scholarly journals Moral Injury Related to Immigration Detention on Nauru: A Qualitative Study

2021 ◽  
Author(s):  
Sandra Passardi ◽  
Debbie Hocking ◽  
Naser Morina ◽  
Suresh Sundram ◽  
Eva Alisic
Keyword(s):  
Mental Health ◽  
Health Outcomes ◽  
Asylum Seekers ◽  
Health Impact ◽  
Moral Injury ◽  
Mental Health Outcomes ◽  
Immigration Detention ◽  
Policy Makers ◽  
Moral Frameworks ◽  
Refugees And Asylum Seekers

Background: Immigration detention is associated with detrimental mental health outcomes but little is known about the underlying psychological processes. Moral injury, the experience of transgression of moral beliefs, may play an important role. Objective: Our aim was to explore refugees’ and asylum seekers’ moral injury appraisals and associated mental health outcomes related to immigration detention on Nauru.Methods: We conducted in-depth interviews with 13 refugees and asylum seekers who had an experience of immigration detention on Nauru and lived in Australia after medical transfer. We used reflexive thematic analysis to develop themes from the data.Results: The participant statement “In my country they torture your body but in Australia they kill your mind.” conveyed key themes in our analysis. We describe 1) how participants’ home country experience and the expectation to get protection led them to seek safety in Australia; 2) how they experienced deprivation, trauma and dehumanisation after arrival, with the Australian government seen as the driving force behind these experiences; and 3) how these experiences led to feeling irreparably damaged.Conclusion: Our findings suggest that moral injury may be one of the mechanisms by which mandatory immigration detention can cause harm. Hence, refugees returned to Australia from offshore detention may benefit from interventions that specifically target moral injury. Our results highlight the potentially deleterious mental health impact of experiencing multiple subtle and substantial transgressions of one’s moral frameworks. Policy makers should incorporate moral injury considerations to prevent damaging refugee mental health.

scholarly journals 'Protection or punishment?' The implications of detention on the mental health and well-being of migrants, a review of the literature.

2020 ◽  
Author(s):  
Edward Stagg
Keyword(s):  
Mental Health ◽  
Health Outcomes ◽  
Asylum Seekers ◽  
Poor Mental Health ◽  
Mental Health Outcomes ◽  
Narrative Synthesis ◽  
Immigration Detention ◽  
The World ◽  
The Uk ◽  
The Impact

Background: The number of individuals forced to leave their home and seek asylum in other countries has risen alongside political instability, conflict and persecution in many parts of the world. These individuals are therefore extremely vulnerable. Many asylum-seekers have witnessed and experienced traumatic events that have contributed to mental illness. Detention is often used to incarcerate asylum-seekers who are waiting for asylum decisions to be made, however many are held in inadequate conditions for long periods of time. With governments using immigration detention increasingly more often, there are serious questions surrounding the impact this has on the mental health of detainees.Methods: A systematic review was undertaken using a comprehensive search strategy across six databases. Both qualitative and quantitative studies were included in the review providing that the mental health implications of immigration detention were explored or measured. Grey literature was also searched. The quality of the included studies were appraised and a narrative synthesis conducted in order to establish the main findings of the review. The results of the narrative synthesis were included in a conceptual model that explains how detention works to influence mental health. Results: 22 studies were included in the review. Six themes were identified from analysis of study findings from around the world. Five of those themes also occurred within studies conducted within the UK. In both the UK and globally: detention was associated with poor and deteriorating mental health outcomes; specific conditions inside detention centres were found to contribute to poor mental health; longer durations spent in detention were associated with poorer mental health outcomes; several negative behavioural and emotional responses to the detention experience were observed – particularly in children; the trauma of detention and mental health difficulties developed while in detention remained with individuals after release. In addition to these five themes, a higher number of relocations between detention centres contributed to greater mental distress among detainees outside the UK.Conclusions: This review provides evidence to suggest that an association exists between immigration detention and poor mental health outcomes and that many of the mediators of this relationship are universal. The findings of this paper have several implications for further research and policy. The UK must end indefinite detention and move towards alternative solutions for dealing with asylum-seekers. Detention should only be used as a last resort. Vulnerable individuals, such as children and individuals with existing mental health issues should never be detained. Finally, greater care should be taken to ensure that families with young children are not separated from one-another. Due to the implications of the findings included in this review, it is vital that scientific research of this type is allowed to continue. Future research must evaluate the feasibility and suitability of alternative policies to detention.

