scholarly journals Refugees, the asylum system and mental healthcare in Ireland

2016 ◽  
Vol 13 (2) ◽  
pp. 35-37 ◽  
Author(s):  
Molly O'Connell ◽  
Richard Duffy ◽  
Niall Crumlish
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Asylum Seekers ◽  
Healthcare Delivery ◽  
Mental Healthcare ◽  
Refugee Status ◽  
Current Health ◽  
Refugee Mental Health ◽  
Service Policy ◽  
Refugees And Asylum Seekers

The number of people seeking refugee status in Ireland is increasing year on year and the burden of mental illness experienced by refugees and asylum seekers is high. The College of Psychiatrists of Ireland has recommended the establishment of a number of specialist refugee mental health teams. In this paper we discuss the Irish asylum system, the Irish evidence regarding mental illness in this population, and current health service policy regarding refugee mental health. We propose a model of specialist refugee mental healthcare delivery.

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.

scholarly journals The Social Determinants of Refugee Mental Health in the Post-Migration Context: A Critical Review

2017 ◽  
Vol 63 (5) ◽  
pp. 297-303 ◽  
Author(s):  
Michaela Hynie
Keyword(s):  
Mental Health ◽  
Mental Disorders ◽  
Mental Health Professionals ◽  
Social Determinants ◽  
Critical Review ◽  
Asylum Seekers ◽  
Refugee Mental Health ◽  
Migration Trauma ◽  
Refugees And Asylum Seekers ◽  
The Impact

With the global increase in the number of refugees and asylum seekers, mental health professionals have become more aware of the need to understand and respond to the mental health needs of forced migrants. This critical review summarizes the findings of recent systematic reviews and primary research on the impact of post-migration conditions on mental disorders and PTSD among refugees and asylum seekers. Historically, the focus of mental health research and interventions with these populations has been on the impact of pre-migration trauma. Pre-migration trauma does predict mental disorders and PTSD, but the post-migration context can be an equally powerful determinant of mental health. Moreover, post-migration factors may moderate the ability of refugees to recover from pre-migration trauma. The importance of post-migration stressors to refugee mental health suggests the need for therapeutic interventions with psychosocial elements that address the broader conditions of refugee and asylum seekers’ lives. However, there are few studies of multimodal interventions with refugees, and even fewer with control conditions that allow for conclusions about their effectiveness. These findings are interpreted using a social determinants of health framework that connects the risk and protective factors in the material and social conditions of refugees’ post-migration lives to broader social, economic and political factors.

Providing Care for Migrants and Refugees

2017 ◽  
Vol 41 (S1) ◽  
pp. S35-S35
Author(s):  
M. Schouler-Ocak
Keyword(s):  
Mental Health ◽  
Healthcare System ◽  
Mental Health Professionals ◽  
Asylum Seekers ◽  
Mental Health Problems ◽  
Service Providers ◽  
Mental Healthcare ◽  
Healthcare Services ◽  
Common Mental Health Problems ◽  
Refugees And Asylum Seekers

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.

scholarly journals Multiculturalism and Compassion: Responding to Mental Health Needs Among Refugees and Asylum Seekers Comment on "A Crisis of Humanitarianism: Refugees at the Gates of Europe"

2019 ◽  
Vol 8 (12) ◽  
pp. 734-736 ◽  
Author(s):  
Emily Satinsky ◽  
Theodoros A. Filippou ◽  
Antonis A. Kousoulis
Keyword(s):  
Mental Health ◽  
Asylum Seekers ◽  
Culturally Relevant ◽  
Mental Healthcare ◽  
Service Design ◽  
Health Needs ◽  
Political Climate ◽  
Mental Health Needs ◽  
Refugees And Asylum Seekers

As Fotaki (2019) argues, the current political climate in Europe is threatening principles of humanitarianism, particularly among refugees and asylum seekers. This commentary builds on that argument, with a spotlight on mental health and culturally relevant service design. By addressing some of the barriers faced by refugees and asylum seekers in accessing mental healthcare, we can address inequalities and develop compassionate societies.

