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1.
PLoS One ; 17(2): e0261773, 2022.
Article in English | MEDLINE | ID: covidwho-1793545

ABSTRACT

PURPOSE: The COVID-19 pandemic and associated risk-mitigation strategies have altered the social contexts in which adolescents in low- and middle-income countries live. Little is known, however, about the impacts of the pandemic on displaced populations, and how those impacts differ by gender and life stage. We investigate the extent to which the pandemic has compounded pre-existing social inequalities among adolescents in Jordan, and the role support structures play in promoting resilience. METHODS: Our analysis leverages longitudinal quantitative survey data and in-depth qualitative interviews, collected before and after the onset of COVID-19, with over 3,000 Syrian refugees, stateless Palestinians and vulnerable Jordanians, living in camps, host communities and informal tented settlements. We utilize mixed-methods analysis combining multivariate regression with deductive qualitative tools to evaluate pandemic impacts and associated policy responses on adolescent wellbeing and mental health, at three and nine months after the pandemic onset. We also explore the role of support systems at individual, household, community, and policy levels. FINDINGS: We find the pandemic has resulted in severe economic and service disruptions with far-reaching and heterogenous effects on adolescent wellbeing. Nine months into the pandemic, 19.3% of adolescents in the sample presented with symptoms of moderate-to severe depression, with small signs of improvement (3.2 percentage points [pp], p<0.001). Two thirds of adolescents reported household stress had increased during the pandemic, especially for Syrian adolescents in host communities (10.7pp higher than any other group, p<0.001). Social connectedness was particularly low for girls, who were 13.4 percentage points (p<0.001) more likely than boys to have had no interaction with friends in the past 7 days. Adolescent programming shows signs of being protective, particularly for girls, who were 8.8 percentage points (p<0.01) more likely to have a trusted friend than their peers who were not participating in programming. CONCLUSIONS: Pre-existing social inequalities among refugee adolescents affected by forced displacement have been compounded during the COVID-19 pandemic, with related disruptions to services and social networks. To achieve Sustainable Development Goal targets to support healthy and empowered development in adolescence and early adulthood requires interventions that target the urgent needs of the most vulnerable adolescents while addressing population-level root causes and determinants of psychosocial wellbeing and resilience for all adolescent girls and boys.


Subject(s)
Adolescent Health/trends , COVID-19/psychology , Refugees/psychology , Adolescent , Child , Female , Humans , Jordan/epidemiology , Male , Mental Health , Pandemics , Psychology , SARS-CoV-2/pathogenicity , Social Environment , Socioeconomic Factors , Young Adult
2.
Front Public Health ; 9: 576481, 2021.
Article in English | MEDLINE | ID: covidwho-1760272

ABSTRACT

Introduction: Forcibly displaced people are at particular risk of mental health problems and also face specific integration challenges upon resettlement. Existing literature suggests that there may be a bidirectional relationship between mental health and integration. The present study seeks to understand the relationship between integration processes and mental health problems or significant negative emotional experiences among adult refugees in Germany. Method: Applying a qualitative approach, we conducted 54 semi-structured interviews with refugees and asylum seekers who arrived in Germany between 2013 and 2018 currently residing in Berlin, Leipzig, or the Duisburg area in North Rhine-Westphalia. Data was collected between December 2018 and September 2019. We analyzed transcripts inductively using thematic analysis. Results: Five themes covering the various links between integration and mental health problems or significant negative emotional experiences were identified. First, we found that the mental health consequences of past adverse experiences, as well as ongoing worries about those left behind in the homeland, can seriously impede refugees' ability to pursue activities key to integration. Second, the process of applying for and securing asylum can result in uncertainty and fear, which, in turn, burden the individual and may impact motivation for integration. Third, many of our participants described mental health ramifications related to feeling stuck and thwarted in the pursuit of building a life, especially in securing employment. Fourth, some participants described feeling so overwhelmed by fundamental tasks throughout the integration process, namely, language learning and bureaucratic processes, that these take a psychological toll. Fifth, we identified several forms of social disconnection between refugees and members of the host community due to xenophobia, social and cultural differences, physical and emotional isolation in refugee camps, as well as with co-nationals and fellow refugees. Negative emotions, mistrust, and socio-cultural differences that emerge throughout the integration processes seem to erode social cohesion among refugee communities, potentially further threatening mental health. Conclusion: Mental health problems and integration processes appear to be closely related across different areas of integration. Innovative solutions to challenges identified by members of the refugee community in Germany stand to benefit mental health and integration outcomes simultaneously.