scholarly journals A Scoping Review and Conceptual Model of Social Participation and Mental Health among Refugees and Asylum Seekers

2019 ◽  
Vol 16 (20) ◽  
pp. 4027 ◽  
Author(s):  
Maria Niemi ◽  
Hélio Manhica ◽  
David Gunnarsson ◽  
Göran Ståhle ◽  
Sofia Larsson ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Outcomes ◽  
Social Participation ◽  
Scoping Review ◽  
Asylum Seekers ◽  
Protective Factor ◽  
Well Being ◽  
Social Structures ◽  
Mental Health Outcomes ◽  
Refugees And Asylum Seekers

Social participation plays a key role in the integration of refugees and asylum seekers into their host societies, and is also closely tied to the mental health of those populations. The aim of this scoping review was to study how the concept of social participation is described in empirical research, and how it is associated with mental health outcomes. Methods: In total, 64 studies were identified through searches in PubMed, PsycInfo, and Sociological Abstracts. These studies describe various forms of social participation among refugees and asylum seekers, and 33 of them also addressed various forms of mental health outcomes. Results: The identified studies described forms and conditions of social participation—both in the host country and transnationally—that could be synthesized into three broad dimensions: (1) Regulatory frameworks, conditions and initiatives; (2) Established societal organizations and social structures; and (3) Community organized groups. Each of these consisted of several sub-domains. The identified dimensions of social participation were also associated with psychosocial well-being and decreased psychological distress. Conclusions: There is a need for policies to enable and support the participation of refugees and asylum seekers in various dimensions of social structures in host societies. Social participation enhances resilience, re-establishes social lives, and acts as a protective factor against poor mental health outcomes.

Health Impact of Interpersonal Violence 2: Medical and Mental Health Outcomes

1997 ◽  
Vol 23 (2) ◽  
pp. 65-78 ◽  
Author(s):  
Heidi S. Resnick ◽  
Ron Acierno ◽  
Dean G. Kilpatrick
Keyword(s):  
Mental Health ◽  
Health Outcomes ◽  
Interpersonal Violence ◽  
Health Impact ◽  
Mental Health Outcomes

scholarly journals Mental health services designed for Black, Asian and Minority Ethnics (BAME) in the UK: a scoping review of case studies

2020 ◽  
Vol 24 (2) ◽  
pp. 81-95
Author(s):  
Mariam Vahdaninia ◽  
Bibha Simkhada ◽  
Edwin van Teijlingen ◽  
Hannah Blunt ◽  
Alan Mercel-Sanca
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Health Outcomes ◽  
Scoping Review ◽  
Asylum Seekers ◽  
Mental Health Outcomes ◽  
Content Type ◽  
The Past ◽  
The Uk

Purpose Mental health disparities exist among Black, Asian and Minority Ethnics (BAME) populations. This paper aims to provide an overview of mental health services designed for the BAME population in the UK, both established BAME communities and refugee/asylum-seekers. Design/methodology/approach A range of electronic databases were searched for peer-reviewed studies conducted within the past decade in the UK. Using the Arksey and O’Malley methodology, data were extracted, analysed and summarised. Findings A total of 13 papers were identified, mostly non-randomised community-based. Studies were very heterogeneous in terms of their sample and service provided. After the initial appraisal, the authors presented a narrative synthesis. Overall, all studies reported positive mental health outcomes and beneficial effects. Research limitations/implications Because of the time limitations and quality of the papers, the authors only included peer-reviewed journal papers. Practical implications Mental health services provided for BAME people, both established and refugee/asylum-seekers are feasible and improve engagement with the services and mental health outcomes. Initiatives are required to facilitate the integration of these targeted services within mental health and community services for BAME in the UK. Originality/value This scoping review is a snapshot of the mental health services designed for BAME people in the UK, either established or refugee/asylum-seekers in the past 10 years and adds to the evidence-based knowledge from these studies.

