scholarly journals Barriers to Accessing Mental Health Services among Syrian Refugees in Ankara

Author(s):  
Cengiz Kilic ◽  
Edip Kaya ◽  
Ozge Karadag ◽  
Sarp Uner

Abstract Background Syrian refugees are seriously traumatized by the conflict in their country. Consequently, mental health problems, particularly depression and PTSD, are prevalent among refugees. Despite this fact, they make little use of mental health services. Using a population sample of Syrian refugees living in Ankara, we assessed the perceived need for and contact with mental health services, as well as the barriers to access these services. Methods This was a cross-sectional study of 420 Syrian refugees living in Ankara city center, using face to face interviews administered at the respondents’ home by trained, Arabic-speaking interviewers. The data were collected in October–November 2016 in two neighborhoods of Ankara, where most of Syrian refugees were concentrated. PTSD and depression were assessed using Harvard Trauma Questionnaire and Beck Depression Inventory, respectively. Both measures have been validated in Arabic. Results Of all the refugees in our sample, 14.8% (N = 62) stated that they felt the need for mental healthcare since arriving in Turkey. The actual number contacting any mental health service, however, was very low (N = 6). Multivariate analyses revealed that traumatic stress scores predicted the perceived need for contacting services. Though women reported much higher need for contact with mental health services than men, there was no gender effect on actual contact. Speaking Turkish seemed to increase contact with services, which is in line with language being listed as the most important barrier to accessing care. Conclusions Our results show that, although refugees with mental health problems are more likely to contact services than others, most of those who need mental health care go untreated, and there is a significant gender inequity in this regard. To address this treatment gap, and to provide adequate care for refugees with mental health problems, common barriers (language, stigma, and awareness) should be identified and dealt with.

2021 ◽  
Author(s):  
Cengiz Kilic ◽  
Edip Kaya ◽  
Ozge Karadag ◽  
Sarp Uner

Abstract Background: Syrian refugees are seriously traumatized by the conflict in their country. Consequently, mental health problems, particularly depression and PTSD, are prevalent among refugees. Despite this fact, they make little use of mental health services. Using a population sample of Syrian refugees living in Ankara, we assessed the perceived need for and contact with mental health services, as well as the barriers to access these services.Methods: This was a cross-sectional study of 420 Syrian refugees living in Ankara city center, using face to face interviews administered at the respondents’ home by trained, Arabic-speaking interviewers. The data were collected in October–November 2016 in two neighborhoods of Ankara, where most of Syrian refugees were concentrated. PTSD and depression were assessed using Harvard Trauma Questionnaire and Beck Depression Inventory, respectively. Both measures have been validated in Arabic.Results: Of all the refugees in our sample, 14.8% (N=62) stated that they felt the need for mental healthcare since arriving in Turkey. The actual number contacting any mental health service, however, was very low (N=6). Multivariate analyses revealed that traumatic stress scores predicted the perceived need for contacting services. Though women reported much higher need for contact with mental health services than men, there was no gender effect on actual contact. Speaking Turkish seemed to increase contact with services, which is in line with language being listed as the most important barrier to accessing care. Conclusions: Our results show that, although refugees with mental health problems are more likely to contact services than others, most of those who need mental health care go untreated, and there is a significant gender inequity in this regard. To address this treatment gap, and to provide adequate care for refugees with mental health problems, common barriers (language, stigma, and awareness) should be identified and dealt with.