Subject(s)
Mental Health , Refugees , Adult , Germany , Humans , Refugee Camps , Refugees/psychology
3.
Int J Environ Res Public Health ; 19(6)2022 03 16.
Article in English | MEDLINE | ID: covidwho-1742480

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/psychology
4.
Int J Environ Res Public Health ; 19(3)2022 02 08.
Article in English | MEDLINE | ID: covidwho-1686761

ABSTRACT

The current longitudinal study sought to identify predictors of professional help seeking for mental health problems amongst Afghan and Iraqi refugees five years post-settlement utilising the Building a New Life in Australia dataset (BNLA). Data were collected via face-to-face or phone interviews across five waves from October 2013 to March 2018. Afghan and Iraqi born refugees numbering 1180 and over 18 years of age with a permanent humanitarian visa were included in this study. The results suggest differences in help-seeking behaviors amongst the two ethnic groups. Amongst the Afghan sample, older adults with high psychological distress were more likely to seek help, while living in regional Australia, not requiring interpreters, and knowing how to find out information about government services were related to lower likelihood of help-seeking. Within the Iraqi sample, poor overall health and knowing how to find out about services were related to a greater likelihood of help-seeking, while fewer financial hardships decreased the likelihood of help-seeking. Amongst those with probable PTSD, disability was associated with an increased likelihood of help-seeking while experiencing fewer financial hardships and living in regional Australia resulted in a lower likelihood of help-seeking in this group. These results have implications for promotional material and mental health interventions, suggesting that more integrated services tailored to specific characteristics of ethnic groups are needed.


Subject(s)
Refugees , Stress Disorders, Post-Traumatic , Adolescent , Adult , Aged , Australia , Female , Humans , Longitudinal Studies , Mental Health , Refugees/psychology , Stress Disorders, Post-Traumatic/psychology
5.
PLoS One ; 16(12): e0261359, 2021.
Article in English | MEDLINE | ID: covidwho-1581748

ABSTRACT

BACKGROUND: Refugees are at increased risk for COVID-19 infection in part due to their living conditions, which make it harder to adopt and adhere to widely accepted preventive measures. Little empirical evidence exists about what refugees know about COVID-19 and what they do to prevent infection. This study explored what refugee women and their health care workers understand about COVID-19 prevention, the extent of their compliance to public health recommendations, and what influences the adoption of these measures. METHODS: In October 2020, we conducted 25 in-depth interviews with facility and community health care staff (n = 10) and refugee women attending antenatal and postnatal care services (n = 15) in Eastleigh, Nairobi. FINDINGS: While researchers found a high level of awareness about COVID-19 and related prevention and control measures among refugee women, various barriers affected compliance with such measures, due in part to poverty and in part to rampant misconceptions informed by religious beliefs and political narratives about the virus. CONCLUSIONS: These findings indicated that Kenya's Ministry of Health needs to institute a concerted and continuous education program to bring refugee communities up to speed about COVID-19 and its prevention. In addition to disseminating information about the need to wear masks and repeatedly wash hands, supplies-masks, soap and access to water-need to be made available to poor refugee communities. Future research could explore which measures for disseminating factual information work best in refugee populations with different cultural norms and how best to target interventions to these groups.


Subject(s)
COVID-19/prevention & control , Health Knowledge, Attitudes, Practice/ethnology , Refugees/psychology , Adult , COVID-19/psychology , Female , Health Personnel , Humans , Kenya/epidemiology , Middle Aged , Pandemics/prevention & control , Patient Compliance/psychology , Public Health , Qualitative Research , SARS-CoV-2/pathogenicity , Surveys and Questionnaires
6.
Eur J Psychotraumatol ; 12(1): 1997173, 2021.
Article in English | MEDLINE | ID: covidwho-1537454