scholarly journals O5C.3 The mental health impact of deployment to iraq and afghanistan: what does the current data show?

2019 ◽  
Vol 76 (Suppl 1) ◽  
pp. A46.1-A46
Author(s):  
Sharon Stevelink ◽  
Margaret Jones ◽  
Lisa Hull ◽  
David Pernet ◽  
Shirlee MacCrimmon ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Disorders ◽  
Health Outcomes ◽  
Alcohol Misuse ◽  
Common Mental Disorders ◽  
Health Impact ◽  
Current Data ◽  
Mental Health Outcomes ◽  
The Uk ◽  
The Impact

The longer term mental health outcomes of UK serving and ex-serving personnel have been the subject of much speculation. The latest research findings from the third phase of a longitudinal study will be presented, which is the only military cohort study of its kind in the UK. Data was collected among 8093 personnel between 2014 and 2016. The study examined the prevalence of mental disorders and alcohol misuse, whether rates differed between serving and ex-serving regular personnel and the impact of various deployment exposures. The prevalence of probable posttraumatic stress disorder was 6.2% (95% confidence interval (CI) 5.5–6.9), 21.9% (95% CI 20.8–23.0) for common mental disorders and 10.0% (95% CI 9.2–10.9) for alcohol misuse. Deployment to Iraq or Afghanistan and self-reported role during deployment were associated with significantly worse mental health outcomes and alcohol misuse in ex-serving regular personnel but not in currently serving regular personnel. There was no association with number of deployments for any outcome. The findings highlight the importance of the continued monitoring of following personnel throughout their military career and beyond. The implications of the study outcomes will be discussed in the light of the mental health provision for serving and ex-serving personnel.

scholarly journals History for some or lesson for all? A systematic review and meta-analysis on the immediate and long-term mental health impact of the 2002–2003 Severe Acute Respiratory Syndrome (SARS) outbreak

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Steven W. H. Chau ◽  
Oscar W. H. Wong ◽  
Rema Ramakrishnan ◽  
Sandra S. M. Chan ◽  
Evelyn K. Y. Wong ◽  
...  
Keyword(s):  
Mental Health ◽  
Risk Factors ◽  
Health Outcomes ◽  
General Public ◽  
Healthcare Workers ◽  
Meta Analysis ◽  
Health Impact ◽  
Mental Health Outcomes ◽  
Post Discharge

Abstract Background The aims of this systematic review and meta-analysis are to examine the prevalence of adverse mental health outcomes, both short-term and long-term, among SARS patients, healthcare workers and the general public of SARS-affected regions, and to examine the protective and risk factors associated with these mental health outcomes. Methods We conducted a systematic search of the literature using databases such as Medline, Pubmed, Embase, PsycInfo, Web of Science Core Collection, CNKI, the National Central Library Online Catalog and dissertation databases to identify studies in the English or Chinese language published between January 2003 to May 2020 which reported psychological distress and mental health morbidities among SARS patients, healthcare workers, and the general public in regions with major SARS outbreaks. Results The literature search yielded 6984 titles. Screening resulted in 80 papers for the review, 35 of which were included in the meta-analysis. The prevalence of post-recovery probable or clinician-diagnosed anxiety disorder, depressive disorder, and post-traumatic stress disorder (PTSD) among SARS survivors were 19, 20 and 28%, respectively. The prevalence of these outcomes among studies conducted within and beyond 6 months post-discharge was not significantly different. Certain aspects of mental health-related quality of life measures among SARS survivors remained impaired beyond 6 months post-discharge. The prevalence of probable depressive disorder and PTSD among healthcare workers post-SARS were 12 and 11%, respectively. The general public had increased anxiety levels during SARS, but whether there was a clinically significant population-wide mental health impact remained inconclusive. Narrative synthesis revealed occupational exposure to SARS patients and perceived stigmatisation to be risk factors for adverse mental health outcomes among healthcare workers, although causality could not be determined due to the limitations of the studies. Conclusions The chronicity of psychiatric morbidities among SARS survivors should alert us to the potential long-term mental health complications of covid-19 patients. Healthcare workers working in high-risk venues should be given adequate mental health support. Stigmatisation against patients and healthcare workers should be explored and addressed. The significant risk of bias and high degree of heterogeneity among included studies limited the certainty of the body of evidence of the review.

