Distress and impaired functioning, coping mechanisms and barriers to access mental health services among Syrian refugees and Jordanian adults after eight years of Syrian crisis: a cross-sectional study (Preprint)

2021 ◽  
Author(s):  
Yousef Khader ◽  
Ahmad Bawaneh ◽  
Zaid Al-Hamdan

BACKGROUND The Syrian conflict started in 2011 and resulted ever since in a large displacement of Syrians. Conflict-related violence coupled with displacement related stressors such as poverty, poor access to health services, loss of family support and discrimination had a significant impact on the mental health and psychosocial wellbeing of Syrian refugee OBJECTIVE This study aimed to identify the perceived symptoms of severe distress and impaired functioning, identify coping mechanisms and identify the barriers to access mental health services among Syrian refugees and Jordanian adults. METHODS This cross-sectional study study took place in 14 randomly selected sites in Jordan where Syrian refugees are concentered and from Za’tari refugee camp. A toolkit for humanitarian settings was used for data collection. RESULTS Of the 1424 participants, 43.4% had distress; 38.9% among host population, 57.0% among refugees in urban communities, and 23.0% among refugees in camp (p <0.005). Overall, finding comfort in faith and spiritual beliefs was the most common coping mechanism reported by those who perceived to be experiencing distress. CONCLUSIONS A significant proportion of Syrian refugees had distress symptoms. It is recommended to incorporate mental health services into broad-based community settings, such as schools, primary prevention or case management programs.

2020 ◽  
Vol 66 (6) ◽  
pp. 600-606 ◽  
Author(s):  
Adalberto Campo-Arias ◽  
Guillermo A Ceballos-Ospino ◽  
Edwin Herazo

Background: Access barriers are all situations or conditions that limit seeking, receiving or enjoying benefits offered by the health system. This set of situations translates into underutilization of the services offered. In Colombia, there is little information about barriers to accessing medical care in general, and even less in the specific field of mental health. Aim: To determine the barriers to accessing psychiatric care in outpatients in Santa Marta, Colombia. Methods: The authors designed a cross-sectional study with a non-probability sample of adult patients who consulted between August and December 2018. The barriers to access were measured with a 20-item version of the Barriers to Access to Care Evaluation (BACE) scale. Results: A total of 247 patients participated; they were between 18 and 82 years (mean ( M) = 47.5, standard deviation ( SD) = 13.9). A total of 69 (27.9%) patients classified as having major attitudinal barriers; 62 (25.1%) patients, major barriers related to stigma-discrimination; and 41 (16.6%) patients, major instrumental barriers. Concerning the associated variables, age less than 45 years was related to major attitudinal barriers (odds ratio (OR) = 2.9, 95% confidence interval (CI) 1.6-5.5), major barriers related to stigma-discrimination (OR = 3.8, 95% CI 2.0-7.2) and major instrumental barriers (OR = 2.7, 95% CI 1.3-5.3). Men reported major instrumental barriers more frequently than women (OR = 2.8, 95% CI 1.3-5.8). Conclusion: The major attitudinal, related to stigma-discrimination and instrumental barriers to access frequently delay a consultation with mental health services. Actions are necessary to reduce barriers to accessing mental health care.


2021 ◽  
Author(s):  
Carlos Alberto dos Santos Treichel ◽  
Ioannis Bakolis ◽  
Rosana Teresa Onocko-Campos

Abstract Background: Although it is known that several factors may influence the access to specialized care, the factors related to the maintenance of a link with Primary Care by patients who accessed Specialized Mental Health Services (SMHS) remain unknown. The aim of this study was to evaluate the determinants of timely access to SMHS and maintenance of a link with Primary Care. Methods: This is a cross-sectional study, conducted with 341 users of SMHS at outpatient and community level in a medium-sized city in Brazil. Associations between the outcomes and the other variables were explored with the use of Poisson regression models with robust variance estimators. Results: Among the factors associated with the study outcomes, those related to the organization of services and the movement between them were noteworthy. Patients referred by Primary Care were less likely to access specialized services in a timely manner (RR: 0.61; 95% CI: 0.40, 0.93). However, the referral of cases by Primary Care (RR: 1.38; 95% CI: 1.06, 1.79) and follow-up with visits by Community Health Agents (RR: 1.26; 95% CI: 1.04, 1.53) appeared to favor maintenance of the patient-Primary Care link. Conclusion: This study reinforces the idea that integration between Primary Care and SMHS should be strengthened, both to reduce waiting times for between-service referrals and benefit continuity of care.


2021 ◽  
Author(s):  
Precious Anyanwu ◽  
Tyler J Varisco ◽  
Matthew A. Wanat ◽  
Shweta Bapat ◽  
Kasey Claborn ◽  
...  