ABSTRACT

Background: Refugees may be especially vulnerable to the adverse effects of COVID-19. Therefore it is critical that refugee communities are supported to access COVID-19 vaccines and for public health responses to address vaccine hesitancy. Objective: To investigate the key demographic factors, barriers and attitudes associated with vaccine hesitancy in a community sample of refugees. Method: Participants in the Refugee Adjustment Study, a cohort of refugees living in Australia, were invited to complete a survey about their COVID-19 vaccine intentions, barriers to access and attitudes relating to the vaccine. Results: Of the 516 participants, 88% were unvaccinated and 28.1% were classed as vaccine hesitant. Key predictors of vaccine hesitancy were younger age, information and trust barriers, lower logistical barriers, and attitudes relating to low control and risk posed by COVID-19. Conclusions: Findings suggest that public health strategies need to address trust, control and risk perception attitudes to increase COVID-19 vaccine uptake in resettled refugee communities.


Antecedentes: Los refugiados pueden ser especialmente vulnerables a los efectos adversos del COVID-19. Por lo tanto, es fundamental que las comunidades de refugiados reciban apoyo para acceder a las vacunas COVID-19 y para que las respuestas de salud pública aborden la indecisión ante las vacunas.Objetivo: Investigar los factores demográficos clave, las barreras y las actitudes asociadas con la indecisión ante las vacunas en una muestra comunitaria de refugiados.Método: Se invitó a los participantes en el Estudio de Adaptación de Refugiados, una cohorte de refugiados que viven en Australia, a completar una encuesta sobre sus intenciones de vacunarse contra el COVID-19, barreras de acceso y actitudes relacionadas con la vacuna.Resultados: De los 516 participantes, el 88% no estaban vacunados y el 28,1% se clasificaron como reacios a vacunarse. Los predictores clave de la vacilación a la vacuna fueron menor edad, las barreras en información y confianza, menores barreras logísticas y las actitudes relacionadas con bajo control y el riesgo que plantea el COVID-19.Conclusiones: Los hallazgos sugieren que las estrategias de salud pública deben abordar las actitudes de confianza, control y percepción del riesgo para aumentar la aceptación de la vacuna COVID-19 en las comunidades de refugiados reasentados.


Subject(s)
COVID-19 Vaccines , Refugees/psychology , /psychology , Adult , Australia , COVID-19/epidemiology , COVID-19/prevention & control , Cohort Studies , Cross-Sectional Studies , Female , Humans , Intention , Male , Refugees/statistics & numerical data , SARS-CoV-2 , Surveys and Questionnaires , Trust , Vaccination/statistics & numerical data , /statistics & numerical data
7.
Eur J Psychotraumatol ; 12(1): 1991651, 2021.
Article in English | MEDLINE | ID: covidwho-1510838

ABSTRACT

Background: The COVID-19 pandemic has resulted in increased anxiety and depression around the world. Refugees may be particularly vulnerable to the mental health effects of the pandemic because of their higher rates of mental health disorders, trauma histories, and daily stressors. Objectives: This study used data from a controlled trial of a brief behavioural intervention for psychological distress in Syrian refugees living in Azraq Camp in Jordan to examine the psychological effects of the pandemic on refugee mental health. Method: A total of 410 participants were randomized to either the intervention or control arms of the trial and were assessed at baseline and 3-month follow-up. Half the sample (199; 48.5%) completed their 3-month follow-up assessment after the pandemic restrictions began in Jordan and 211 (51.5%) completed the assessment prior to the pandemic. Refugees were independently assessed for symptoms of PTSD, anxiety, and depression at baseline and follow-up, and pandemic-related worries were assessed at follow-up for those who completed their assessment during the pandemic. Results: The most commonly reported worries were economic difficulties (82.4%), shortage of essential supplies (71.3%), and infecting others (59.7%) or themselves (51.9%). Refugees who were assessed during the pandemic had less severe PTSD symptoms than those assessed prior to the pandemic. Significant predictors of pandemic-related worries were lower levels of depression prior to the pandemic and greater anxiety during the pandemic. Conclusion: These findings highlight the specific needs of refugees during the pandemic and suggest that pre-existing mental health issues may not necessarily be the key risk factors for who will experience major mental health issues or worries during the pandemic.


