening Tool for Anxiety Disorders (MHS: A), which measures GAD. A total of 527 Koreans completed online and offline (i.e., paper-and pencil) versions of the MHS: A, Beck Anxiety Inventory (BAI), Generalized Anxiety Disorder-7 (GAD-7), and Penn State Worry Questionnaire (PSWQ). The participants had an average age of 38.6 years and included 340 (64.5%) females. Participants were also administered the Mini-International Neuropsychiatric Interview (MINI). Internal consistency, convergent/criterion validity, item characteristics, and test information were assessed based on the item response theory (IRT), and a factor analysis and cut-off score analyses were conducted. The MHS: A had good internal consistency and good convergent validity with other anxiety scales. The two versions (online/offline) of the MHS: A were nearly identical (r = 0.908). It had a one-factor structure and showed better diagnostic accuracy (online/offline: sensitivity = 0.98/0.90, specificity = 0.80/0.83) for GAD detection than the GAD-7 and BAI. The IRT analysis indicated that the MHS: A was most informative as a screening tool for GAD. The MHS: A can serve as a clinically useful screening tool for GAD in Korea. Furthermore, it can be administered both online and offline and can be flexibly used as a brief mental health screener, especially with the current rise in telehealth.

Contextual housing environment and mental health of asylum seekers – a multi-level analysis

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
A Mohsenpour ◽  
L Biddle ◽  
K Bozorgmehr
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Logistic Regression ◽  
Random Sample ◽  
Asylum Seekers ◽  
Depression Symptoms ◽  
Housing Environment ◽  
Multi Level ◽  
High Degree ◽  
Very High

Abstract Background Housing is an important determinant of health among asylum seekers and refugees (ASR). Little is known about the effects of contextual housing environment. We used state-wide reliable and valid data to examine these effects on ASR mental health. Methods We drew a balanced random sample of 58 shared refugee accommodation centers (SRA) from 1938 centres with 70,634 ASR in Germany's 3rd largest federal state. We measured depression (PHQ2) and anxiety (GAD2) using established instruments in nine languages. We assessed physical housing environment with a validated multi-dimensional Small-area Housing Environment Deterioration index (SHED). Linking survey- and SHED-data to GIS- and secondary data sources on accommodation size and remoteness, district urbanity and deprivation, we used multi-level logistic regression to calculate exposure effects and 95 % confidence intervals (CI), while adjusting for age, sex, relocations and chronic illness. Results Of 412 ASR living in 58 SRA, 45.0% of inhabitants and 35.7% of SRA were rated as having a high/very high degree of deterioration. The odds for reporting symptoms of generalized anxiety increased for the highest degree of deterioration (1.30; 0.37-4.55), large accommodation size (1.01; 1.00-1.03), remoteness (1.63; 0.61 - 4.36), district urbanity (1.67; 0.66-4.20) and deprivation (1.33; 0.60-2.92). The odds of depression symptoms increased in SRA with highest deterioration (1.98; 0.74-5.33) and accommodation remoteness (1.10; 0.48-2.52), decreased in SRA with district urbanity (0.63; 0.31-1.28) and district deprivation (0.66; 0.36-1.23) but not large accommodation size (1.00; 0.99-1.02). Conclusions Almost half of ASR are living in SRA with high/very high degree of deterioration. There is a general tendency of higher odds for mental illness symptoms conditional on housing environment. Future analyses with sample size calculations are needed to better understand these health associations for shared refugee accommodation. Key messages We described contextual housing environment, i.e. degree of deterioration, accommodation size, remoteness, urbanity and deprivation, of a balanced random sample of 58 shared refugee accommodations. In multi-level logistic regression, contextual housing environment tends to be associated with higher odds for reporting symptoms of mental illness.

scholarly journals Generalized Anxiety as a Risk Factor for Dysfunctional Eating Behavior after Obesity Surgery during the COVID-19 Pandemic

2021 ◽  
Vol 18 (20) ◽  
pp. 10890
Author(s):  
Corinna Pfeiffer ◽  
Adam Schweda ◽  
Lynik Chantal Schüren ◽  
Marco Niedergethmann ◽  
Jasmin Steinbach ◽  
...  
Keyword(s):  
Mental Health ◽  
Risk Factors ◽  
Risk Factor ◽  
Obesity Surgery ◽  
Eating Behavior ◽  
Anxiety And Depression ◽  
Generalized Anxiety ◽  
Depression And Anxiety ◽  
General Anxiety ◽  
The Impact