Mental health-related stigma and attitudes toward patient care among providers of mental health services in a rural Chinese county

2021 ◽  
pp. 002076402199280
Author(s):  
Yuer Deng ◽  
An-Li Wang ◽  
Rosemary Frasso ◽  
Mao-Sheng Ran ◽  
Tian-Ming Zhang ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Healthcare System ◽  
Healthcare Delivery ◽  
Healthcare Providers ◽  
Mental Healthcare ◽  
Educational Background ◽  
Mental Health Recovery ◽  
Public Health Issue ◽  
People With Mental Illness

Background and aims: The increasing prevalence of mental illness and low treatment rate presents a pressing public health issue in China. Pervasive stigma is a significant barrier to mental health recovery and community inclusion. In particular, stigmatizing or supportive attitudes held by healthcare providers could either perpetuate or mitigate self-stigma of people with mental illness. Moreover, mental health resources are unevenly distributed in China, with most of them concentrated in urban centers and provincial capitals. This study explores healthcare providers’ attitudes toward mental illness and the challenges they faced at work in a rural Chinese county. Method: Four focus groups were conducted with 36 healthcare providers from a three-tier mental healthcare system in a rural county in southwestern China. Focus group discussions were recorded and transcribed verbatim. The team employed a conventional content analysis approach for data analysis. All transcripts were double-coded by three bilingual team members who are native Chinese speakers. Coding discrepancies were resolved by consensus. Results: Healthcare providers recruited from the county, township, and village levels varied in educational background, professional qualification, and experience of working with people with mental illness. Five thematic categories identified across four groups include (1) barriers to mental healthcare delivery, (2) keys to mental health recovery, (3) providers’ attitudes toward providing care, (4) providers’ perception toward patients and family members, and (5) providers’ perception of training needs. Conclusions: This is a unique study that included healthcare providers from a three-tier healthcare system. Findings signal the importance of understanding healthcare practitioners’ experiences and views to inform the design of training initiatives in rural or low-resource communities.

scholarly journals Mental healthcare of asylum-seekers and refugees

2008 ◽  
Vol 14 (6) ◽  
pp. 452-459 ◽  
Author(s):  
Helen McColl ◽  
Kwame McKenzie ◽  
Kamaldeep Bhui
Keyword(s):  
Mental Illness ◽  
Royal College ◽  
Health Professionals ◽  
Asylum Seekers ◽  
Mental Healthcare ◽  
Position Statement ◽  
Service Development ◽  
Complex Needs ◽  
Refugees And Asylum Seekers ◽  
Asylum Seekers And Refugees

Many health professionals feel ill-equipped to deal with the complex needs of asylum-seekers and refugees. This article offers an overview of the literature, and reviews the demography, epidemiology and causes of mental illness in refugee and asylum-seeker groups. It discusses the types of service configurations and service response that would be appropriate. It highlights the findings of the Royal College of Psychiatrists' consensus team and their position statement on the treatment of refugees and asylum-seekers. It finishes with some thoughts about what clinicians can do to improve their treatment. Clearly, there is a need for more training, education and service development.

scholarly journals Creating a ‘reverse’ integrated primary and mental healthcare clinic for those with serious mental illness

2015 ◽  
Vol 17 (05) ◽  
pp. 421-427 ◽  
Author(s):  
Alexandros Maragakis ◽  
Ragavan Siddharthan ◽  
Jill RachBeisel ◽  
Cassandra Snipes
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Illness ◽  
Quality Of Care ◽  
Serious Mental Illness ◽  
Mental Healthcare ◽  
Policy Reforms ◽  
Mental Health Settings ◽  
Primary Care Practitioners

