scholarly journals Addressing the gaps in mental health care for internally displaced persons

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Sandeep R Sabhlok ◽  
Vivian Pender ◽  
Elizabeth Mauer ◽  
Michael S Lipnick ◽  
Gunisha Kaur
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Internally Displaced Persons ◽  
Displaced Persons ◽  
Internally Displaced

scholarly journals Mental health care utilisation among internally displaced persons in Ukraine: results from a nation-wide survey

2017 ◽  
Vol 28 (1) ◽  
pp. 100-111 ◽  
Author(s):  
B. Roberts ◽  
N. Makhashvili ◽  
J. Javakhishvili ◽  
A. Karachevskyy ◽  
N. Kharchenko ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Multivariate Regression ◽  
Health Care Utilisation ◽  
Internally Displaced Persons ◽  
Displaced Persons ◽  
Treatment Gap ◽  
Internally Displaced ◽  
Care Utilisation

AimsThere are an estimated 1.5 million internally displaced persons (IDPs) in Ukraine because of the armed conflict in the east of the country. The aim of this paper is to examine utilisation patterns of mental health and psychosocial support (MHPSS) care among IDPs in Ukraine.MethodsA cross-sectional survey design was used. Data were collected from 2203 adult IDPs throughout Ukraine between March and May 2016. Data on mental health care utilisation were collected, along with outcomes including post-traumatic stress disorder (PTSD), depression and anxiety. Descriptive and multivariate regression analyses were used.ResultsPTSD prevalence was 32%, depression prevalence was 22%, and anxiety prevalence was 17%. Among those that likely required care (screened positive with one of the three disorders, and also self-reporting a problem) there was a large treatment gap, with 74% of respondents who likely required MHPSS care over the past 12 months not receiving it. For the 26% (N = 180) that had sought care, the most common sources of services/support were pharmacies, family or district doctor/paramedic (feldsher), neurologist at a polyclinic, internist/neurologist at a general hospital, psychologists visiting communities, and non-governmental organisations/volunteer mental health/psychosocial centres. Of the 180 respondents who did seek care, 163 could recall whether they had to pay for their care. Of these 163 respondents, 72 (44%) recalled paying for the care they received despite government care officially being free in Ukraine. The average costs they paid for care was US$107 over the previous 12 months. All 180 respondents reported having to pay for medicines and the average costs for medicines was US$109 over the previous 12 months. Among the 74% had not sought care despite likely needing it; the principal reasons for not seeking care were: thought that they would get better by using their own medications, could not afford to pay for health services or medications, no awareness of where to receive help, poor understanding by health care providers, poor quality of services, and stigma/embarrassment. The findings from multivariate regression analysis show the significant influence of a poor household economic situation on not accessing care.ConclusionsThe study highlights a high burden of mental disorders and large MHPSS treatment gap among IDPs in Ukraine. The findings support the need for a scaled-up, comprehensive and trauma-informed response to provision of MHPSS care of IDPs in Ukraine alongside broader health system strengthening.

scholarly journals Psychotherapy in the Kurdistan region of Iraq (KRI): Preferences and expectations of the Kurdish host community, internally displaced- and Syrian refugee community

2021 ◽  
pp. 002076402199521
Author(s):  
Kerem Böge ◽  
Eric Hahn ◽  
Judith Strasser ◽  
Stephanie Schweininger ◽  
Malek Bajbouj ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Patient Satisfaction ◽  
Mental Health Care ◽  
Host Community ◽  
Internally Displaced Persons ◽  
Syrian Refugees ◽  
Displaced Persons ◽  
Internally Displaced ◽  
Satisfaction With Services

Background and Aim: The Kurdish Region of Iraq (KRI) is home to Kurds, internally displaced persons, and Syrian refugees. In the last decades, its inhabitants have witnessed a great deal of political instability, which has led to increased rates of psychological distress. Mental illness contrasts with limited access to and availability of mental health services – and so the treatment gap remains high. This study aims to investigate the perspectives, perceptions, and expectations of Syrian refugees, internally displaced persons and KRI host community members concerning mental health care in the governorate of Duhok. Attitudes and perspectives regarding psychotherapy, such as satisfaction with services, effects of therapy, bias toward therapy, and stigma, are explored. Methods: One hundred one participants were recruited from hospitals, clinical settings, and institutions from the governorate of Duhok in the KRI. Participants received the Patient Satisfaction Questionnaire (PSQ) and were asked to evaluate services through four subscales: patient satisfaction, effects of therapy, bias toward therapy, and stigma. Results: Results revealed overall high satisfaction with services and effects of therapy. In contrast, both bias and stigma subscales were rated more ambivalently. Conclusion: Patient satisfaction is key for assessing health care quality, understanding attitudes toward therapy, and help-seeking behavior. Results offer insight for stakeholders in the psychosocial field allowing for a better understanding and improvement of availability and access to quality-driven mental health care services

Access to Mental Health Services Among Internally Displaced Persons in Ukraine: Results from a Nationwide Survey

