Reframing resilience: Strengthening continuity of patient care to improve the mental health of immigrants and refugees

2019 ◽  
Vol 29 (1) ◽  
pp. 69-79 ◽  
Author(s):  
Lloy Wylie ◽  
Ann Marie Corrado ◽  
Nandni Edwards ◽  
Meriem Benlamri ◽  
Daniel E. Murcia Monroy
2021 ◽  
pp. 002076402110272
Author(s):  
Luciana de Andrade Carvalho ◽  
Laura Helena Andrade ◽  
Patrícia Lin Ang ◽  
Carmen Lucia Albuquerque de Santana ◽  
Francisco Lotufo Neto ◽  
...  

Background: Immigrants and refugees have specific mental health needs. Studies of immigrant/refugee psychiatric patients in Latin America are scarce. Aims: Present the profile of patients from an outpatient psychiatric service in Sao Paulo (Brazil) to better inform mental health service planning for immigrants and refugees in the Global South. Methods: Exploratory study to characterize the sociodemographic and mental health profile of refugees and immigrants attending outpatient psychiatric service from 2003 to 2018. Chi-square tests and logistic regressions were used to examine the association of demographic variables, exposure to violence, and immigrant status with psychiatric diagnosis. Cluster analysis was used to identify subgroups within the sample. Results: A total of 162 immigrants and refugees referred to the service obtained treatment. Of these patients, 57.4% were men, 59.8% were refugees/asylum seekers, 51.9% were Black, 48.8% were single, 64.2% had 10 years of education, and 57.4% were unemployed; the mean age of the sample was 35.9. Half of the sample (52.5%) was exposed to violence. The most common diagnosis was depression (54.2%), followed by PTSD (16.6%). Approximately 34% of the participants sought psychiatric care within 6 months of arrival. Logistic regressions showed that men had lower odds of presenting with depression (OR = 0.34). Patients with PTSD were more likely to be refugees (OR = 3.9) and not have a university degree (OR = 3.1). In the cluster analysis, a cluster of patients with PTSD included almost all Black refugee men exposed to violence. Most patients diagnosed with psychotic disorders were also Black refugee men. Conclusion: Immigrants and refugees represent a vulnerable group. The majority of the sample was Black, refugee men, who were also more likely to present with PTSD. Future studies are needed to better understand issues in treatment adherence in relation to socioeconomic characteristics.


2010 ◽  
Vol 34 (9) ◽  
pp. 361-363 ◽  
Author(s):  
Tom Burns

SummaryUK mental healh services have been distinguished by their continuity of care but recently there has been a move to separating consultant responsibility for in-patient and out-patient care. Local examples of the success of this approach have been published but there has been remarkably little careful thought about its longer-term impacts. International comparisons would suggest that there are significant potential disadvantages, including increased bed pressures. Some disadvantages, such as the poor fit with the Mental Health Act and patient dissatisfaction with structural discontinuity are already obvious. A more considered debate is called for.


1995 ◽  
Vol 19 (2) ◽  
pp. 106-107
Author(s):  
Rosemary Lethem

The purpose of aftercare is to enable patients to return to their home or accommodation other than a hospital or nursing home, and to minimse the need for future in-patient care. Under section 117 of the Mental Health Act 1983, local health and social services authorities have a legal duty to provide aftercare for certain categories of patients when they leave hospital (Department of Health and Welsh Office, 1993).


Author(s):  
Dr. Rita Dhungel

1026 immigrants and refugees tested positive for HIV (IRLWH) in Canada in 2018 (Haddad, et al, 2019). IRLWH experience discriminatory behaviors because of because of the immigration and HIV status; culturally appropriate supports and resources for IRLWH are lacking. Financial difficulties are experienced by many new immigrants, they may be unable to meet their health care or mental health needs, particularly if they are IRLWH (Chen et al., 2015). Language barriers, loss of social support and a lack of health coverage can impact the ability for IRLWH to access care (Rapid Response Service, 2014). There can be stigma surrounding HIV within the cultural community, impacting the level of support for IRLWH (Rapid Response Service, 2014). IRLWH experience mistreatment by service providers, lack of culturally and linguistically appropriate services, lack of awareness of local programs, unemployment and housing issues in Canada (Chen et al., 2015; Gatteri et al., 2020). To augment the limited extant knowledge on the challenges of IRLWH and based on the implications of a study that claimed the need for a further research exploring the voices of IRLWH using photovoice (Getteri, et.al., 2020), this community based photovoice study was designed with an aim to understand intersectional oppressions experienced by IRLWH across Alberta in general, with a focus on the COVID-19 pandemic in particular from determinants of health perspectives. Keywords: Immigrants and Refugees; HIV, Photovoice, Intersectional Violence, Mental Health


Author(s):  
Sofie Bäärnhielm ◽  
Mike Mösko ◽  
Aina Basilier Vaage

In this chapter, we discuss the pros and cons of separate versus integrated services for immigrants and refugees. Our discussion is based on experiences from three high-income countries: Germany, Norway, and Sweden. All three, regardless of general public insurance systems covering healthcare costs, have barriers to mental health care for migrants and refugees. Additionally, their mental health care systems are unaccustomed to responding to cultural variety in patients’ expression of distress, explanatory models of illness, consequences of pre-migratory difficulties, and post-migratory adversities. Attention to post-traumatic stress and social determinants of mental health is also restricted. To bridge barriers and improve access to mental health care for immigrants and refugees, we will comment on the importance of adapting care, training of professionals, and outreach programmes. Also emphasized is the value of culturally sensitive mental health-promoting strategies to improve mental health literacy and reduce stigma among immigrants and refugees.


Author(s):  
Sandeep Bhatti ◽  
Rachel Brown ◽  
Orla Macdonald ◽  
Dan White

The roles of the clinical pharmacists and medicines management technicians within the inpatient psychiatric setting are many and varied. This chapter explores some of these roles and examines how they enhance patient care and support the aims of mental health trusts and inpatient psychiatry. This is primarily achieved through effectively and efficiently managing medicines. The aim of the clinical pharmacy team is to promote high-quality, value-for-money care which is patient-centred and based upon improving patient outcomes. The chapter also discusses how pivotal papers and reports have shaped the services that pharmacy departments deliver to psychiatric inpatients.


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