2018 ◽  
Vol 9 ◽  
pp. 110-133
Author(s):  
Anne Mari Steigen ◽  
Bengt Eriksson ◽  
Ragnfrid Eline Kogstad ◽  
Helge Prytz Toft ◽  
Daniel Bergh

Young adults with mental health problems who do not attend school or work constitute a significant welfare challenge in Norway. The welfare services available to these individuals include nature-based services, which are primarily located on farms and integrate the natural and agricultural environment into their daily activities. The aim of this study is to examine young adults (16–30 years old) not attending school or work who participated in nature-based services in Norway. In particular, the study analyses mental health problems among the participants and in-group variations regarding their symptoms of mental health problems using the Hopkins Symptoms Checklist (HSCL-10). This paper compares symptoms of mental health problems among participants in nature-based services with those of a sample from the general population and a sample of those receiving clinical in-patient mental healthcare. A questionnaire was developed for the study and was completed by 93 participants in nature-based services. The majority of these participants were recruited from the Norwegian Labour and Welfare Administration (NAV), local mental health services, and school authorities. Results indicate that just more than half of the respondents exhibited symptoms of mental health problems based on their HSCL-10 scores. In general, they reported fewer symptoms than the clinical in-patient sample (18–30 years old) and more symptoms than the general population sample (18–19 years old). Among the participants in nature-based services, those recruited through NAV and local mental health services exhibited no differences in symptoms. Half of the participants older than 23 years in nature-based services had not completed upper secondary school. The participants, including those with symptoms of mental health problems and low expectations at the outset of their participation, generally expressed high satisfaction with the services.


2015 ◽  
Vol 39 (4) ◽  
pp. 153-155 ◽  
Author(s):  
Sokratis Dinos

SummaryEvidence suggests disparities in the prevalence of mental health problems and access to mental healthcare for a number of minority groups. The main response from mental health services falls into two related categories: (a) cultural adaptations of existing evidence-based interventions (EBIs) and/or (b) cultural competence of mental health professionals. This editorial looks at the evidence on culturally adapted EBIs and argues that although such interventions can be effective, they also carry the risk of alienating members of the groups they are aimed at. Recommendations focus on identifying issues that pertain to being from a racial minority and/or possessing other stigmatised identities that can have an impact on mental health problems, which may be overlooked by mental health services by assuming an overarching predominant cultural identity.


Author(s):  
Trisni Handayani ◽  
Dian Ayubi ◽  
Dien Anshari

ABSTRAK Latar belakang. Prevalensi penduduk Indonesia yang menderita gangguan mental emosional mengalami peningkatan, dimana prevalensi sebesar 6% pada tahun 2013 meningkat menjadi 9,8% pada tahun 2018. Pelayanan kesehatan jiwa bagi setiap orang dengan masalah kejiwaan (ODMK) belum diwujudkan secara optimal di wilayah Kecamatan Bogor Timur. Masih sedikit ODMK yang memanfaatkan pelayanan kesehatan jiwaTujuan. Penelitian ini bertujuan untuk mengetahui hubungan literasi kesehatan mental dengan pemanfaatan pelayanan kesehatan jiwa.Metode. Penelitian ini menggunakan desain cross-sectional dengan pendekatan kuantitatif. Responden adalah orang dengan masalah kejiwaan yang bertempat tinggal di Kecamatan Bogor Timur. Teknik multistage random sampling digunakan untuk memilih 139 responden. Pengumpulan data dilakukan dengan wawancara menggunakan kuesioner. Data dianalisis menggunakan uji regresi logistik ganda.Hasil. Nilai rerata literasi kesehatan mental sebesar 73,08 (skala 100). Sebanyak 56,1% ODMK telah memanfaatkan pelayanan kesehatan jiwa dan 57,6% responden berumur ≥30 tahun. Pada mereka yang mempunyai literasi kesehatan mental tinggi, sebanyak 64,9% telah memanfaatkan pelayanan kesehatan jiwa. Hasil analisis multivariat menunjukkan hubungan signifikan antara literasi kesehatan mental dengan perilaku pemanfaatan pelayanan kesehatan jiwa pada ODMK setelah variabel jenis kelamin dan ketersediaan pelayanan kesehatan jiwa dikendalikan.Kesimpulan. Orang dengan literasi kesehatan mental yang tinggi cenderung memanfaatkan pelayanan kesehatan jiwa dibanding dengan mereka dengan literasi rendah.  ABSTRACTBackground. In Indonesia, prevalence of emotional mental disorder has increased from 6% in 2013 to 9.8% in 2018. Mental health service has not optimally utilized by people with mental health problems in East Bogor sub-district. Objective. This study aimed to determine the relationship of mental health literacy with mental health service use. Method. This study used a cross sectional design with a quantitative approach. Respondents were people with mental health problems who lived in East Bogor Sub-District. A total of 139 respondents were selected using multistage random sampling technique. Data were collected by in-person interview using a questionnaire. Data were analysed using a multiple logistic regression test for multivariate model selection. Results. The results of this study showed that the mean score of mental health literacy was 73.08 (scale of 100). There were 56.1% respondents utilized mental health services. As many as 57.6% respondents aged ≥30 years. Among those who have high mental health literacy, 64.9% of them have utilized mental health services.  Results from multivariate analysis showed that there was a significant relationship between mental health literacy and the use of mental health service in people with mental health problems, after adjustment with gender and mental health service availability.Conclusion. People with high mental health literacy tended to use mental health services compared to those with low literacy.


