We aimed to assess the opinion of primary care workers, social workers, translators and mental health caregivers who work with asylum seekers about the latter's unmet needs and barriers to access to mental healthcare

A high prevalence of mental illness has been reported in asylum seekers. The present cross-sectional study examined suicidal thoughts, treatment modalities (outpatient crisis intervention, inpatient care), and their determinants in asylum seekers (n = 119) and permanent residents (n = 120) attending the same outpatient clinic in Geneva, Switzerland. The most frequent diagnoses were depressive disorders (64.7%) and posttraumatic stress disorder (34.5%) in asylum seekers and psychotic (55.0%) and depressive disorders (33.3%) in permanent residents. The frequency of suicidal thoughts was similar in both groups (>30%). Asylum seekers benefited from outpatient crisis intervention more frequently than residents did (26.9% vs. 5.8%), whereas inpatient care was less frequent (25.2% vs. 44.2%). In asylum seekers, acute suicidal thoughts were associated with increased frequency of outpatient crisis interventions, and, suicidal thoughts, psychosis, or personality disorders were associated with higher rates of hospitalization. Documenting clinical characteristics and service utilization of asylum seekers is a prerequisite to organizing targeted interventions.

Background: Brief therapy centers (BTCs) are outpatient mental health units based initially on a psychodynamic model of crisis intervention, and evolving later into a global care approach. The main objective of BTC is to provide mentally ill patients with a viable alternative to hospitalization. Methods: We undertook a retrospective study of 323 patients admitted to a BTC in Geneva in order to understand the evolution of our patients care over the changes in psychiatry over the last 2 decades. To this end, we considered predictive factors of relapse for 160 individuals with repeated "revolving door" admissions compared to 163 patients with a single admission to the BTC. To analyze data, we mainly use analysis of variance and logistic regression with SPSS software. Results: Living alone, lower socio-educational levels, unstable working conditions, crisis factor of professional trouble, and preexisting psychiatric conditions, such as depression, bipolar disorders, psychotic disorders or borderline personality disorder, that required multiple social and systemic interventions, and medical treatments (such as antipsychotics and mood stabilizers) increase probability that patients relapse and require multiple BTC admissions. Conclusions: The results of the present study that are considered as preliminary, support the development of ambulatory mental health units that attempt to adapt their intervention practices to different populations in order to prevent the revolving door phenomenon and therefore contribute to improve the global system of mental health.

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