BMC Public Health
Volume 17, Issue 1, 2017

Improving the provision of services to young people from refugee backgrounds with comorbid mental health and substance use problems: Addressing the barriers (Article) (Open Access)

Posselt M.* , McDonald K. , Procter N. , De Crespigny C. , Galletly C.
  • a Discipline of Psychiatry, School of Medicine, University of Adelaide, Eleanor Harrald Building, Frome Rd, Adelaide, SA, Australia
  • b Jean Hailes Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
  • c School of Nursing and Midwifery, University of South Australia, Adelaide, SA, Australia
  • d School of Nursing, University of Adelaide, Adelaide, SA, Australia
  • e Discipline of Psychiatry, School of Medicine, University of Adelaide, Eleanor Harrald Building, Frome Rd, Adelaide, SA, Australia, Ramsay Health Care, Adelaide, Australia, Northern Adelaide Local Health Network, Adelaide, Australia

Abstract

Background: South Australia (SA) has resettled 151,134 refugees in the last ten years (Department of Immigration and Border Protection, Settlement reporting facility, 2014). Northern metropolitan Adelaide, an area which experiences significant social disadvantage, has received a significant number of (predominantly young) refugees. Research indicates that refugee youth are at elevated risk of mental health (MH) and alcohol and other drug (AOD) problems. These factors, along with the low socio-economic status of northern Adelaide, the number of refugee youth residing there, and the added complexity of treating comorbid MH and AOD problems (comorbidity) prompted this research. We investigated the barriers and facilitators to culturally responsive comorbidity care for these youth and whether the MH and AOD services were equipped to provide such support. Methods: This mixed-methods study employed semi-structured interviews with refugee youth and service providers and an online survey with managers of services. Thirty participants (15 refugee youth, 15 service providers) took part in the semi-structured interviews and 56 (40 complete, 16 partially-complete) in the survey. Results: Thematic analysis of the interview data revealed the most commonly reported barriers related to four broad areas: (1) organisational and structural, (2) access and engagement, (3) treatment and service delivery, and (4) training and resources. Survey data supported the barriers identified in the qualitative findings. Conclusions: This research highlights significant gaps in the response of MH and AOD services to refugee youth with comorbidity. Based on the findings, ways of overcoming the barriers are discussed, and are of particular relevance to policy makers, organisations and clinicians. © 2017 The Author(s).

Author Keywords

youth Comorbidity Refugee Mental health Substance use Service provision

Index Keywords

refugee mental health service complication human Refugees Substance-Related Disorders Adolescent Health Services drug dependence ethnology Mental Health Services Mental Disorders interview mental disease Young Adult Humans psychology Adolescent Interviews as Topic male female standards organization and management South Australia adult child health care Health Services Accessibility health care delivery Child
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85016128165&doi=10.1186%2fs12889-017-4186-y&partnerID=40&md5=0c2631b0f63b2e6006e3c39ca8e6446e
DOI: 10.1186/s12889-017-4186-y
ISSN: 14712458
Original Language: English