Individuals with serious mental illness (SMI) are more likely to experience preventable medical health issues, such as diabetes, hyperlipidemia, obesity, and cardiovascular disease, than the general population. To further compound this issue, these individuals are less likely to seek preventative medical care. These factors result in higher usage of expensive emergency care, lower quality of care, and lower life expectancy. This manuscript presents literature that examines the health disparities this population experiences, and barriers to accessing primary care. Through the identification of these barriers, we recommend that the field of family medicine work in collaboration with the field of mental health to implement ‘reverse’ integrated care (RIC) systems, and provide primary care services in the mental health settings. By embedding primary care practitioners in mental health settings, where individuals with SMI are more likely to present for treatment, this population may receive treatment for somatic care by experts. This not only would improve the quality of care received by patients, but would also remove the burden of managing complex somatic care from providers trained in mental health. The rationale for this RIC system, as well as training and policy reforms, are discussed.

scholarly journals The DELTA® nursing measure: Its development and testing for nursing utility

2013 ◽  
Vol 18 (1) ◽  
Author(s):  
Hendrik J. Loubser ◽  
Judith C. Bruce ◽  
Daleen Casteleijn
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Content Analysis ◽  
Health Outcomes ◽  
Mental Healthcare ◽  
Mental Health Outcomes ◽  
Psychiatric Nurses ◽  
Multidisciplinary Teams ◽  
Analysis Techniques ◽  
Care Plans

In the specialised nursing field of acute mental illness nurses expressed a need to measure and evaluate their patients’ mental-health outcomes both empirically and routinely. The aim was to develop and test a measurement tool, named the DELTA nursing measure, which could be embedded routinely into the nursing process and care plans, enabling the psychiatric nurses to score and evaluate their patients’ acute mental-health outcomes. A qualitative, exploratory study design was used to address two sequential objectives. Firstly, qualitative data that described observable behaviours in patients with acute mental illness were collected from psychiatric nurses (n = 5) who were experienced in acute mental healthcare. The data were analysed using inductive content analysis techniques to design and construct the DELTA nursing measure. In the second objective, the nursing utility of the DELTA nursing measure was studied. This was done by training and testing a new team of psychiatric nurses (n = 25) working in a 116-bed acute psychiatric hospital, in the application of the DELTA nursing measure. After 30 months a focus group (n = 6) representing this team was held to explore their perceptions and experiences of the nursing utility of the newly-developed measure. The descriptive data were analysed using deductive content analysis techniques. The outcome of the DELTA nursing measure as a routine nursing measure of acute mental illness provided good results. The nursing-utility characteristics have confirmed positive responses with regard to its acceptance, usefulness and confidence as a worthwhile tool to be used in expediting nursing services in acute mental healthcare. The positive responses to the DELTA nursing measure are noteworthy. It has the potential to add substantial value to the mental health care field in nursing by adding a measurable dimension to patient outcomes, a much needed requirement by patients, multidisciplinary teams and healthcare funders.In die gespesialiseerde verplegingsveld van akute psigiatrie het verpleegkundiges ’n behoefte uitgespreek om roetineweg pasiënte se geestesgesondheidsuitkomste empiries te meet en te evalueer. Die doel van die studie was om ’n meetinstrument, genoemd die ‘DELTA nursing measure’, te ontwikkel en toets wat ingebed kan word in die verplegingsproses en versorgingsplan en wat psigiatriese verpleegkundiges in staat kan stel om roetine-weg die pasiënte se akute geestesgesondheidsuitkomste te meet en te evalueer. ’n Kwalitatiewe, eksploratiewe studie ontwerp is gebruik om twee opeenvolgende doelwitte aan te spreek. Eerstens is kwalitatiewe data wat observeerbare gedrag in pasiënte met akute geestessiektes beskryf ingesamel van psigiatriese verpleegkundiges (n = 5) wat ervaring het in akute geestesgesondheidsorg. Die data is geanaliseer met induktiewe inhouds analiese tegnieke om die ontwerp en konstruksie van die ‘DELTA nursing measure’ te bewerkstellig. In die tweede doelwit was die ‘DELTA nursing measure’ se bruikbaarheid vir verpleging bestudeer. Om dit te doen was ’n nuwe span psigiatriese verpleegkundiges (n = 25) wat werksaam was in ’n 116-bed akute psigiatriese hospitaal opgelei en getoets in die gebruik van die ‘DELTA nursing measure’. Na 30 maande is ’n fokusgroep (n = 6) gehou wat verteenwoordigend was van die span om hulle persepsies en ervarings van die nuut-ontwikkelde meetskaal se bruikbaarheid te eksploreer. Beskrywende data is met behulp van deduktiewe inhouds tegnieke geanaliseer. Die uitkoms van die ‘DELTA nursing measure’ as ’n routine verplegingmeetskaal vir die bepaling van akuutheid in psigiatrie het baie goeie resultate opgelewer. Die bruikbaarheidseienskappe het positiewe response bevestig dat aanvaarding, betroubaarheid en vertroue bereik is en dat dit ’n nuttige instrument is om die verplegingsdiens te bevorder. Die positiewe response op die ‘DELTA nursing measure’ is merkwaardig. Dit het die potensiaal om ’n betekenisvolle bydrae te lewer tot die psigiatriese verplegingsveld omdat dit ’n meetbare dimensie toevoeg tot pasient uitkomste, ’n hoogs-benodigde vereiste van pasiënte, multidissiplinêre spanne en gesondheidsorgbefondsers.