Purpose: The present study investigates the impact of obesity surgery on mental health (i.e., eating behavior and distress) during the COVID-19 pandemic. Methods: Two hundred fifty-four participants were recruited via social media. One hundred fourteen (44.53%) of them were surgery candidates (waiting for obesity surgery), while 142 (55.46%) had already undergone surgery. Participants who underwent surgery were compared to participants that did not yet undergo surgery in terms of mental burden (depression and anxiety), as well as safety and eating behavior. Further moderation analyses attempted to identify risk factors for increased COVID-19-related dysfunctional eating behavior after surgery. Results: Participants who underwent surgery showed generally lower levels of depression and general anxiety on a trend level. Moderation analyses suggested that people with high levels of generalized anxiety actually show more dysfunctional COVID-19-specific eating behavior after obesity surgery. Conclusion: On a trend level, obesity surgery appears to attenuate symptoms of generalized anxiety and depression. Yet, surgery patients with high levels of generalized anxiety exhibit even higher levels of dysfunctional eating during the COVID-19 pandemic. It is therefore particularly important to support people at risk.

Psychometric Properties of the German Version of the Scale to Assess the Therapeutic Relationship in Community Mental Health Care (D-STAR)

2012 ◽  
Vol 28 (4) ◽  
pp. 255-261 ◽  
Author(s):  
Sabine Loos ◽  
Reinhold Kilian ◽  
Thomas Becker ◽  
Birgit Janssen ◽  
Harald Freyberger ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Community Mental Health ◽  
Mental Health Care ◽  
Psychometric Properties ◽  
Therapeutic Relationship ◽  
Internal Consistency ◽  
Convergent Validity ◽  
Community Mental Health Care ◽  
German Version

Objective: There are presently no instruments available in German language to assess the therapeutic relationship in psychiatric care. This study validates the German version of the Scale to Assess the Therapeutic Relationship in Community Mental Health Care (D-STAR). Method: 460 persons with severe mental illness and 154 clinicians who had participated in a multicenter RCT testing a discharge planning intervention completed the D-STAR. Psychometric properties were established via item analysis, analyses of missing values, internal consistency, and confirmatory factor analysis. Furthermore, convergent validity was scrutinized via calculating correlations of the D-STAR scales with two measures of treatment satisfaction. Results: As in the original English version, fit indices of a 3-factor model of the therapeutic relationship were only moderate. However, the feasibility and internal consistency of the D-STAR was good, and correlations with other measures suggested reasonable convergent validity. Conclusions: The psychometric properties of the D-STAR are acceptable. Its use can be recommended in German-speaking countries to assess the therapeutic relationship in both routine care and research.

Overcoming the deficiency of refugee mental health research

2019 ◽  
Author(s):  
Kristina Kalfic ◽  
Glenn Mitchell ◽  
Lezanne Ooi ◽  
Sibylle Schwab ◽  
Natalie Matosin
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Health Research ◽  
Asylum Seekers ◽  
Scientific Discovery ◽  
Mental Health Research ◽  
Psychiatric Research ◽  
Risk And Resilience ◽  
Refugee Mental Health ◽  
Refugees And Asylum Seekers

The growing number of refugees and asylum seekers are one of the most significant global challenges of this generation. We are currently witnessing the highest level of displacement in history, with over 65 million displaced people in the world. Refugees and asylum seekers are at higher risk to develop mental illness due to their trauma and chronic stress exposures, and particularly post-migration stressors. Yet global and Australian psychiatric research in this area is greatly lacking, particularly with respect to our understanding of the molecular underpinnings of risk and resilience to mental illness in traumatised populations. In this Viewpoint, we explore the reasons behind the lack of refugee mental health research and use this context to propose new ways forward. We believe that scientific discovery performed with a multidisciplinary approach will provide the broad evidence-base required to improve refugee mental health. This will also allow us to work towards the removal of damaging policies that prolong and potentiate mental health deterioration among refugees and asylum seekers, which impacts not only on the individuals but also host countries’ social, economic and healthcare systems.

The Coronavirus Disease 2019 Pandemic in Taiwan: An Facebook Online study on Concern/Fear Regarding the Disease and General Anxiety and Relevant Factors (Preprint)

2020 ◽  
Author(s):  
Peng-Wei Wang ◽  
Wei-Hsin Lu ◽  
Yi-Lung Chen ◽  
Dian-Jeng Li ◽  
Yu-Ping Chang ◽  
...  
Keyword(s):  
Mental Health ◽  
Environmental Factors ◽  
Online Survey ◽  
Psychological Impact ◽  
Health Resources ◽  
World Health ◽  
Regional Government ◽  
General Anxiety ◽  
Self Confidence ◽  
Health Organization