Antecedentes: La ansiedad y la depresión alrededor del mundo se han incrementado como consecuencia de la pandemia por la COVID-19. Los refugiados pueden ser particularmente vulnerables a los efectos de la pandemia sobre la salud mental a sus tasas más altas de trastornos de salud mental, de antecedentes de trauma y de estresores diarios.Objetivos: Este estudio empleó los datos del ensayo controlado de una intervención conductual breve para la angustia psicológica en refugiados sirios que vivían en el campo Azraq en Jordania. Se buscó evaluar los efectos psicológicos de la pandemia sobre la salud mental de los refugiados.Método: Un total de 410 participantes fueron asignados aleatoriamente, bien al grupo de intervención o bien al grupo de control del ensayo, y fueron evaluados al inicio y a los 3 meses de seguimiento. La mitad de la muestra (199; 48,5%) completó la evaluación a los 3 meses de seguimiento después de que comenzaran las restricciones de la pandemia en Jordania, mientras que 211 (51,5%) completaron esta evaluación antes de la pandemia. Los refugiados fueron evaluados de forma independiente para detectar síntomas del TEPT, de la ansiedad y de la depresión al inicio y en el seguimiento. Las preocupaciones relacionadas a la pandemia se evaluaron durante el seguimiento en aquellos que completaron su evaluación durante la pandemia.Resultados: Las preocupaciones más comúnmente reportadas fueron las dificultades económicas (82,4%), la escasez de suministros esenciales (71,3%) y la infección de otros (59,7%) o de ellos mismos (51,9%). Los refugiados que fueron evaluados durante la pandemia tenían síntomas de TEPT menos severos que aquellos que fueron evaluados antes de la pandemia. Los predictores significativos de las preocupaciones relacionados con la pandemia fueron niveles más bajos de depresión antes de la pandemia y mayor ansiedad durante la pandemia.Conclusiones: Estos hallazgos destacan las necesidades especificas de los refugiados durante la pandemia y sugieren que los problemas de salud mental preexistentes no necesariamente pueden ser los factores de riesgo clave para aquellos que experimentarán los principales problemas de salud mental o preocupaciones durante la pandemia.


Subject(s)
COVID-19 , Mental Health , Psychotherapy, Group , Refugees , Adult , Anxiety/epidemiology , Depression/epidemiology , Humans , Jordan/epidemiology , Psychological Distress , Refugees/psychology , Refugees/statistics & numerical data , Stress Disorders, Post-Traumatic , Syria/ethnology
8.
Health Educ Behav ; 49(1): 17-25, 2022 02.
Article in English | MEDLINE | ID: covidwho-1463167

ABSTRACT

Refugee children are less likely than their non-refugee peers to receive timely diagnoses and treatment for mental and/or behavioral health problems, despite facing multiple risk factors including potential exposure to trauma during premigration, migration, and postmigration experiences. Social-Emotional Learning offers preventive mental health education for children through well-established, evidenced-based curricula. Although there are clear benefits of Social-Emotional Learning curricula, which can help children achieve long-term success emotionally and academically, Social-Emotional Learning curricula are not easily accessible for refugee children, often because of language and socioeconomic barriers. In this pilot study, we evaluated the feasibility and acceptability of an adapted Social-Emotional Learning program that included culturally specific, multilingual, trauma-informed wellness, and physical education during the COVID-19 pandemic: EMPOWER (Emotions Program Outside the Clinic With Wellness Education for Refugees). We used the Intervention Mapping framework which guided the (1) planning, (2) program development, and (3) mixed-method evaluation of the feasibility and acceptability of the EMPOWER pilot. We found that this adaptation was well-received by Afghan refugee families and that COVID-19 safety measures were well-understood after participation. Challenges emerged around videoconferencing connectivity and around finding a common language for discussing emotions. Future iterations of the program and evaluations will require continued partnerships with community members and organizations. As we continue and expand EMPOWER, we aim to evaluate short-term improvement in Social-Emotional Learning competence as well as long-term mental and behavioral health outcomes for children and their families.