2020 ◽  
pp. jramc-2019-001396 ◽  
Author(s):  
Ren-Ping Gu ◽  
X R Liu ◽  
X F Ye

IntroductionThe People’s Liberation Army (PLA, China) Navy is increasingly conducting military operations other than war overseas. Factors such as confrontations with pirates, special environments and long sailing times have resulted in mental health problems. However, the navy’s actual utilisation of mental health services is low. This study examined members’ rate of willingness to seek help and the factors that act as barriers to willingness to seek mental health services in the PLA Navy.MethodsThis cross-sectional study was conducted at the Zhoushan Base, operated by the East Sea Fleet, between March 2019 and April 2019. We distributed a 12-item questionnaire to examine participants’ attitudes and perceived barriers to mental healthcare. We recruited 676 navy personnel. Participants’ willingness to seek help if they had mental health problems was also assessed.ResultsThe response rate was 99%. A total of 88.44% of the sample reported being willing to seek help. Univariate analysis suggested that those not willing to seek help were more likely to agree with the items, ‘Mental healthcare does not work’ and ‘My unit leadership might treat me differently’ and all organisational barriers, and they were more likely to have concerns about ‘embarrassment’ and ‘being weak’ than those willing to seek help. After controlling for demographic characteristics, binary logistic regression analyses confirmed that a lack of knowledge regarding the location of mental health clinics and being perceived as weak were the main factors preventing participants’ willingness from seeking help.ConclusionsExtensive efforts to decrease organisational barriers and stigma towards mental healthcare should be a priority for researchers and policymakers to improve the usage of mental health services. Psychoeducation aimed at de-stigmatising mental health problems should be delivered and the accessibility and availability of mental health services should be increased.


2017 ◽  
Vol 25 (4) ◽  
pp. 407-410 ◽  
Author(s):  
Geoffrey Ryan ◽  
Ian Marley ◽  
Melanie Still ◽  
Zaza Lyons ◽  
Sean Hood

Objective: Medical students have higher rates of mental illness compared to the general population. Little is known about services accessed by medical students for mental-health problems. This study aimed to assess the use of mental-health services by Australian medical students and to identify barriers that may prevent students from using mental-health services. Method: A cross-sectional online survey was designed and administered to medical students at the University of Western Australia. Questions focused on self-reported psychological well-being, use of mental-health services, the perceived usefulness of services and barriers to the use of services. Results: The response rate was 41% ( n=286). Sixty-two per cent self-reported experiencing mental-health problems, and of these, 75% had used at least one service. General practitioners and psychiatrists were rated as the most effective service type. The main barriers to seeking help were not enough time, affordability and concerns regarding stigma, including disclosure and peer judgement. Conclusion: A high proportion of students with self-reported mental-health problems had accessed services. However, barriers were also identified. Access to mental-health services needs to be improved, and strategies aimed at reducing stigma and raising awareness of mental-health issues should be encouraged by medical faculties.


