Psychological Distress, Post-Traumatic Stress, and Suicidal Ideation Among Resettled Nepali-Speaking Bhutanese Refugees in the United States: Rates and Predictors.

INTRODUCTION: Bhutanese refugees may exhibit psychological distress (PD), post-traumatic stress (PTS), and suicidal ideation (SI), but little is known about predictors of these mental health problems. PURPOSE: To examine rates and predictors of PD, PTS, and SI among Bhutanese refugees. METHODS: Cross-sectional correlational study of 209 Bhutanese refugees in Midwestern United States. Data were collected using the Hopkins Symptom Checklist/Nepali version and Refugee Health Screener-15/PTS subscale and then analyzed using simultaneous multiple regression. RESULTS: Rates of PD, PTS, and SI were 18.7%, 8.1%, and 7.7%, respectively. Significant predictors of PD were a history of mental health treatment (p<.001) and fewer years of schooling (p = .032). Predictors of PTS were history of mental health treatment (p<.001), female gender (p = .016), fewer years of schooling (p = .012), and being single/previously married (p = .004). PTS predicted SI (ρ<.001). DISCUSSION: Health providers should routinely assess Bhutanese refugees' mental health status for timely further assessment and treatment.

Validation of the Hopkins Symptom Checklist-25/Nepali Version Among Bhutanese Refugees in the United States.

BACKGROUND: Bhutanese refugees' mental problems are relatively high. The Hopkins Symptom Checklist-25 (HSCL-25) has been used widely in examining refugees' mental health, but its psychometric properties in Nepali version is unknown. PURPOSE: To examine psychometric properties of the HSCL-25/Nepali version. METHODS: Bhutanese refugees (n = 209) responded to demographic questionnaire, the HSCL-25/Nepali, and the Refugee Health Survey-15. Exploratory factor analysis (EFA), convergent validity, and internal consistency were performed. RESULTS: After three rounds of EFA, item 14 was deleted resulting in HSCL-24/Nepali with good construct validity and excellent internal consistency (α = .94). CONCLUSIONS: The HSCL-24/Nepali version is reliable and valid and can be used to culturally, appropriately assess psychological distress of Bhutanese refugees as it omits item 14 that captures individual's sexual interest.