Helen McColl1, Sonia Johnson. 1. Early Intervention in Psychosis Team, Paterson Centre, 20 South Wharf Road, London W2 1PD, UK. helenmccoll@nhs.net
Abstract
BACKGROUND: Asylum seekers and refugees may have substantial needs for mental health care, to which both pre-migration and post-migration traumas are likely to contribute. However, there is a paucity of data available to guide appropriate service development. AIMS: To ascertain numbers and describe the characteristics and needs of asylum seekers and refugees in contact with London Community Mental Health Teams (CMHTs). METHOD: Data were obtained from staff and clinical records regarding socio-demographic and clinical characteristics and service use. Camberwell Assessment of Need Short Appraisal Schedule (CANSAS) and Health of the Nation Outcome Scales (HoNOS) were completed. RESULTS: A total of 104 (11%) of the CMHT population were asylum seekers or refugees. Co-morbidity was frequent, and psychiatrists reported significant diagnostic uncertainty for 30%. The most common diagnoses were depression (50%) and post-traumatic stress disorder (PTSD) (41%), and just over half had a psychotic diagnosis (53%). Social isolation was common, levels of unmet need were high (mean of 6.8 unmet needs each using CANSAS) and the group used few services other than CMHTs. CONCLUSIONS: The combination of high levels of need and limited service use suggests a need to develop more effective services. High rates of diagnostic uncertainty suggest a need for a clearer understanding of the complex clinical syndromes afflicting this group.
BACKGROUND: Asylum seekers and refugees may have substantial needs for mental health care, to which both pre-migration and post-migration traumas are likely to contribute. However, there is a paucity of data available to guide appropriate service development. AIMS: To ascertain numbers and describe the characteristics and needs of asylum seekers and refugees in contact with London Community Mental Health Teams (CMHTs). METHOD: Data were obtained from staff and clinical records regarding socio-demographic and clinical characteristics and service use. Camberwell Assessment of Need Short Appraisal Schedule (CANSAS) and Health of the Nation Outcome Scales (HoNOS) were completed. RESULTS: A total of 104 (11%) of the CMHT population were asylum seekers or refugees. Co-morbidity was frequent, and psychiatrists reported significant diagnostic uncertainty for 30%. The most common diagnoses were depression (50%) and post-traumatic stress disorder (PTSD) (41%), and just over half had a psychotic diagnosis (53%). Social isolation was common, levels of unmet need were high (mean of 6.8 unmet needs each using CANSAS) and the group used few services other than CMHTs. CONCLUSIONS: The combination of high levels of need and limited service use suggests a need to develop more effective services. High rates of diagnostic uncertainty suggest a need for a clearer understanding of the complex clinical syndromes afflicting this group.
Authors: Maya Semrau; Mark van Ommeren; Monica Blagescu; Andre Griekspoor; Louise M Howard; Mark Jordans; Heidi Lempp; Anita Marini; Jon Pedersen; Isabelle Pilotte; Mike Slade; Graham Thornicroft Journal: Am J Public Health Date: 2012-08-16 Impact factor: 9.308
Authors: Helen McColl; Craig Higson-Smith; Sarah Gjerding; Mostafa H Omar; Basma Abdel Rahman; Mona Hamed; Aida S El Dawla; Miriam Fredericks; Nicole Paulsen; Gugu Shabalala; Carmen Low-Shang; Fernando Valadez Perez; Liliana S Colin; Aurora D Hernandez; Eliomara Lavaire; Arely Pa Zuñiga; Lucia Calidonio; Carmen L Martinez; Yasser Abu Jamei; Zeyad Awad Journal: Int J Ment Health Syst Date: 2010-06-18