A Central Clearing Clinic to Provide Mental Health Services for Refugees in Germany

Abstract

Objective: To determine migration related distress pattern in refugees and feasibility of a de novo established, central low-threshold outpatient clinic serving more than 80,000 newly arrived refugees in the metropole of Berlin.Methods: In an observational cohort study the relative prevalence of major psychiatric disorders by age, place of living within berlin, language and region of origin were assessed in a refugee cohort from 63 nationalities speaking 36 languages.Findings: Within 18 months, a total of 3,096 cases with a mean age of 29.7 years (11.7) have been referred from all 12 districts and 165 of 182 subdistricts of Berlin to the CCC. 33.7% of the patients were female. The three most frequent diagnoses were unipolar depression (40.4%), posttraumatic stress disorder (24.3%), and adjustment disorder (19.6%).Conclusion: The present data gives insight into the distribution of mental disorders in a large sample of refugees and provides evidence that a CCC is an effective service to quickly and broadly provide psychiatric consultations and thus to overcome classical barriers refugees usually experience in the host communities. In Berlin, Germany, and Europe treatment resources for this population should focus on stress and trauma related disorders.

Health system responsiveness to the mental health needs of Syrian refugees: mixed-methods rapid appraisals in eight host countries in Europe and the Middle East

“…Availability and accessibility of mental health services were concerns in all countries. Demand outstrips supply of mental health resources, with insufficient numbers of mental health workers and/or services reported in Egypt, Jordan 38 – 40 , Türkiye, Switzerland 41 – 44 , Sweden 45 , 46 , Germany 47 – 50 , and in Lebanon:…”

“…This is important, as acceptability seems to be a key issue across countries. Cultural and language barriers, as aspects of acceptability, were predominantly mentioned in European countries, likely due to the greater differences with Syrian society both culturally and linguistically 47 , 48 , 53 , 61 – 66 . A Syrian refugee in the Netherlands highlighted this communication challenge:…”

Refugee Mental Health, Global Health Policy, and the Syrian Crisis

“…The Charité University Hospital in Berlin has been at the center of efforts to design, research, and implement mental health services for refugees. They have partnered with NGOs to provide services in Jordan, and in Berlin offer treatments from a specialist outpatient clinic for refugees ( 221 ). There are also a number of other research-based initiatives underway, including the development of a new screening tool ( 222 ), interventions for children ( 223 ), and multidisciplinary treatment packages for adults ( 224 ).…”

Engaging Refugees With a Culturally Adapted Digital Intervention to Improve Sleep: A Randomized Controlled Pilot Trial

“…The United High Commissioner for Refugees (UNHCR) reports on 82.4 million forcibly displaced people in the end of 2020, including 34.4 million people displaced abroad 1 (1). This poses challenges on healthcare systems in the arrival countries (2)(3)(4)(5), mainly because refugees are exposed to many stressors before, during, and after flight (6,7). The many stressors influence refugee's mental health (8)(9)(10) and, correspondingly, the prevalence of trauma-associated disorders such as posttraumatic stress disorder or depression is enhanced (11)(12)(13)(14).…”