Subject(s)
COVID-19 , Refugees , Adolescent , Child , Curriculum , Emotions , Health Promotion , Humans , Pandemics/prevention & control , Pilot Projects , Refugees/psychology , SARS-CoV-2
9.
Torture ; 31(1): 37-52, 2021.
Article in English | MEDLINE | ID: covidwho-1450937

ABSTRACT

INTRODUCTION: Due to the COVID-19 pandemic, Freedom from Torture developed remote telephone assessments to provide interim medico-legal reports, ensuring people could obtain medical evidence to support their asylum claim. METHOD: To audit this new way of working, feedback was collected from the doctors, interpreters, individuals being assessed, and senior medical and legal staff who reviewed the reports. This paper presents findings from the first 20 assessments. RESULTS: Individuals assessed reported that the doctor developed good rapport, but in 35% of assessments reported that there were some experiences they felt unable to disclose. In 70% of assessments, doctors felt that rapport was not as good compared to face-to-face. In the majority of assessments, doctors were unable to gain a full account of the torture or its impact. They reported feeling cautious about pressing for more information on the telephone, mindful of individuals' vulnerability and the difficulty of providing support remotely. Nevertheless, in 85% of assessments doctors felt able to assess the consistency of the account of torture with the psychological findings, in accordance with the Istanbul Protocol (United Nations, 2004). Factors that hindered the assessment included the inability to observe body language, the person's ill health, and confidentiality concerns. CONCLUSION: This research indicates that psychological medico-legal reports can safely be produced by telephone assessment, but are more likely to be incomplete in terms of both full disclosure of torture experiences and psychological assessment. The limitations underline the need for a follow-up face-to-face assessment to expand the psychological assessment as well as undertake a physical assessment.


Subject(s)
COVID-19/epidemiology , Physician-Patient Relations/ethics , Refugees/psychology , Remote Consultation/ethics , Telephone , Torture , Humans , Medical History Taking , Pandemics , Physical Examination , SARS-CoV-2 , United Kingdom/epidemiology
10.
Public Health Rep ; 136(6): 774-781, 2021.
Article in English | MEDLINE | ID: covidwho-1430318

ABSTRACT

OBJECTIVE: Little is known about COVID-19 vaccination intentions among refugee communities in the United States. The objective of this study was to measure COVID-19 vaccination intentions among a sample of refugees in the United States and the reasons for their vaccine acceptance or hesitancy. METHODS: From December 2020 through January 2021, we emailed or text messaged anonymous online surveys to 12 bilingual leaders in the Afghan, Bhutanese, Somali, South Sudanese, and Burmese refugee communities in the United States. We asked community leaders to complete the survey and share the link with community members who met the inclusion criteria (arrived in the United States as refugees, were aged ≥18, and currently lived in the United States). We compared the characteristics of respondents who intended to receive the COVID-19 vaccine with those of respondents who did not intend to receive the vaccine or were unsure. We then conducted crude and adjusted logistic regression analysis to measure the association between employment as an essential worker and COVID-19 vaccine acceptance. RESULTS: Of 435 respondents, 306 (70.3%) indicated that they planned to receive a COVID-19 vaccine. Being an essential worker (adjusted odds ratio [aOR] = 2.37; 95% CI, 1.44-3.90) and male sex (aOR = 1.87; 95% CI, 1.12-3.12) were significantly associated with higher odds of intending to receive a COVID-19 vaccine. Among respondents who intended to receive a COVID-19 vaccine, wanting to protect themselves (68.6%), family members (65.0%), and other people (54.3%) were the main reasons. CONCLUSION: Many refugees who responded to the survey, especially those who worked in essential industries, intended to receive a COVID-19 vaccine. Community organizations, health care providers, and public health agencies should work together to ensure that vaccine registration and vaccination sites are accessible to refugees.


Subject(s)
COVID-19 Vaccines/administration & dosage , COVID-19/epidemiology , COVID-19/prevention & control , Patient Acceptance of Health Care/ethnology , Refugees/psychology , Adolescent , Adult , Africa/ethnology , Asia/ethnology , COVID-19/ethnology , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Pandemics , SARS-CoV-2 , Sex Factors , Socioeconomic Factors , United States/epidemiology , Young Adult
11.
Sch Psychol ; 36(5): 348-357, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1373363

