Barriers to Accessing Mental Health Services among Syrian Refugees in Ankara
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.