Factors Associated with Implementing the Integrated Behavioral Health Care Model and Iraqi Refugees in the USA

Abstract

The aim was to identify which factors facilitate providing integrated behavioral health care for Iraqi refugees in nationally recognized community health center in Northern USA. The social-ecological model (SEM) framework guided this qualitative case study exploring the experience of 11 professional staff. Data were collected from June through August 2021 through individual interviews. Eight themes emerged based on the SEM levels: Intrapersonal-gender-driven engagement; interpersonal-the need for discretion and trusting relationship; community-collaboration with community resources and integrator from the community; organizational-holistic care, and long-term care; and policy-insufficient educational preparation. The results highlight components for clinical practice and policymakers regarding a population that is a big consumer of mental health care. Future research should explore other vulnerable populations, the effect of social groups, and the incorporation of community resources as part of the integrated care team.

Mental Health Care Access Among Arab Immigrants in the United States: Application of Public Arena Model

“…Other, less ideal policy options exist. It comprises advocating for integrating behavioral health and primary care services for immigrant populations (Falconer et al, 2018 ; Peer et al, 2023 ). This approach entails central components, including patient-targeted alignment, inclusive and harmonized care, permanent access, and a system-based tactic (Odgkinson et al, 2017 ).…”

“…Researchers have demonstrated that incorporating mental health services into primary care enhances both physical and mental health outcomes, in part because of integrating linguistic services on the provision of care to immigrants with complicated health care issues (Aupont et al, 2013; Kolk et al, 2014). Integration may also help Arab immigrants with severe emotional disturbances reduce their symptoms while enhancing retention and access to care (Odgkinson et al, 2017 ; Peer et al, 2023 ), possibly by reducing the associated stigma via more accessible treatments in a trusted environment (Hodgkinson et al, 2017 ). Evidence from prior literature indicates that that an integrated behavioral care approach has the possibility of promoting engagement with mental health services and maintain care continuity, while decreasing costs of care and stereotyping associated with behavioral healthcare (Falconer et al, 2018 ; Peer et al, 2023 ).…”

“…Integration may also help Arab immigrants with severe emotional disturbances reduce their symptoms while enhancing retention and access to care (Odgkinson et al, 2017 ; Peer et al, 2023 ), possibly by reducing the associated stigma via more accessible treatments in a trusted environment (Hodgkinson et al, 2017 ). Evidence from prior literature indicates that that an integrated behavioral care approach has the possibility of promoting engagement with mental health services and maintain care continuity, while decreasing costs of care and stereotyping associated with behavioral healthcare (Falconer et al, 2018 ; Peer et al, 2023 ). However, this policy approach faces significant obstacles, as it requires enough mental health clinicians and support workers to effectively facilitate cooperation with physical medical specialists; clinics in larger cities may be better positioned to provide such integrated services (Odgkinson et al, 2017 ; Knopf et al, 2016 ).…”

“…However, this policy approach faces significant obstacles, as it requires enough mental health clinicians and support workers to effectively facilitate cooperation with physical medical specialists; clinics in larger cities may be better positioned to provide such integrated services (Odgkinson et al, 2017 ; Knopf et al, 2016 ). Facility-imposed time restrictions on physicians may hinder ensuring that good quality mental health treatments are provided, i.e., like those of a mental health professional (Knopf et al, 2016 ; Peer et al, 2023 ). Primary care physicians also lack the necessary training and support to confidently identify patients with significant mental health issues (Knopf et al, 2016 ).…”