Mental health of refugees in primary care

2021 ◽  
pp. 431-438
Author(s):  
Edvard Hauff ◽  
Reidun Brunvatne
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Low Income ◽  
Mental Health Problems ◽  
Early Stage ◽  
Healthcare Services ◽  
Low Income Countries ◽  
Torture Survivors ◽  
Early Screening ◽  
Vulnerable Patients

Primary health care is usually the first level of formal health services that refugees meet in the country of resettlement. Providing culture-sensitive, accessible, and equitable services is a major challenge in high-income countries but even more so in middle- and low-income countries, where there are fewer resources. Presenting complaints are often multiple and complex. Early screening for mental health problems is controversial, and the priority is to establish a good working alliance and trust at an early stage. Vulnerable patients who may have limited or no social support or social capital due to split families; women and children exposed to sexual violence or trafficking; and torture survivors need special care and attention. Healthcare services are often fragmented making it difficult for people to traverse these services. Furthermore, there is a general need for competency building. The organization of primary mental health care for refugees in Norway is described as an example and a lesson for other countries who are facing similar problems.

scholarly journals Recovery From Severe Mental Health Problems: A Systematic Review of Service User and Informal Caregiver Perspectives

2021 ◽  
Vol 12 ◽  
Author(s):  
Norha Vera San Juan ◽  
Petra C. Gronholm ◽  
Margaret Heslin ◽  
Vanessa Lawrence ◽  
Matthew Bain ◽  
...  
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Low Income ◽  
Mental Health Problems ◽  
Health Problems ◽  
Social Needs ◽  
Low Income Countries ◽  
Service Development ◽  
Service Users ◽  
Personal Recovery

Introduction: The recovery approach aims to have users' perspectives at the heart of service development and research; it is a holistic perspective that considers social needs, personal growth and inclusion. In the last decade recovery-oriented research and practice has increased greatly, however, a comprehensive model of recovery considering exclusively the perspectives of people with lived experience has not been devised.Aims: This review aimed to develop a framework and contextualize service users' and informal caregivers' understanding of recovery from severe mental health problems.Methods: We systematically searched 6 databases including key terms related to knowledge, experience and narratives AND mental health AND personal recovery. The search was supplemented with reference sourcing through gray literature, reference tracking and expert consultation. Data analysis consisted of a qualitative meta-synthesis using constant comparative methods.Results: Sixty-two studies were analyzed. A pattern emerged regarding the recovery paradigms that the studies used to frame their findings. The resulting recovery framework included the domains Social recovery; Prosperity (Legal, political, and economic recovery); Individual Recovery; and Clinical Recovery Experience (SPICE). Service users' definitions of recovery tended to prioritize social aspects, particularly being accepted and connecting with others, while caregivers focused instead on clinical definitions of recovery such as symptom remission. Both groups emphasized individual aspects such as becoming self-sufficient and achieving personal goals, which was strongly linked with having economic means for independence.Conclusions: The recovery model provided by this review offers a template for further research in the field and a guide for policy and practice. Predominant definitions of recovery currently reflect understandings of mental health which focus on an individual perspective, while this review found an important emphasis on socio-political aspects. At the same time, only a small number of studies took place in low-income countries, focused on minoritized populations, or included caregivers' perspectives. These are important gaps in the literature that require further attention.Systematic Review Registration: The review protocol was registered on PROSPERO (CRD42017076450); https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=76450.

Behavioral and mental health problems in low-income children with special health care needs

2004 ◽  
Vol 18 (3) ◽  
pp. 79-87 ◽  
Author(s):  
Janie Canty-Mitchell ◽  
Joan K Austin ◽  
Kim Jaffee ◽  
Rong Amy Qi ◽  
Nancy Swigonski
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Low Income ◽  
Mental Health Problems ◽  
Special Health Care Needs ◽  
Health Care Needs ◽  
Care Needs ◽  
Special Health Care ◽  
Low Income Children ◽  
Special Health

scholarly journals Integration of mental health care into primary care

2000 ◽  
Vol 176 (6) ◽  
pp. 581-588 ◽  
Author(s):  
D. Chisholm ◽  
S. James ◽  
K. Sekar ◽  
K. Kishore Kumar ◽  
R. Srinivasa Murthy ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Mental Disorder ◽  
Mental Health Care ◽  
Low Income ◽  
Common Mental Disorder ◽  
Low Income Countries

BackgroundTargeting resources on cost-effective care strategies is important for the global mental health burden.AimsTo demonstrate cost–outcome methods in the evaluation of mental health care programmes in low-income countries.MethodFour rural populations were screened for psychiatric morbidity. Individuals with a diagnosed common mental disorder were invited to seek treatment, and assessed prospectively on symptoms, disability, quality of life and resource use.ResultsBetween 12% and 39% of the four screened populations had a diagnosable common mental disorder. In three of the four localities there were improvements over time in symptoms, disability and quality of life, while total economic costs were reduced.ConclusionEconomic analysis of mental health care in low-income countries is feasible and practicable. Our assessment of the cost-effectiveness of integrating mental health into primary care was confounded by the naturalistic study design and the low proportion of subjects using government primary health care services.

scholarly journals Stigma and discrimination limit access to mental health care

2008 ◽  
Vol 17 (1) ◽  
pp. 14-19 ◽  
Author(s):  
Graham Thornicroft
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Illness ◽  
Mental Health Care ◽  
Low Income ◽  
Help Seeking ◽  
Mental Illnesses ◽  
Low Income Countries ◽  
Stigma And Discrimination ◽  
Epidemiological Surveys

AbstractThis editorial provides an overview of how far access to mental health care is limited by perceptions of stigma and anticipated discrimination. Globally over 70% of young people and adults with mental illness receive no treatment from healthcare staff. The rates of non-treatment are far higher in low income countries. Evidence from some descriptive studies and epidemiological surveys suggest that potent factors increasing the likelihood of treatment avoidance, or long delays before presenting for care include: (i) lack of knowledge about the features and treatability of mental illnesses; (ii) ignorance about how to access assessment and treatment; (iii) prejudice against people who have mental illness, and (iv) expectations of discrimination against people who have a diagnosis of mental illness. The associations between low rates of help seeking, and stigma and discrimination are as yet poorly understood and require more careful characterisation and analysis, providing the platform for more effective action to ensure that a greater proportion of people with mental illness are effectively treated in future.

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