ABSTRACT

COVID-19 has exacerbated the challenges that newcomer refugee and immigrant families face. While many of the supports that schools typically offer were disrupted by the pandemic, school-based assistance remains critical in this challenging context. In addition to education-related challenges, many newcomer families have been disproportionately impacted across financial, employment, and health contexts. The present study highlights the perspectives of newcomer families to understand their experiences, stressors, and ability to cope during the pandemic, as well as how their school communities can offer support to mitigate the potential for increased disparities. Qualitative interviews were conducted with 14 parents (Mage = 38.68) and 13 students (Mage = 14.31) engaged in a school-based intervention for newcomer students. Among students, 71.4% were identified as male, and the majority of caregivers were mothers (85.7%). Newcomer families reported significant challenges due to COVID-19, including difficult social-emotional adjustment, financial challenges, and significant academic difficulties. Themes also emerged related to sources of support and coping. Implications for how schools can further support newcomer families given these challenges and strengths are considered. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Subject(s)
COVID-19 , Emigrants and Immigrants/psychology , Family/psychology , Refugees/psychology , Students/psychology , Adolescent , Adult , Female , Humans , Male , Parents/psychology , Qualitative Research , Schools
13.
PLoS One ; 16(6): e0253648, 2021.
Article in English | MEDLINE | ID: covidwho-1280639

ABSTRACT

AIM: This study aimed to assess the fear of COVID-19 and its associates among older Rohingya (Forcibly Displaced Myanmar Nationals or FDMNs) in Bangladesh. METHOD: We conducted a cross-sectional survey among 416 older FDMNs aged 60 years and above living in camps of Cox's Bazar, Bangladesh. A semi-structured questionnaire was used to collect information on participants' socio-demographic and lifestyle characteristics, pre-existing non-communicable chronic conditions, and COVID-19 related information. Level of fear was measured using the seven-item Fear of COVID-19 Scale (FCV-19S) with the cumulative score ranged from 7 to 35. A multiple linear regression examined the factors associated with fear. RESULTS: Among 416 participants aged 60 years or above, the mean fear score was 14.8 (range 8-28) and 88.9% of the participants had low fear score. Participants who were concerned about COVID-19 (ß: 0.63, 95% CI: -0.26 to 1.53) and overwhelmed by COVID-19 (ß: 3.54, 95% CI: 2.54 to 4.55) were significantly more likely to be fearful of COVID-19. Other factors significantly associated with higher level of fear were lesser frequency of communication during COVID-19, difficulty in obtaining food during COVID-19, perception that older adults are at highest risk of COVID-19 and receiving COVID-19 related information from Radio/television and friends/family/neighbours. CONCLUSIONS: Our study highlighted that currently there little fear of COVID-19 among the older Rohingya FDMNs. This is probably due to lack of awareness of the severity of the disease in. Dissemination of public health information relevant to COVID-19 and provision of mental health services should be intensified particularly focusing on the individual who were concerned, overwhelmed or fearful of COVID-19. However, further qualitative research is advised to find out the reasons behind this.


Subject(s)
Attitude to Health , COVID-19/psychology , Fear , Refugees/psychology , Aged , Bangladesh , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Myanmar , Socioeconomic Factors , Surveys and Questionnaires , Vulnerable Populations/psychology
14.
Australas Psychiatry ; 29(4): 417-419, 2021 08.
Article in English | MEDLINE | ID: covidwho-1166849

ABSTRACT

OBJECTIVE: This paper highlights the significant mental health vulnerabilities of people who have sought asylum in Australia and their additional adversities as a result of the Covid-19 pandemic. CONCLUSIONS: Australia's policies in relation to asylum seekers result in multiple human rights violations and add significantly to mental health vulnerabilities. Despite a majority being identified as refugees, people spend years in personal and administrative limbo and are denied resettlement in Australia. Social isolation and other restrictions associated with Covid-19 and recent reductions in welfare and housing support compound their difficulties. The clinical challenges in working with people impacted by these circumstances and the role of psychiatrists and the RANZCP in advocacy are identified.