2021 ◽  
Author(s):  
Yousef Khader ◽  
Ahmad Bawaneh ◽  
Zaid Al-Hamdan

BACKGROUND The Syrian conflict started in 2011 and resulted ever since in a large displacement of Syrians. Conflict-related violence coupled with displacement related stressors such as poverty, poor access to health services, loss of family support and discrimination had a significant impact on the mental health and psychosocial wellbeing of Syrian refugee OBJECTIVE This study aimed to identify the perceived symptoms of severe distress and impaired functioning, identify coping mechanisms and identify the barriers to access mental health services among Syrian refugees and Jordanian adults. METHODS This cross-sectional study study took place in 14 randomly selected sites in Jordan where Syrian refugees are concentered and from Za’tari refugee camp. A toolkit for humanitarian settings was used for data collection. RESULTS Of the 1424 participants, 43.4% had distress; 38.9% among host population, 57.0% among refugees in urban communities, and 23.0% among refugees in camp (p <0.005). Overall, finding comfort in faith and spiritual beliefs was the most common coping mechanism reported by those who perceived to be experiencing distress. CONCLUSIONS A significant proportion of Syrian refugees had distress symptoms. It is recommended to incorporate mental health services into broad-based community settings, such as schools, primary prevention or case management programs.


2014 ◽  
Vol 18 (1) ◽  
pp. 35-44 ◽  
Author(s):  
Catherine Conchar ◽  
Julie Repper

Purpose – A systematic review of the literature on “wounded healers” was undertaken to identify, define and interpret the term and its application within the mental health environment. The paper aims to discuss these issues. Design/methodology/approach – Eight key medical/social sciences databases were interrogated. In total, 835 papers were identified in the systematic database search and abstracts were obtained for each to determine whether they met the inclusion criteria. In total, 237 sources were retrieved for critical reading, to assess relevance and value to the review, and 125 documents were subsequently included. Through thematic analysis a number of themes and sub themes were identified Findings – The archetypal image of the wounded healer originates in ancient mythology and crosses many cultures. There are many interpretations and applications of the belief that having healed their own wounds a person is in a better position to heal others, however, the evidence to support this is not so robust. Of more direct relevance to contemporary practice are reports of supporting staff with mental health problems to make a contribution to mental health services, most recently through the employment of peer support workers. Originality/value – As peer support workers are increasingly being employed in mental health services, it is helpful to consider the many existing staff who bring personal experience of mental health problems. This paper explores the evidence that their lived experience makes a difference to the way that they work and considers their employment support needs.


Author(s):  
N. Crowley ◽  
H. O’Connell ◽  
M. Gervin

Autistic spectrum disorder (ASD) is a neuro-developmental disability with multi-systemic impacts. Individuals with ASD without intellectual impairment (DSM-V) or Aspergers (DSM-IV) are often particularly vulnerable to mental health problems such as anxiety disorders including social phobia and generalised anxiety disorder, depressive disorders and psychosis. Adults with ASD without intellectual impairment suffer higher rates of physical and psychiatric morbidity, display a poorer ability to engage with treatment and have a lower chance of recovery compared with the general population. It is widely acknowledged that adults with suspected ASD without intellectual impairment and co-morbid mental health problems are often not best supported through adult mental health services and often require more tailored supports. This review seeks to (a) increase awareness in the area of undiagnosed cases of ASD without intellectual impairment in adult mental health settings and (b) highlights the importance of identifying this population more efficiently by referring to best practice guidelines. The value of future research to examine the benefit of having a team of specialist staff within adult mental health teams who have received ASD training and who are supported to work with the ‘core difficulties’ of ASD is discussed and a model for the same is proposed. It is proposed that a specialist team could form a ‘hub’ for the development of expertise in ASD, which when adequately resourced and funded could reach across an entire region, offering consultancy and diagnostic assessments and interventions.


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