ObjectivesOur aim was to summarise the current evidence regarding gender differences in the mental health of unaccompanied refugee minors (URM) and to identify gaps in research.SettingWe focused on quantitative studies presenting primary data from Organisation for Economic Co-Operation and Development(OECD)countries. Language was restricted to English or German.ParticipantsTo be eligible, a study had to involve (former) URM who immigrated to an OECD country.DesignWe conducted a systematic review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The databases MEDLINE, CINAHL, LIVIVO, PSYNDEX and PsycINFO were searched from 1990 to 2017. Studies were judged for eligibility by two independent reviewers each. We narratively summarised our results.Results9 primary studies, all from Europe, examined gender differences in the mental health of URM. The majority of the included studies found female URM to be more often affected by post-traumatic or depressive symptoms than their male counterparts. There is only weak evidence regarding other mental health outcomes. Two studies each conducted gender-specific analyses on anxiety and externalising behaviour, but no statistically significant differences between female and male URM were detected.ConclusionsFemale gender is associated with a higher vulnerability towards certain mental health problems among URM residing in Europe. However, the lack of representative studies using reliable diagnostic methods indicates that the findings so far should be treated with caution. Further research is needed to clarify the role of gender for mental health in URM and to examine underlying mechanisms.
Background: Prevalence rates of posttraumatic stress disorder and depression are high among refugees in Germany. However, knowledge on subjective as well as objective need for psychotherapy and utilization of psychotherapeutic treatment is scarce. Both structural and personal barriers regarding utilization of mental health services must be addressed in order to increase treatment efficiency. Objective: The aim of this study was to determine the objective as well as the perceived need for treatment, the utilization of mental health care among refugees in the past 12 months, and the perceived barriers to treatment. Method: By means of face-to-face interviews, an unselected convenience sample of 177 adult refugees were interviewed in either Arabic, Farsi, Kurmancî, English, or German. The general sample was reached through social workers. In addition to the Refugee Health Screener-15 (RHS-15), utilization of psychotherapeutic and psychiatric care as well as the subjective needs and barriers to treatment were assessed. Results: According to the RHS-15 54.8% of participants (n = 97) suffered from relevant mental health problems. However, although 28 (28.9%) of the 97 participants who scored above the RHS-15 cut-off perceived a need for therapy, none of them had received psychotherapy as recommended by the German S3 Guidelines. Missing information about mental health and language difficulties were the most frequently cited barriers to mental health services. Conclusions: Psychologically distressed refugees do not receive sufficient treatment. The reduction of barriers to treatment as well as extension of mental health services to lower thresholds should be considered in the future. Uso de servicios de salud mental y barreras percibidas para el tratamiento entre refugiados adultos en AlemaniaAntecedentes: Las tasas de prevalencia de trastorno de estrés postraumático y depresión son elevadas en los refugiados en Alemania. Sin embargo, es escaso el conocimiento sobre la necesidad subjetiva y objetiva de acceder a psicoterapia y sobre el uso de tratamiento psicoterapéutico. Se deben abordar las barreras tanto estructurales como personales en relación al uso de servicios de salud mental para poder lograr aumentar la eficiencia del tratamiento. Objetivo: El objetivo de este estudio fue determinar la necesidad objetiva y percibida de acceder a tratamiento, el uso de atenciones en salud mental entre los refugiados en los últimos 12 meses, y las barreras percibidas para acceder a tratamiento. Método: Mediante entrevistas cara a cara, una muestra no seleccionada de conveniencia de 177 adultos refugiados fueron entrevistados en árabe, persa, kurdo del norte, inglés o alemán. La muestra general fue contactada mediante trabajadoras sociales. Adicionalmente al Tamizaje de Salud del Refugiado-15 (RHS-15 por sus siglas en inglés), se evaluó el uso de atenciones psiquiátricas y psicológicas, así como también las necesidades y barreras subjetivas para acceder a tratamiento. Resultados: De acuerdo al RHS-15 el 54.8% de los participantes ...
Background: Accessing and using health care in European countries pose major challenges for asylum seekers and refugees due to legal, linguistic, administrative, and knowledge barriers. This scoping review will systematically describe the literature regarding health care for asylum seekers and refugees in high-income European countries, and the experiences that they have in accessing and using health care. Methods: Three databases in the field of public health were systematically searched, from which 1665 studies were selected for title and abstract screening, and 69 full texts were screened for eligibility by the main author. Of these studies, 44 were included in this systematic review. A narrative synthesis was undertaken. Results: Barriers in access to health care are highly prevalent in refugee populations, and can lead to underusage, misuse of health care, and higher costs. The qualitative results suggest that too little attention is paid to the living situations of refugees. This is especially true in access to care, and in the doctor-patient interaction. This can lead to a gap between needs and care. Conclusions: Although the problems refugees and asylum seekers face in accessing health care in high-income European countries have long been documented, little has changed over time. Living conditions are a key determinant for accessing health care.
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