Subject(s)
COVID-19/psychology , Mental Health/statistics & numerical data , Refugees/psychology , Anxiety , Australia , COVID-19/epidemiology , COVID-19/prevention & control , Health Services Accessibility , Human Rights , Humans , Pandemics , SARS-CoV-2
16.
J Am Board Fam Med ; 34(Suppl): S210-S216, 2021 Feb.
Article in English | MEDLINE | ID: covidwho-1099978

ABSTRACT

Certain members of society are disproportionately affected by the COVID-19 crisis and the added strain being placed on already overextended health care systems. In this article, we focus on refugee newcomers. We outline vulnerabilities refugee newcomers face in the context of COVID-19, including barriers to accessing health care services, disproportionate rates of mental health concerns, financial constraints, racism, and higher likelihoods of living in relatively higher density and multigenerational dwellings. In addition, we describe the response to COVID-19 by a community-based refugee primary health center in Ontario, Canada. This includes how the clinic has initially responded to the crisis as well as recommendations for providing services to refugee newcomers as the COVID-19 crisis evolves. Recommendations include the following actions: (1) consider social determinants of health in the new context of COVID-19; (2) provide services through a trauma-informed lens; (3) increase focus on continuity of health and mental health care; (4) mobilize International Medical Graduates for triaging patients based on COVID-19 symptoms; and (5) diversify communication efforts to educate refugees about COVID-19.


Subject(s)
Emigrants and Immigrants , Family Practice/organization & administration , Health Services Accessibility/organization & administration , Refugees , COVID-19/epidemiology , Emigrants and Immigrants/education , Emigrants and Immigrants/psychology , Emigrants and Immigrants/statistics & numerical data , Female , Health Services Accessibility/economics , Humans , Male , Ontario/epidemiology , Pandemics , Refugees/education , Refugees/psychology , Refugees/statistics & numerical data , SARS-CoV-2 , Social Determinants of Health/economics
17.
Front Public Health ; 8: 589264, 2020.
Article in English | MEDLINE | ID: covidwho-1069766

ABSTRACT

Lebanon's management of the COVID-19 pandemic is largely being maneuvered amid the country's escalating triple fold crisis. As the country continues to grapple with political stagnation, a dwindling economy and currency, all while working through an ongoing refugee crisis, mental health in times of Coronavirus in Lebanon remains unaddressed. This piece explores the effects of this triple fold crisis upon the mental health of the country's refugees and most vulnerable groups, and provides room for discussions on the potential benefits of telemental health as an intervention in low-income and conflict settings. Although the implementation of TMH services in Lebanon among vulnerable communities in times of COVID-19 is not a priority, this piece insists it would ultimately fill a substantial mental health gap during the country's ongoing difficult transitory period.


Subject(s)
COVID-19/transmission , Mental Health , Refugees/psychology , Vulnerable Populations/psychology , Health Policy , Humans , Lebanon , Politics , SARS-CoV-2 , Telemedicine
18.
Trials ; 22(1): 117, 2021 Feb 05.
Article in English | MEDLINE | ID: covidwho-1067264

ABSTRACT

This article describes how one trial site of the Refugee Emergency: Defining and Implementing Novel Evidence-based psychosocial interventions (RE-DEFINE) study, designed to evaluate a Self Help+ intervention with Arabic-speaking refugees and asylum seekers currently living in the UK and experiencing stress, was adapted to accommodate social distancing rules and working from home during the COVID-19 restrictions. Digital divide, risk and safety management, acceptability of remote data collection and practical considerations are described. The adaptions to methods have practical implications for researchers looking for more flexible approaches in response to continuing restrictions resulting from COVID-19, and the authors believe that others could adopt such an approach. The need for a further acceptability study focusing on human and economic costs and benefits of telephone and video as an alternative to face-to-face data collection is indicated. TRIALS REGISTRATION: Refugee Emergency - Defining and Implementing Novel Evidence-based psychosocial interventions RE-DEFINE. (Trials registration numbers NCT03571347 , NCT03587896 ) https://doi.org/10.1136/bmjopen-2019-030259 (2019).


