Frontiers in Psychiatry
Volume 10, Issue SEP, 2019

Implementing a need-adapted stepped-care model for mental health of refugees: Preliminary data of the state-funded project “Refukey” (Article) (Open Access)

Trilesnik B.* , Altunoz U. , Wesolowski J. , Eckhoff L. , Ozkan I. , Loos K. , Penteker G. , Graef-Calliess I.T.
  • a Department of Psychology, Humboldt University of Berlin, Berlin, Germany
  • b Department of General Psychiatry and Psychotherapy, KRH Psychiatry Wunstorf, Wunstorf, Germany
  • c Department of Economic and Social Psychology, Institute of Psychology, Georg-August-University Goettingen, Goettingen, Germany
  • d Faculty of Physics, Ludwig Maximilian University of Munich, Munich, Germany
  • e Psychiatric Outpatient Clinic, Asklepios Fachklinikum Göttingen, Göttingen, Germany
  • f NTFN e.V, Hannover, Germany
  • g NTFN e.V, Hannover, Germany
  • h Department of General Psychiatry and Psychotherapy, KRH Psychiatry Wunstorf, Wunstorf, Germany, Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany

Abstract

Introduction: Refugees have been shown to be a rather vulnerable population with increased psychiatric morbidity and lack of access to adequate mental health care. By expanding regional psychosocial and psychiatric-psychotherapeutic care structures and adapting psychiatric routine care to refugees’ needs, the state-funded project “refuKey” based in Lower Saxony, Germany, pursues to ease access to mental health care and increase service quality for refugees. A stepped-care treatment model along with intercultural opening of mental health care services is proposed. Methods: The project is subject to a four-part evaluation study. The first part investigates the state of psychiatric routine care for refugees in Lower Saxony by requesting data from all psychiatric clinics, participating and non-participating ones, regarding the numbers of refugee patients, their diagnoses, settings of treatment, etc. The second part explores experiences and work satisfaction of mental health care professionals treating refugees in refuKey cooperation clinics. The third part consists of interviews and focus group discussions with experts regarding challenges in mental health care of refugees and expectations for improvement through refuKey. The fourth part compares mental health parameters like depression, anxiety, traumatization, somatization, psychoticism, quality of life, as well as “pathways-to-care” of refuKey-treated refugees before and after treatment and, in a follow-up, to a non-refuKey-treated refugee control group. Results: RefuKey-treated refugees reported many mental health problems and estimated their mental health burden as high. The symptoms decreased significantly over the course of treatment. Mental health in the refuKey sample was strongly linked to post-migration stressors. Discussion: The state of mental health care for refugees is discussed. Implications for the improvement and the need for adaptation of routine mental health care services are drawn. © 2019 Trilesnik, Altunoz, Wesolowski, Eckhoff, Ozkan, Loos, Penteker and Graef-Calliess.

Author Keywords

Mental health Intercultural opening Refugees Post-migration living difficulties Stepped-care model

Index Keywords

information processing Germany depression refugee anxiety disorder human psychosis controlled study Job Satisfaction psychosocial care mental health care interview psychotherapy quality of life focus group discussion male family separation female evaluation study prevalence Article employment status major clinical study job accommodation adult posttraumatic stress disorder psychological well-being work experience Loneliness disease severity psychosomatic disorder psychotrauma patient worry Fear somatization mental health care personnel
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85072998462&doi=10.3389%2ffpsyt.2019.00688&partnerID=40&md5=79e2b2e048aa80974c39970af5b9149c
DOI: 10.3389/fpsyt.2019.00688
ISSN: 16640640
Original Language: English