Abstract: Aims: To compare county-level differences in the number of buprenorphine prescribers listed in the publicly available Substance Abuse and Mental Health Services Administration (SAMHSA) Buprenorphine Practitioner Locator and in the Drug Enforcement Administration’s (DEA) Controlled Substance Act (CSA) database and to determine if disparities in access exist in poorer areas with more non-white residents. Design: Cross-sectional study Setting: TexasMeasurements: County-level counts of buprenorphine prescribers were calculated from both the publicly available SAMHSA buprenorphine practitioner locator list and the DEA CSA database. These were then used to estimate the number of providers per 100,000 residents in each county. Regional variation in access to buprenorphine was compared descriptively across the state using poverty data from the US Census and county-level demography from the Texas Demographic Center. Results: This study found 68.8% more X-waivered providers on the DEA CSA database (n=2,622) with at least one provider reported in 125 of 144 counties in the state (49.2%) compared to the SAMHSA Buprenorphine Practitioner Locator (n=1,553) with at least one provider reported in 103 counties (40.5%). This difference was magnified in Texas Public Health Region 11. This is the poorest region of the state (23.7% of residents below the federal poverty line) and contains the most non-white residents 87.4% vs 54.9% (SD: 13.6%). This region had the lowest number of buprenorphine prescribers with 3.8 providers per 100,000 on the DEA CSA database and 2.5 providers per 100,000 in the SAMHSA Buprenorphine Practitioner Locator.Conclusions: The lack of a complete, public registry of buprenorphine prescribers makes it difficult for patients to identify a convenient buprenorphine prescriber and for referring physicians to help their patients access care. This may be especially true in poorer and more diverse areas with fewer buprenorphine prescribers.


Author(s):  
Carlos Alberto dos Santos Treichel ◽  
Ioannis Bakolis ◽  
Rosana Teresa Onocko-Campos

Abstract Background Although access to specialized services is one of the main components of the study of paths to mental health care worldwide, the factors related to the continuity of the patient’s link with Primary Care after admission to a Specialized Mental Health Services still need to be explored in greater depth. Thus, this study aimed to evaluate the determinants of timely access to Specialized Mental Health Services (outcome 1) and maintenance of a link with Primary Care after patients’ admission (outcome 2). Methods This is a cross-sectional study, conducted with 341 users of Specialized Mental Health Services at outpatient and community level in a medium-sized city in Brazil between August and November 2019. Associations between the outcomes and the other variables were explored with the use of Poisson regression models with robust variance estimators. Results Factors positively associated with timely access were the diagnosis of psychosis or psychoactive substance misuse. The inversely associated factors with this outcome were higher income, having their need for mental health care identified in an appointment for general complaints, having been referred to the current service by Primary Care, having attended the current service for up to 3 years and delay until the first appointment (in a previous service). Regarding the maintenance of a link with Primary Care, factors positively associated were being referred to the current service by Primary Care or private service and receiving visits from Community Health Agents. The inversely associated factors with this outcome were male sex, being employed, having a diagnosis of psychosis or psychoactive substance misuse, and a greater perception of social support. Conclusions In addition to individual factors, factors related to the organization of services and the referral between them stood out in influencing both the access and maintenance of the patients’ link with Primary Care. Thus, this study reinforces the idea that integration between Primary Care and Specialized Mental Health Services should be strengthened, both to reduce waiting times for between-service referrals and benefit of care continuity.


2007 ◽  
Vol 100 (2) ◽  
pp. 400-406 ◽  
Author(s):  
Megumi Sasaki

The present cross-sectional study assessed the attitude of Japanese undergraduates towards mental health services and investigated whether mental distress is associated with reluctance to use, and a decreased perceived need for, mental health services. A convenience sample of 194 students (98 men and 96 women) completed the 28-item Japanese version of the General Health Questionnaire and questions regarding reluctance to use and perceived need for mental health services. Participants were in the second to fourth years of undergraduate work and their majors were psychology and technology. Analyses showed that approximately 70% of students were reluctant to use mental health services and this reluctance was less in the group scoring high on anxiety and insomnia than the group scoring lower. Also, perceived need for mental health services was higher for those scoring high on depression. There were some discrepancies in the results and previous studies. Implications of these findings for clinical and preventive practice and for direction for research are discussed.


Author(s):  
Sawsan M. A. Abuhamdah ◽  
Abdallah Y. Naser ◽  
Ghada Mohammad Abdelwahab ◽  
Ahmad AlQatawneh

Objectives: To examine the prevalence of mental distress among university students in Jordan. Methods: An online cross-sectional study using a self-administered questionnaire was conducted between 12th of June and the 4th of August 2021 in Jordan to measure student mental stress using Self-Reporting Questionnaire-20 (SRQ-20). Results: A total of 1063 university students participated in the study. One-third of the participating students reported that they had a history of COVID-19 infection. More than half of the participating university students (65.7%) were found to have mental distress (measured symptomatically by the SRQ-20 with a score of eight or more). The average mental distress score was 9.8 (SD: 5.5) out of 20. Female students, students from non-medical colleges, students in their last years of study, students with chronic diseases and those with low income were associated with high levels of mental distress (p < 0.05). With regards to social support, a moderate level of social support was received from three sources: persons considered as significant others, family members, and friends. The average social support score for the participating university students was 41.9 (SD: 10.3) out of 60 (equivalent to 69.8%). Conclusions: Mental distress is prevalent among university students in Jordan. There is a need for evidence-based governmental strategies and interventions that provide social support at universities such as self-help measures and professional mental health services as part of student health services that would be helpful to reduce the burden of mental distress of students and promote the mission of the integration of mental health in all university policies.


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