Refugees and asylum seekers

Author(s):  
Tom K.J. Craig

The number of people displaced from their homes as the result of war, civil unrest, and persecution worldwide is now at the highest level on record. Around a fifth make it to affluent Western nations, prompting a marked rise in tension and in efforts to stem the tide by tightening quotas, clamping down on ‘illegals’, and erecting physical barriers. Given the traumas that drive people to flee their homes and the struggles many face in resettlement, it is hardly surprising that there is a high prevalence of mental health problems. While these conditions can be successfully treated using methods known to be effective in non-migrants, the interventions typically rely on expert therapists delivering a Westernized model of therapy. More research is needed to develop and test effective interventions that could be delivered by a much broader workforce, including those in the developing countries where the majority of refugees remain.

Author(s):  
Keith Hariman ◽  
Antonio Ventriglio ◽  
Dinesh Bhugra

An estimated 3.3% of the global population lives outside their place of birth. This heterogenous group includes not only high-skilled labour and expats, but also refugees and asylum seekers. Research has shown that the prevalence of certain mental illnesses, such as post-traumatic stress disorder and depression, may be higher in migrants than in the general population. However, some migrants might not be able to receive the relevant mental health treatment owing to various social, cultural, and physical barriers. One possible solution is the use of telepsychiatry, defined as the delivery of psychiatric intervention from a distance. This includes real-time videoconferencing, pre-recorded videos, or even decision support systems. This technology has the ability to connect migrants with a clinician who understands their language and culture, thereby improving the patient satisfaction and outcome. The benefits of telepsychiatry, along with the challenges in its implementation, will be discussed in this chapter, as will potential problems related to ethics, regulation, and confidentiality.


Author(s):  
Yulisha Byrow ◽  
Rosanna Pajak ◽  
Tadgh McMahon ◽  
Amitabh Rajouria ◽  
Angela Nickerson

Rates of help-seeking for mental health problems are low amongst refugee communities, despite the high prevalence of PTSD reported amongst these individuals. Research suggests that the key barriers to seeking help for psychological problems include structural barriers (e.g., unstable housing), cultural barriers (e.g., mental health stigma), and barriers specific to refugees and asylum seekers (e.g., visa status). This study examined the effect of structural, cultural and refugee specific barriers on the relationship between PTSD symptom severity and intentions to seek help from professional, social, and community sources. Data was collected from 103 male refugees and asylum seekers with an Arabic-, Farsi-, or Tamil-speaking background. Participants completed measures indexing demographics, trauma exposure, PTSD symptoms, mental health stigma, and help-seeking intentions. Path analyses indicated that PTSD severity was associated with lower help-seeking intentions indirectly via mental health stigma (self-stigma for seeking help and self-stigma for PTSD) and visa security. PTSD severity was also associated with greater help-seeking intentions from community members indirectly via structural barriers. These findings are important to consider when identifying key barriers to mental health help-seeking and developing interventions designed to increase help-seeking for psychological problems, within this group.


2017 ◽  
Vol 41 (S1) ◽  
pp. S35-S35
Author(s):  
M. Schouler-Ocak

With growing globalisation and an increasing number of people on the move across boundaries, it has become vital that service providers, policy makers and mental health professionals are aware of the different needs of the patients they are responsible. One of the most fundamental barriers for migrants, refugees and asylum seekers in accessing health services are inadequate legal entitlement and, mechanisms for ensuring that they are well known and respected in practice. Access to the healthcare system is impeded by language and cultural communication problems. Qualified language and cultural mediators are not widely available, and moreover, are not regularly asked to attend. This can lead to misunderstandings, misdiagnosis and incorrect treatment, with serious consequences for the afflicted. The language barrier represents one of the main barriers to access to the healthcare system for people who do not speak the local language; indeed, language is the main working tool of psychiatry and psychotherapy, without which successful communication is impossible. Additionally, the lack of health literacy among the staff of institutions, which provide care for refugees and asylum seekers means that there is a lack of knowledge about the main symptoms of common mental health problems among these groups. The healthcare services, which are currently available, are not well prepared for these increasing specific groups. In dealing with ethnic minorities, including asylum seekers and refugees, mental healthcare professionals need to be culturally competent.In this talk, main models for providing mental health care for migrants and refugees will be presented and discussed.Disclosure of interestThe author has not supplied his declaration of competing interest.


