ABSTRACT
Refugees and asylum seekers often face delayed mental health diagnoses, treatment, and care. COVID-19 has exacerbated these issues. Delays in diagnosis and care can reduce the impact of resettlement services and may lead to poor long-term outcomes. This scoping review aims to characterize studies that report on mental health screening for resettling refugees and asylum seekers pre-departure and post-arrival to a resettlement state. We systematically searched six bibliographic databases for articles published between 1995 and 2020 and conducted a grey literature search. We included publications that evaluated early mental health screening approaches for refugees of all ages. Our search identified 25,862 citations and 70 met the full eligibility criteria. We included 45 publications that described mental health screening programs, 25 screening tool validation studies, and we characterized 85 mental health screening tools. Two grey literature reports described pre-departure mental health screening. Among the included publications, three reported on two programs for women, 11 reported on programs for children and adolescents, and four reported on approaches for survivors of torture. Programs most frequently screened for overall mental health, PTSD, and depression. Important considerations that emerged from the literature include cultural and psychological safety to prevent re-traumatization and digital tools to offer more private and accessible self-assessments.
Subject(s)
COVID-19 , Refugees , Stress Disorders, Post-Traumatic , Torture , Adolescent , COVID-19/diagnosis , COVID-19/epidemiology , Child , Female , Humans , Mental Health , Refugees/psychology , Stress Disorders, Post-Traumatic/psychology , Torture/psychologyABSTRACT
[Image omitted;see PDF] Source : Reproduction autorisée de la figure de Schwan K, Versteegh A, Perri M, Caplan R, Baig K, Dej E, et al., Huit défis clés et occasions de changement, p. 6. En ligne à : http://womenshomelessness.ca/wp-content/uploads/WG_ES1_FRENCH-1.pdf Une analyse des données du recensement canadien de 2014 a révélé que plus d’un million de femmes ont déclaré avoir été en situation d’itinérance cachée à un moment de leur vie, situation souvent associée à des expériences négatives vécues pendant l’enfance, à des réseaux sociaux faibles et à des milieux de vie comprenant diverses identités de genre 6. Dans le cadre d’une initiative plus vaste visant à élaborer des lignes directrices de pratique clinique pour offrir du soutien aux personnes itinérantes au Canada 19 20, un processus de consensus par méthode Delphi modifiée 21 a été utilisé pour s’assurer que les femmes en situation d’itinérance figurent parmi les populations prioritaires. Notre article vise à examiner les interventions fondées sur des données probantes et les pratiques exemplaires spécialement conçues pour soutenir les femmes en situation ou à risque d’itinérance, afin d’élaborer une approche plus efficace et mieux adaptée aux besoins particuliers de ces femmes.
ABSTRACT
INTRODUCTION: While much of the literature on homelessness is centred on the experience of men, women make up over one-quarter of Canada's homeless population. Research has shown that women experiencing homelessness are often hidden (i.e. provisionally housed) and have different pathways into homelessness and different needs as compared to men. The objective of this research is to identify evidence-based interventions and best practices to better support women experiencing or at risk of homelessness. METHODS: We conducted a scoping review with a gender and equity analysis. This involved searching MEDLINE, CINAHL, PsycINFO and other databases for systematic reviews and randomized trials, supplementing our search through reference scanning and grey literature, followed by a qualitative synthesis of the evidence that examined gender and equity considerations. RESULTS: Of the 4102 articles identified on homelessness interventions, only 4 systematic reviews and 9 randomized trials were exclusively conducted on women or published disaggregated data enabling a gender analysis. Interventions with the strongest evidence included post-shelter advocacy counselling for women experiencing homelessness due to intimate partner violence, as well as case management and permanent housing subsidies (e.g. tenant-based rental assistance vouchers), which were shown to reduce homelessness, food insecurity, exposure to violence and psychosocial distress, as well as promote school stability and child well-being. CONCLUSION: Much of the evidence on interventions to better support women experiencing homelessness focusses on those accessing domestic violence or family shelters. Since many more women are experiencing or at risk of hidden homelessness, population-based strategies are also needed to reduce gender inequity and exposure to violence, which are among the main structural drivers of homelessness among women.