scholarly journals Changing Approaches to Mental Healthcare in the Caribbean Conferences on Mental Health, 1957-1969

2020 ◽  
Vol 4 ◽  
Author(s):  
Deborah Toner ◽  
Clare Anderson ◽  
Shammane Joseph Jackson
Keyword(s):  
Public Health ◽  
Mental Health ◽  
Mental Illness ◽  
Mental Healthcare ◽  
Health Conditions ◽  
Late Nineteenth Century ◽  
Religious Leaders ◽  
Public Health Officials ◽  
The Caribbean ◽  
Late Nineteenth

This paper examines discussions among physicians, psychologists, public health officials, religious leaders and others who participated in the Caribbean Conferences on Mental Health between 1957 and 1969. Their discussions demonstrate major changes in the understanding of causes, definitions and appropriate treatments of mental health conditions, compared to the late nineteenth century, which saw a wave of major reforms to the management of mental illness in public asylums. Although major shifts in professional understandings of mental health were evident in the mid-twentieth century, the Caribbean Conferences on Mental Health reveal that the problems hindering the implementation of these new approaches were largely similar to those that Guyana and other Caribbean countries continue to face today.

scholarly journals Heard, known and safe in general practice? An interview study with patients with severe and persistent mental illness

BJGP Open ◽  
2021 ◽  
pp. BJGPO.2021.0201
Author(s):  
Nancy Jennifer Sturman ◽  
Ryan Williams ◽  
Marianne Wyder ◽  
Johanna Lynch
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
General Practice ◽  
Physical Health ◽  
Mental Healthcare ◽  
Health Issues ◽  
Structured Interviews ◽  
Convenience Sample ◽  
Persistent Mental Illness ◽  
Community Mental Health Clinics

BackgroundAlthough GPs provide care to many patients with severe and persistent mental illness, the role and skillset of the GP in this space are contested. Patients are less satisfied with GP care of mental health than physical health issues.AimTo explore patient expectations and experiences of GP roles in their mental health, and identify opportunities for improving mental health care in general practice.Design & settingPatient participants were recruited from community mental health clinics in Brisbane, Australia.MethodIndividual semi-structured interviews were conducted with a convenience sample of patients. Interviews were audio-recorded and transcribed professionally. The authors conducted an inductive thematic analysis, attending to participant vulnerability and reflexivity.Results16 interviews were conducted by one author (RW), average duration 29 minutes. Three overarching themes were identified: being heard; being known; and being safe. Participants greatly valued ‘good GPs’ who were able to detect early signs of relapse, and with whom they came to feel heard, known and safe over time. Experiences of perfunctory, hurried care and avoidance of mental health issues were also reported. Many participants were uncertain whether GP training in mental health was sufficient to keep them safe. Patients may suspect negative attitudes to mental illness in GPs who actively engage predominantly with their physical health.ConclusionSome GPs play central roles in patients’ mental healthcare. Barriers for others need further exploration, and may include time, confidence and/or expertise. Findings challenge GPs to engage more actively and effectively with these patients in theirgeneral practice consultations.

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