Evaluating Mental Health in Cuban Refugees: The Role of the Refugee Health Screener-15

Bosson, Rahel; Schlaudt, V.; Williams, Monnica T.; Carrico, Ruth; Peña, Adriana; Ramírez, Julio; Kanter, Jonathan W.

doi:10.18297/rgh/vol1/iss1/4

Cited by 7 publications

(8 citation statements)

References 15 publications

(27 reference statements)

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“…The Refugee Health Screener-15 (RHS-15) [6] was designed to identify refugees who present with issues that likely demand psychiatric attention. The RHS-15 was standardized to create "diagnostic proxies" for PTSD, depression, and anxiety, with good sensitivity and specificity across diverse nationalities [6][7][8]. Diagnostic proxies were used in place of diagnostic interviews to decrease financial and time resources spent by completing fully structured diagnostic interviews [6].…”

Section: Identifying Refugees In Need Of Mental Health Servicesmentioning

confidence: 99%

Traumatic Experiences and Mental Health Risk for Refugees

Schlaudt

Bosson

Williams

et al. 2020

IJERPH

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Refugees who settle in Western countries exhibit a high rate of mental health issues, which are often related to experiences throughout the pre-displacement, displacement, and post-displacement processes. Early detection of mental health symptoms could increase positive outcomes in this vulnerable population. The rates and predictors of positive screenings for mental health symptoms were examined among a large sample of refugees, individuals with special immigrant visas, and parolees/entrants (N = 8149) from diverse nationalities. Logistic regression analyses were used to determine if demographic factors and witnessing/experiencing violence predicted positive screenings. On a smaller subset of the sample, we calculated referral acceptance rate by country of origin. Refugees from Syria, Iraq, and Afghanistan were most likely to exhibit a positive screening for mental health symptoms. Refugees from Sudan, Iraq, and Syria reported the highest rate of experiencing violence, whereas those from Iraq, Sudan, and the Democratic Republic of Congo reported the highest rate of witnessing violence. Both witnessing and experiencing violence predicted positive Refugee Health Screener-15 (RHS-15) scores. Further, higher age and female gender predicted positive RHS-15 scores, though neither demographic variable was correlated with accepting a referral for mental health services. The findings from this study can help to identify characteristics that may be associated with risk for mental health symptoms among a refugee population.

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Section: Identifying Refugees In Need Of Mental Health Servicesmentioning

confidence: 99%

Traumatic Experiences and Mental Health Risk for Refugees

Schlaudt

Bosson

Williams

et al. 2020

IJERPH

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“…Thirteen of the 15 items were taken from these instruments to measure the degree of distress associated with symptoms of PTSD, depression, and anxiety using a Likert response set ranging from not at all (0 points) to extremely bothersome (4 points); item 14 measures the degree to which individuals believe that they can cope using a Likert scale ranging from being able to cope with anything that comes your way (0 points) to unable to cope with anything (4 points); and item 15 is a distress thermometer ranging from 0 (no distress) to 10 (extreme distress). The RHS-15 total score is the sum of items 1 to 14 (score range, 0-56), and a positive RHS-15 result was defined as: (1) a total score of 12 or greater (of 56) or (2) a distress thermometer of 5 or greater (of 10), which is consistent with the cutoff found to optimize sensitivity and specificity for PTSD, depression, and anxiety …”

Section: Methodsmentioning

confidence: 94%

“…Emotional Distress in Unaccompanied Migrant Children and Adolescents distress, including symptoms of the common psychiatric conditions of major depression, anxiety, and PTSD, in refugee populations. Translation of the RHS-15 into available languages, including Spanish, 37 has been performed in iterative, participatory processes, including refugees, experts, and professional translators to optimize the cultural responsiveness and linguistic relevance of the items.…”

Section: Jama Network Open | Psychiatrymentioning

confidence: 99%

“…It has strong psychometric properties, 29,37,38 including high sensitivity and specificity against validated diagnostic proxies of PTSD (0.81 and 0.87, respectively), anxiety (0.94 and 0.86, respectively), and depression (0.95 and 0.89, respectively). 24 The 15-item version of the RHS-15 includes items from the Hopkins Symptoms Checklist-25, the New Mexico Refugee Symptom Checklist-121, and the Posttraumatic Symptoms Scale-Self Report, which were selected based on their association with PTSD, depression, and anxiety.…”

Section: Jama Network Open | Psychiatrymentioning

confidence: 99%

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Persistence of Emotional Distress in Unaccompanied Migrant Children and Adolescents Primarily From the Northern Triangle of Central America