scholarly journals The mental health impact of the covid-19 pandemic on healthcare workers, and interventions to help them: a rapid systematic review

2020 ◽  
Author(s):  
Ashley Elizabeth Muller ◽  
Elisabet Vivianne Hafstad ◽  
Jan Peter William Himmels ◽  
Geir Smedslund ◽  
Signe Flottorp ◽  
...  
Keyword(s):  
Mental Health ◽  
Social Support ◽  
Systematic Review ◽  
Health Outcomes ◽  
Healthcare Workers ◽  
Mental Health Problems ◽  
Health Impact ◽  
Health Problems ◽  
Mental Health Outcomes ◽  
Sleeping Problems

Background: The covid-19 pandemic has heavily burdened, and in some cases overwhelmed, healthcare systems throughout the world. Healthcare workers are not only at heightened risk of infection, but also of adverse mental health outcomes. Identification of organizational, collegial and individual risk and resilience factors impacting the mental health of healthcare workers are needed to inform preparedness planning and sustainable response. Methods: We performed a rapid systematic review to identify, assess and summarize available research on the mental health impact of the covid-19 pandemic on healthcare workers. On 11 May 2020, we utilized the Norwegian Institute of Public Health's Live map of covid-19 evidence, the visualization of a database of 20,738 screened studies, to identify studies for inclusion. We included studies reporting on any type of mental health outcome in any type of healthcare workers during the pandemic. We described interventions reported by the studies, and narratively summarized mental health-related outcomes, as study heterogeneity precluded meta-analysis. We assessed study quality using design-specific instruments. Results: We included 59 studies, reporting on a total of 54,707 healthcare workers. The prevalence of general psychological distress across the studies ranged from 7-97% (median 37%), anxiety 9-90% (median 24%), depression 5-51% (median 21%), and sleeping problems 34-65% (median 37%). Seven studies reported on implementing mental health interventions, and most focused on individual symptom reduction, but none reported on effects of the interventions. In most studies, healthcare workers reported low interest in and use of professional help, and greater reliance on social support and contact with family and friends. Exposure to covid-19 was the most commonly reported correlate of mental health problems, followed by female gender, and worry about infection or about infecting others. Social support correlated with less mental health problems. Discussion: Healthcare workers in a variety of fields, positions, and exposure risks are reporting anxiety, depression, sleep problems, and distress during the covid-19 pandemic, but most studies do not report comparative data on mental health symptoms. before the pandemic. There seems to be a mismatch between risk factors for adverse mental health outcomes among healthcare workers in the current pandemic and their needs and preferences, and the individual psychopathology focus of current interventions. Efforts to help healthcare workers sustain healthy relationships to colleagues, family and friends over time may be paramount to safeguard what is already an important source of support during the prolonged crisis. Expanding interventions' focus to incorporate organizational, collegial and family factors to support healthcare workers responding to the pandemic could improve acceptability and efficacy of interventions. Other: The protocol for this review is available online. No funding was received.