2017 ◽  
Vol 41 (S1) ◽  
pp. S614-S614 ◽  
Author(s):  
B. Roberts ◽  
N. Makhashvili ◽  
J. Javakhishvili
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Health Services ◽  
Health Care Providers ◽  
Psychosocial Support ◽  
Emotional Problem ◽  
Internally Displaced Persons ◽  
Displaced Persons ◽  
Care Providers ◽  
Internally Displaced

BackgroundThere are an estimated 1.4 million internally displaced persons (IDPs) in Ukraine as a result of the armed conflict in Ukraine.Objectives(i) Measure the burden of key mental disorders (PTSD, depression and anxiety); (ii) examine rates of utilization of health and psychosocial support services; (iii) examine the patterns of utilisation of services.MethodsThe study used a cross-sectional survey design and was conducted throughout Ukraine between March and May 2016 with 2203 IDPs aged 18 years and over. Time-location sampling was chosen as a probabilistic sampling method. Outcome measures were the PCL-5 for PTSD, the PHQ-9 for depression and the GAD-7 for anxiety. Descriptive and multivariate regression analyses were used.ResultsOf the 2203 respondents, 703 reported experiencing a mental health or emotional problem over the previous 12 months and were also screened positive with PTSD, depression or anxiety. Of these 703, 180 had sought care (with sources of care to be given in the presentation). Therefore, 523 respondents did not seek care, equating to an overall treatment gap of 74%, (74% for PTSD, 71% for depression and 70% for anxiety). Key reasons for not utilising treatment included preferring to use their own medications (n = 176); unaffordability of health services (n = 118) or medications (n = 140); poor understanding by health care providers (n = 123); poor quality of services (n = 78) and stigma/embarrassment (n = 41).ConclusionsThe findings support the need for a scaled-up, comprehensive and trauma informed response to provision of the mental health care of IDPs in Ukraine.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Refugee mental health challenges in Africa

2007 ◽  
Vol 4 (1) ◽  
pp. 3-4
Author(s):  
Frank G. Njenga
Keyword(s):  
Mental Health ◽  
United Nations ◽  
Low Income ◽  
Low Income Countries ◽  
Internally Displaced Persons ◽  
Displaced Persons ◽  
Internally Displaced ◽  
United Nations High Commissioner ◽  
Refugee Mental Health ◽  
High Commissioner

Nearly all low-income countries are either just themselves emerging from conflict or neighbour a country that has just emerged from one. According to the Office of the United Nations High Commissioner for Refugees (http://www.unhcr.org), of the 38 million uprooted people in 2003 worldwide, Africa played host to 13 million internally displaced persons and 3.5 million refugees.

scholarly journals Mobile clinics in conflict-affected communities of North West and South West regions of Cameroon: an alternative option for differentiated delivery service for internally displaced persons during COVID-19

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Lundi-Anne Omam ◽  
Elizabeth Jarman ◽  
Wilfred Ekokobe ◽  
Agbor Evon ◽  
Esther Njomo Omam
Keyword(s):  
Health Care ◽  
Hiv Care ◽  
Internally Displaced Persons ◽  
Displaced Persons ◽  
Model Of Care ◽  
Internally Displaced ◽  
North West ◽  
Primary Health ◽  
Mobile Clinics ◽  
Living With Hiv

Abstract Introduction The guidelines for differentiated service delivery (DSD) for HIV treatment became operational in Cameroon in 2017 with the Test and Treat national strategy elaborating services that can be decentralized and task shifted at community level, but with little to no guidelines for DSD in fragile and conflict-affected settings. Since 2016, more than 680,000 Cameroonians have been internally displaced due to the conflict in the North West and South West regions (NWSW). This conflict has impacted on the health system with numerous attacks on health facilities and staff, reducing access to health care for internally displaced persons. The outbreak of COVID-19 further reduced humanitarian responses for fear of spreading COVID-19. Mobile clinics were utilized as a model of care in piloting DSD for HIV in conflict-affected settings within the COVID-19 context. Methods The HIV DSD framework was used to evaluate a project that used mobile clinics in 05 divisions across the NWSW to provide primary health care to internally displaced persons in hard-to-reach areas. These mobile clinics were operated in the COVID-19 context and integrated HIV services in the benefit package. The mobile clinics mainstreamed HIV and COVID-19 sensitization during community mobilization, HIV consultations, HIV testing and referrals, and in some cases antiretroviral (ARV) dispensation. The project ran from March to October 2020. The results from the evaluation of this model of HIV care delivery were analysed in 06 of 08 mobile clinics. Results In 07 months, a total of 14,623 persons living in conflict-affected settings were sensitized on HIV, 1979 received HIV testing from which 122 were positive and 33 placed on ARVs. 28 loss-to-follow up people living with HIV were relinked to treatment and 209 consultations for persons living with HIV were conducted. Despite the good collaboration at regional and field level, there was distrust by ARV centers for humanitarian organizations. Conclusion Mobile clinics are a model of care which could be leveraged in fragile and conflict-affected settings as an alternative model of care for HIV DSD to ensure continuum of HIV care and treatment. However this should be integrated within the benefit package of primary health care services offered by mobile clinics.

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