Vega Potler,

Zhang,

Hackley

et al. 2023

JAMA Netw Open

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ImportanceIn the US, unaccompanied migrant children and adolescents (hereinafter referred to as children) are predominantly from Central America’s Northern Triangle. While unaccompanied migrant children are at high risk for psychiatric sequelae due to complex traumatic exposures, longitudinal investigations of psychiatric distress after resettlement are lacking.ObjectiveTo identify factors associated with emotional distress and longitudinal changes in emotional distress among unaccompanied migrant children in the US.Design, Setting, and ParticipantsFor this retrospective cohort study, the 15-item Refugee Health Screener (RHS-15) was administered between January 1, 2015, and December 31, 2019, to unaccompanied migrant children as part of their medical care to detect emotional distress. Follow-up RHS-15 results were included if they were completed before February 29, 2020. Median follow-up interval was 203 days (IQR, 113-375 days). The study was conducted in a federally qualified health center that provides medical, mental health, and legal services. Unaccompanied migrant children who completed the initial RHS-15 were eligible for analysis. Data were analyzed from April 18, 2022, to April 23, 2023.ExposuresTraumatic events before migration, during migration, during detention, and after resettlement in the US.Main Outcomes and MeasuresEmotional distress, including symptoms of posttraumatic stress disorder, anxiety, and depressive symptoms, as indicated by the RHS-15 (ie, score ≥12 on items 1-14 or ≥5 on item 15).ResultsIn total, 176 unaccompanied migrant children completed an initial RHS-15. They were primarily from Central America’s Northern Triangle (153 [86.9%]), were mostly male (126 [71.6%]), and had a mean (SD) age of 16.9 (2.1) years. Of the 176 unaccompanied migrant children, 101 (57.4%) had screen results above the positive cutoff. Girls were more likely to have positive screen results than boys (odds ratio, 2.48 [95% CI, 1.15-5.34]; P = .02). Follow-up scores were available for 68 unaccompanied migrant children (38.6%). On the follow-up RHS-15, most scored above the positive cutoff (44 [64.7%]). Three-quarters of unaccompanied migrant children who scored above the positive cutoff initially continued to have positive scores at follow-up (30 of 40), and half of those with negative screen scores initially had positive scores at follow-up (14 of 28). Female vs male unaccompanied migrant children (unstandardized β = 5.14 [95% CI, 0.23-10.06]; P = .04) and initial total score (unstandardized β = 0.41 [95% CI, 0.18-0.64]; P = .001) were independently associated with increased follow-up RHS-15 total score.Conclusions and RelevanceThe findings suggest that unaccompanied migrant children are at high risk for emotional distress, including symptoms of depression, anxiety, and posttraumatic stress. The persistence of emotional distress suggests that unaccompanied migrant children would benefit from ongoing psychosocial and material support after resettlement.

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“…The reliability of questions 1 through 14 on the RHS‐15 scale is .93 (Hollifield et al, 2013). The RHS‐15 has been widely used in mental health among refugee populations in diverse settings (Bosson et al, 2017; Kaltenbach et al, 2017; Polcher & Calloway, 2016).…”

Section: Methodsmentioning

confidence: 99%

Parenting Among Rohingya and Afghan Refugee Parents Residing in Malaysia

Shaw

Pillai²,

Yang

et al. 2020

Family Relations

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Objective This study examined the measurement properties of parenting‐related measures among 140 Rohingya and Afghan refugee parents residing in Malaysia, then examined factors associated with these parenting outcomes. Background Unprecedented numbers of forced migrant families reside in countries of first asylum with temporary status and limited legal rights. Limited research examines parenting experiences among these communities. Method To examine construct validity and reliability of parenting‐related measures among this sample, we carried out confirmatory factor analysis to examine respectively the factor structure of scales measuring underlying latent constructs of Child Adjustment & Parent Efficacy, the Alabama Parenting Questionnaire, and the Family Functioning Scale. Their associations with individual (gender, age, ethnicity, education), social (marital status, number of children), and environmental factors (time in Malaysia, food insecurity, employment, and emotional distress) were examined using structural equation modeling. Results Residing in Malaysia for a longer period of time was associated with higher child behavioral intensity, lower parent self‐efficacy, and higher family conflict. Food insecurity was associated with lower parent self‐efficacy, and being employed was associated with positive parenting as well as poor supervision. Higher levels of emotional distress were associated with higher child behavioral intensity, lower parent self‐efficacy, and lower levels of poor supervision. Conclusion Displacement challenges negatively affect refugee parents and families. Implications Solutions are needed that bolster the abilities of forced migrants to establish permanence and provide for their families. Additionally, attention toward the unique challenges of refugee families can guide service provision within countries of first asylum.

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Evaluating Mental Health in Cuban Refugees: The Role of the Refugee Health Screener-15

Cited by 7 publications

References 15 publications

Traumatic Experiences and Mental Health Risk for Refugees

Traumatic Experiences and Mental Health Risk for Refugees

Persistence of Emotional Distress in Unaccompanied Migrant Children and Adolescents Primarily From the Northern Triangle of Central America

Parenting Among Rohingya and Afghan Refugee Parents Residing in Malaysia

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