scholarly journals Occupational moral injury and mental health: systematic review and meta-analysis

2018 ◽  
Vol 212 (6) ◽  
pp. 339-346 ◽  
Author(s):  
Victoria Williamson ◽  
Sharon A.M. Stevelink ◽  
Neil Greenberg
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Health Outcomes ◽  
Meta Analysis ◽  
Mental Health Disorders ◽  
Moral Injury ◽  
Mental Health Outcomes ◽  
Measurement Tool ◽  
Post Traumatic Stress ◽  
Health Disorders

BackgroundMany people confront potentially morally injurious experiences (PMIEs) in the course of their work which can violate deeply held moral values or beliefs, putting them at risk for psychological difficulties (e.g. post-traumatic stress disorder (PTSD), depression, etc.).AimsWe aimed to assess the effect of moral injury on mental health outcomes.MethodWe conducted a systematic review and meta-analysis to assess the association between work-related PMIEs and mental health disorders. Studies were independently assessed for methodological quality and potential moderator variables, including participant age, gender and PMIE factors, were also examined.ResultsThirteen studies were included, representing 6373 participants. PMIEs accounted for 9.4% of the variance in PTSD, 5.2% of the variance in depression and 2.0% of the variance in suicidality. PMIEs were associated with more symptoms of anxiety and behavioural problems (e.g. hostility), although this relationship was not consistently significant. Moderator analyses indicated that methodological factors (e.g. PMIE measurement tool), demographic characteristics and PMIE variables (e.g. militaryv.non-military context) did not affect the association between a PMIE and mental health outcomes.ConclusionsMost studies examined occupational PMIEs in military samples and additional studies investigating the effect of PMIEs on civilians are needed. Given the limited number of high-quality studies available, only tentative conclusions about the association between exposure to PMIEs and mental health disorders can be made.Declaration of interestNone.

scholarly journals Mental Health of Keyworkers in the UK during the COVID-19 Pandemic: a Cross-sectional Analysis of a Community Cohort

2020 ◽  
Author(s):  
Kieran Ayling ◽  
Ru Jia ◽  
Trudie Chalder ◽  
Adam Massey ◽  
Elizabeth Broadbent ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Outcomes ◽  
Psychological Factors ◽  
Health Impact ◽  
Mental Health Outcomes ◽  
Cross Sectional ◽  
Cross Sectional Analysis ◽  
Health And Social Care ◽  
The Uk ◽  
Sectional Analysis

AbstractObjectivesPrevious pandemics have resulted in high levels of psychological morbidity among frontline workers. Here we report on the early mental health impact of the COVID-19 pandemic on keyworkers in the UK, as assessed during the first six weeks of nationwide social distancing measures being introduced. Comparisons are made with non-keyworkers, and psychological factors that may be protective to keyworkers’ mental health are explored.DesignCross-sectional analysis of a community cohort study.MethodsDuring April 2020, keyworkers (n=1559) and non-keyworkers (n=1436) completed online measures of depression, anxiety, and stress levels as well as explanatory demographic and psychological factors hypothesised to be related to these mental health outcomes.ResultsKeyworkers reported significantly higher depression, anxiety, and stress than pre-pandemic population norms. Compared to non-keyworkers, keyworkers were more likely to worry about COVID-19 and perceived they were at higher risk from the virus. This was particularly evident for health and social care keyworkers. Younger keyworkers and those in a clinically increased risk group were more likely to report poorer mental health. Lower positive mood, greater loneliness and worrying more about COVID-19 were all associated with poorer mental health outcomes amongst keyworkers.ConclusionsThe mental health impact of the COVID-19 pandemic on keyworkers in the UK has been substantial. Worry about COVID-19 and perceived risk from COVID-19 in keyworkers are understandable given potential increased exposure to the virus. Younger and clinically vulnerable keyworkers may benefit most from any interventions that seek to mitigate the negative mental health impacts of the pandemic.

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