Subject(s)
COVID-19/psychology , Data Collection/methods , Pandemics , Quarantine/psychology , Refugees/psychology , SARS-CoV-2 , Arabs/psychology , COVID-19/epidemiology , COVID-19/ethnology , COVID-19/virology , Follow-Up Studies , Health Surveys , Humans , Physical Distancing , Risk Management , Telephone , Teleworking , United Kingdom/epidemiology
19.
Eur J Public Health ; 31(1): 37-44, 2021 02 01.
Article in English | MEDLINE | ID: covidwho-1015343

ABSTRACT

BACKGROUND: International literature suggests that disadvantaged groups are at higher risk of morbidity and mortality from SARS-CoV-2 infection due to poorer living/working conditions and barriers to healthcare access. Yet, to date, there is no evidence of this disproportionate impact on non-national individuals, including economic migrants, short-term travellers and refugees. METHODS: We analyzed data from the Italian surveillance system of all COVID-19 laboratory-confirmed cases tested positive from the beginning of the outbreak (20th of February) to the 19th of July 2020. We used multilevel negative-binomial regression models to compare the case fatality and the rate of admission to hospital and intensive care unit (ICU) between Italian and non-Italian nationals. The analysis was adjusted for differences in demographic characteristics, pre-existing comorbidities, and period of diagnosis. RESULTS: We analyzed 213 180 COVID-19 cases, including 15 974 (7.5%) non-Italian nationals. We found that, compared to Italian cases, non-Italian cases were diagnosed at a later date and were more likely to be hospitalized {[adjusted rate ratio (ARR)=1.39, 95% confidence interval (CI): 1.33-1.44]} and admitted to ICU (ARR=1.19, 95% CI: 1.07-1.32), with differences being more pronounced in those coming from countries with lower human development index (HDI). We also observed an increased risk of death in non-Italian cases from low-HDI countries (ARR=1.32, 95% CI: 1.01-1.75). CONCLUSIONS: A delayed diagnosis in non-Italian cases could explain their worse outcomes compared to Italian cases. Ensuring early access to diagnosis and treatment to non-Italians could facilitate the control of SARS-CoV-2 transmission and improve health outcomes in all people living in Italy, regardless of nationality.


Subject(s)
COVID-19/epidemiology , Delivery of Health Care/organization & administration , Hospitalization/statistics & numerical data , Intensive Care Units/statistics & numerical data , Refugees/statistics & numerical data , SARS-CoV-2 , Transients and Migrants/statistics & numerical data , Adult , Comorbidity , Delayed Diagnosis , Female , Health Services Accessibility , Healthcare Disparities , Humans , Italy/epidemiology , Male , Middle Aged , Morbidity , Pandemics , Refugees/psychology , Transients and Migrants/psychology
20.
PLoS One ; 16(1): e0244347, 2021.
Article in English | MEDLINE | ID: covidwho-1006431

ABSTRACT

INTRODUCTION: Pneumonia of unknown cause was detected on 30 December 2019 in China. It was categorized as an outbreak and named as COVID-19 by the World Health Organization. The pandemic affects all people, but patient groups such as hemodialysis (HD) patients have been particularly affected. We do not know if refugees suffered more during the outbreak. In this study, we compared depressive symptom frequency between Syrian refugee HD patients and Turkish ones. METHODS: The study had a single-center, cross-sectional design. Demographic and clinical data were collected retrospectively from patients' files containing details about past medical history, demographic variables and laboratory values. Validated Turkish and Arabic forms of Beck Depression Inventory (BDI) were used to assess depressive symptoms. BDI scores were compared according to nationality, demographic features and clinical data. A BDI score more than 14 was accepted as suspicion of depression. RESULTS: 119 patients were enrolled in the study. After the exclusion of 22 patients, 75 Turkish and 22 Syrian patients were included for further analysis. The median BDI (interquartile range) score for Turkish and Syrian patients were 12 (7-23) and 19.5 (12.7-25.2), respectively (p = 0.03). Suspicion of depression was present at 42.7% of Turkish, and 72.7% of Syrian HD patients (p = 0.013). Regarding all patients, phosphorus level, Kt/V, and nationality were significantly different between patients with and without suspicion of depression (p = 0.023, 0.039, 0.013, respectively). CONCLUSION: Syrian patients had higher BDI scores and more depressive symptoms than Turkish patients. Additional national measures for better integration and more mental support to Syrian HD patients are needed.


Subject(s)
COVID-19 , Depression , Pandemics , Refugees/psychology , Renal Dialysis , Adult , Aged , COVID-19/epidemiology , COVID-19/ethnology , COVID-19/psychology , Cross-Sectional Studies , Depression/epidemiology , Depression/psychology , Female , Humans , Male , Middle Aged , Retrospective Studies , Syria/ethnology , Turkey/epidemiology
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