ABSTRACT
Background: Compared to the general German population, refugees in Germany are a high-risk group for trauma spectrum disorders. Currently, many barriers exist for the implementation of a screen-and-treat approach for mental disorders as part of the routine health care provision during the early stage of the immigration process.Objective: The aim of the present study was to develop and test a systematic screening approach to identify individual refugees in need of mental health care during the initial immigration phase.Method: 167 newly arrived refugees underwent a screening interview with the Refugee Health Screener (RHS) carried out by Intercultural Therapy Assistants (ITAs). The ITAs were super-vised by psychologists at a reception centre in Bielefeld, Germany. A subsample of 48 persons partici-pated in clinical validation interviews.Results: Findings demonstrated the need for and feasibility of a systematic screening during the initial immigration phase. However, established cut-off values of the RHS had to be adapted and the screening procedure had to be adjusted due to the needs of a significant number of refugees in severe psychological crises.Conclusion: A systematic screening that is applied shortly after arrival facilitates the early identification of refugees at risk of developing mental disorders and may be helpful to prevent chronic symptom development and an aggravation of psychological crises.
A systematic complementary screening procedure during the initial immigration phase was found to be useful for the identification of refugees in need of mental health care.The procedure could be implemented both safely and efficiently in conjunction with the initial medical check-up for recently arrived refugees.Responding to the needs of the refugees immediately following their arrival in Germany, we adjusted the cut-off of the screening instrument and suggest to explicitly include a detection procedure for severe psychological crises.
Subject(s)
Mental Disorders , Refugees , Humans , Mental Health , Refugees/psychology , Mental Disorders/diagnosis , Mental Disorders/therapy , Mental Disorders/epidemiology , Mass Screening , Germany/epidemiologyABSTRACT
En este trabajo se describe una iniciativa de promoción de la salud en una comunidad nativa de Alaska. La etnia Yupik vive en condiciones de aislamiento en la zona occidental de Alaska y tiene dificultades de acceso a servicios públicos, además de problemas de salud relacionados con los hábitos de vida. El proyecto "Healthy Living Through a Healthy Lifestyle" se basó en la planificación estratégica de servicios de salud y en la implementación de iniciativas de promoción de la salud en un asentamiento de esta etnia. Para ello se organizó un comité compuesto por miembros de la comunidad, profesionales de los servicios y personal investigador de la universidad. Además se contó con dos mediadores comunitarios de salud para facilitar el acceso de las familias a los servicios públicos. El programa puso el acento en la adaptación cultural de sus contenidos, en la colaboración entre los investigadores y los participantes y en la implicación de la comunidad en el diseño, implementación y evaluación del programa.
In this paper, we describe a health promotion initiative in a native community in Alaska. The Yupik ethnic group lives in isolation in Western Alaska and has poor access to public services, as well as health problems related to lifestyle. The "Healthy Living Through a Healthy Lifestyle" project was based on the strategic planning of health services and on the implementation of health promotion initiatives in a settlement of this ethnic group. For this, it was organized a committee of community members, service professionals and University researchers. It included also two community health mediators to facilitate families' access to public services. The program emphasizes cultural adaptation of contents, collaboration between researchers and participants and community involvement in the design, implementation and evaluation of the program.