Author(s):  
Giulia Cossu ◽  
Antonio Preti ◽  
Mauro Giovanni Carta

Refugees from war zones and asylum seekers are exposed to a wide range of traumas, including persecution, humiliation, gender-based violence, human rights violations, and significant family losses. This results in a statistically higher risk of trauma-related mental disorders. However, refugees and asylum seekers are a heterogeneous population, as far as their gender, age, ethnic, cultural, educational and socio-economic background are concerned. There is no certainty that the Western-centred therapies will be effective in the treatment of the trauma-related mental disorders of refugees and asylum seekers. This chapter summarizes the currently available evidence on the mental health of refugees from war zones and asylum seekers, focusing in particular on the results of randomized controlled trials of psychosocial and other non-conventional interventions applied to refugees and asylum seekers. Culturally sensitive approaches, which activate same-cultural community network support, are more likely to contribute to the effectiveness of the care process.


2019 ◽  
Author(s):  
Kristina Kalfic ◽  
Glenn Mitchell ◽  
Lezanne Ooi ◽  
Sibylle Schwab ◽  
Natalie Matosin

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.


2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
H. M. Bjorgaas ◽  
I. Elgen ◽  
T. Boe ◽  
M. Hysing

Introduction. Children with cerebral palsy (CP), one of the most common childhood neurological disorders, often have associated medical and psychological symptoms. This study assesses mental health problems compared to population controls and the ability of a mental health screening tool to predict psychiatric disorders and to capture the complexity of coexisting symptoms.Methods. Children with CP (N=47) were assessed according to DSM-IV criteria using a psychiatric diagnostic instrument (Kiddie-SADS) and a mental health screening questionnaire (SDQ). Participants from the Bergen Child Study, a large epidemiological study, served as controls.Results. Children with CP had significantly higher means on all problem scores including impact scores. Two in three children scored above 90th percentile cutoff on Total Difficulties Score (TDS), and 57% met criteria for a psychiatric disorder, yielding a sensitivity of 0.85 and a specificity of 0.55. Mental health problems coexisted across symptom scales, and peer problems were highly prevalent in all groups of psychiatric disorders.Conclusion. A high prevalence of mental health problems and cooccurrence of symptoms were found in children with CP compared to controls. Screening with SDQ detects mental health problems, but does not predict specific disorders in children with CP. ADHD is common, but difficult to diagnose due to complexity of symptoms. Mental health services integrated in regular followup of children with CP are recommended due to high prevalence and considerable overlap of mental health symptoms.


2011 ◽  
Vol 8 (1) ◽  
pp. 4-5 ◽  
Author(s):  
AbdulKareem AlObaidi

Children and adolescents constitute half of Iraq's population of over 30 million. Mental health problems experienced by Iraqi children and adolescents are a hidden problem. Many factors contribute to the mental health problems of young Iraqis, including being victims and witnesses to violence, seeing family members become victims, being displaced from their homes, and experiencing the instability that still plagues their nation. Iraqis have experienced severe deprivation caused by many years of war, economic embargoes and civil unrest. Violence, poverty and the failure of the education and health systems have severely undermined the well-being of Iraqis, especially children (AlObaidi et al, 2009).


2021 ◽  
pp. 237-246
Author(s):  
Meryam Schouler-Ocak ◽  
Marianne C. Kastrup

Author(s):  
Rachel Tribe ◽  
Angelina Jalonen

This chapter reviews the socio-political environment and legal factors that provide the context and influence the lived experience of many refugees and asylum seekers. These factors are considered in relation to flight, arrival, and settlement in a new country. How these contextual factors may impact upon refugees and asylum seekers, their sense of identity, and mental health will be reviewed. The chapter reflects upon the possible challenges faced by many refugees and asylum seekers, as well as arguing that the strengths, resilience, and coping strategies that many asylum seekers and refugees exhibit need to be adequately considered by clinicians, if a meaningful service is to be provided. The importance of clinicians being culturally curious and listening to service users’ meaning-making is vital. An overview of some other issues that clinicians may need to consider is provided. The chapter contains a number of case studies to illustrate the related issues.


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