BACKGROUND The World Health Organization (WHO) declared COVID-19 a ‘public health emergency of international concern. Both worry and anxiety are the common psychological impact during the pandemic. The level of and determinants for worry and anxiety during COVID-19 are not well explored. OBJECTIVE The present study aimed to explore the associations of demographic and environmental factors with worry toward COVID-19 and general anxiety among people in Taiwan. METHODS In total, 1970 respondents were recruited through a Facebook advertisement and completed an online survey on worry toward COVID-19, general anxiety during the pandemic, and individual and environmental factors. RESULTS In total, 51.7% and 43.4% of respondents reported high levels of worry toward COVID-19 and general anxiety, respectively. Worse self-rated mental health, lower self-confidence in COVID-19 management, and insufficient mental health resources were significantly associated with high levels of both worry toward COVID-19 and general anxiety. Lower perceived confidence in COVID-19 management by the regional government was significantly associated with a higher level of worry toward COVID-19. Lower perceived social support was significantly associated with a higher level of general anxiety during the COVID-19 pandemic. CONCLUSIONS The results showed that high levels of worry toward COVID-19 and general anxiety were prevalent during the disease outbreak. Multiple individual and environmental factors related to worry toward COVID-19 and general anxiety were identified. CLINICALTRIAL

scholarly journals Mental health and resilience among Eritrean refugees at arrival and one-year post-registration in Switzerland: a cohort study

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Afona Chernet ◽  
Nicole Probst-Hensch ◽  
Véronique Sydow ◽  
Daniel H. Paris ◽  
Niklaus D. Labhardt
Keyword(s):  
Mental Health ◽  
Asylum Seekers ◽  
Assessment Tools ◽  
Migration Route ◽  
Post Traumatic Stress ◽  
Hazardous Alcohol Use ◽  
Hazardous Alcohol ◽  
One Year ◽  
The One

Abstract Objective Eritrea is the most frequent country of origin among asylum seekers in Switzerland. On their journey through the desert and across the Mediterranean Sea, Eritrea refugees are often exposed to traumatizing experiences. The aim of this study is to assess the mental health status and resilience of Eritrean migrants in Switzerland upon arrival and one-year post-arrival, using standardized mental health screening and resilience assessment tools. Results At baseline, 107 refugees (11.2% female, median age 25) were interviewed: 52 (48.6%) screened positive for Post-Traumatic Stress Disorder (score ≥ 30), 10.3% for anxiety (≥ 10) and 15.0% for depression (≥ 10); 17.8% scored as risk/hazardous drinkers (≥ 8). The majority (94.4%) had a high resilience score (≥ 65). For one-year follow-up, 48 asylum seekers could be reached. In interviews 18 (38%) of these reported imprisonment in a transit country and 28 (58%) that they had witnessed the death of a close person along the migration route. At the one year assessment, rates of risky/hazardous alcohol use remained unchanged, rates of positive PTSD screening tended to be lower (50.0% (24/48) at baseline vs 25.0% (12/48) at follow-up), as were rates of positive screening for anxiety (8.3% vs 4.2%) and depression (14.6 vs 6.3%).

Recovery Star: validating user recovery

2012 ◽  
Vol 36 (2) ◽  
pp. 45-50 ◽  
Author(s):  
Geoff Dickens ◽  
Judy Weleminsky ◽  
Yetunde Onifade ◽  
Philip Sugarman
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Internal Consistency ◽  
Mental Health Problems ◽  
Service Providers ◽  
Mental Health Recovery ◽  
Addictive Behaviour ◽  
Health Service Providers ◽  
The Uk

Aims and methodMental Health Recovery Star is a multifaceted 10-item outcomes measure and key-working tool that has been widely adopted by service providers in the UK. We aimed to explore its factorial validity, internal consistency and responsiveness. Recovery Star readings were conducted twice with 203 working-age adults with moderate to severe mental health problems attending a range of mental health services, and a third time with 113 of these individuals.ResultsMental Health Recovery Star had high internal consistency and appeared to measure an underlying recovery-oriented construct. Results supported a valid two-factor structure which explained 48% of variance in Recovery Star ratings data. Two Recovery Star items (‘relationships’ and ‘addictive behaviour’) did not load onto either factor. There was good statistically significant item responsiveness, and no obvious item redundancy. Data for a small number of variables were not normally distributed and the implications of this are discussed.Clinical implicationsRecovery Star has been received enthusiastically by both mental health service providers and service users. This study provides further evidence for its adoption in recovery-focused mental health services and indicates that items relating to addictive behaviour, responsibilities and work could be further developed in future.

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