Mental health and drug and alcohol comorbidity in young people of refugee background: a review of the literature

Posselt, Miriam; Galletly, Cherrie; Crespigny, Charlotte de; Procter, Nicholas

doi:10.1080/17523281.2013.772914

Cited by 33 publications

(26 citation statements)

References 28 publications

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“…Comorbidity between mental health and substance use disorders has been well documented in the general population [ 29 – 31 ]. An emerging literature has begun to document comorbidity among forced migrant populations [ 32 – 34 ], who may be particularly vulnerable to substance use as a coping mechanism.…”

Section: Introductionmentioning

confidence: 99%

Epidemiology of Substance Use among Forced Migrants: A Global Systematic Review

et al. 2016

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IntroductionForced migration is occurring at unprecedented levels. Forced migrants may be at risk for substance use for reasons including coping with traumatic experiences, co-morbid mental health disorders, acculturation challenges and social and economic inequality. This paper aimed to systematically review the literature examining substance use among forced migrants, and identify priority areas for intervention and future research.MethodsSeven medical, allied health and social science databases were searched from inception to September 2015 in accordance with PRISMA guidelines to identify original peer-reviewed articles describing any findings relating to alcohol and/or illicit drug use among refugees, internally displaced people (IDPs), asylum seekers, people displaced by disasters and deportees. A descriptive synthesis of evidence from quantitative studies was conducted, focusing primarily on studies which used validated measures of substance use. Synthesis of evidence from qualitative studies focused on identifying prominent themes relating to the contexts and consequences of substance use. Critical Appraisal Skills Programme (CASP) checklists were used to assess methodological quality of included studies.ResultsForty-four quantitative (82% cross-sectional), 16 qualitative and three mixed-methods studies were included. Ten studies were rated as high methodological quality (16%), 39 as moderate quality (62%) and 14 as low quality (22%). The majority of research was conducted among refugees, IDPs and asylum seekers (n = 55, 87%), predominantly in high-income settings. The highest-quality prevalence estimates of hazardous/harmful alcohol use ranged from 17%-36% in camp settings and 4%-7% in community settings. Few studies collected validated measures of illicit drug use. Seven studies compared substance use among forced migrants to other migrant or native-born samples. Among eight studies which conducted multivariable analysis, male sex, trauma exposure and symptoms of mental illness were commonly identified correlates of substance use.ConclusionOur understanding of substance use among forced migrants remains limited, particularly regarding persons displaced due to disasters, development and deportation. Despite a growing body of work among refugee-background populations, few studies include refugees in low and middle-income countries, where over 80% of the global refugee population resides. Findings suggest a need to integrate substance use prevention and treatment into services offered to forced migrants, particularly in camp settings. Efforts to develop and evaluate interventions to reduce substance use and related harms are needed.

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Section: Introductionmentioning

confidence: 99%

Epidemiology of Substance Use among Forced Migrants: A Global Systematic Review

et al. 2016

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“…Possible explanations for an uneven burden of drug‐related harms have been offered in various studies with CALD groups who use drugs. These include barriers to suitable and timely preventative and treatment interventions , disproportionate policing and incarceration of particular CALD populations , and the relationship between disadvantage and substance use . Racism and discrimination may also fortify in‐group practices, meaning that riskier injecting practices may more easily become norms .…”

Section: Introductionmentioning

confidence: 99%

Risk and blood‐borne virus testing among men who inject image and performance enhancing drugs, Sydney, Australia

Rowe¹,

Berger²,

Yaseen³

et al. 2017

Drug and Alcohol Review

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“…A small number of studies have identified risk factors that are associated with an increased risk for substance use in groups with refugee backgrounds (Ezard, 2012;Ezard et al, 2011;Miremadi, Ganesan, & McKenna, 2011;Posselt, Galletly, de Crespigny, & Procter, 2014). Only a handful of studies could be identified that looked specifically at substance use with Karen people who were refugees (Ezard et al, 2011;McCleary & Wieling, 2016).…”

Section: Harmful Alcohol Use In the Karen Communitymentioning

confidence: 99%

The Karen Chemical Dependency Collaboration: Lessons Learned in Using a Collaborative Framework to Promote Refugee Integration

McCleary

Horn

Toe

et al. 2018

ASW

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While refugee integration is defined as a bidirectional process of mutual learning and adaptation, in practice, the U.S. resettlement program continues to emphasize refugees’ acculturation processes and places little emphasis on cultural or logistical adaptation of existing services. When adaptation does happen, it is often structured around dominant notions of health and well-being. There is a need to explore bidirectional integration processes and existing systems adaptations to accommodate people with refugee backgrounds at the institutional level. This article details a framework to build a sustainable collaboration between a refugee community and existing health and social service systems to reduce harmful alcohol use. The conceptual framework emphasizes three components: 1) adaptation of refugees’ indigenous expertise, networks, systems, and resources; 2) adaptation of existing systems to serve new groups in culturally relevant and effective ways; and 3) the participatory processes through which refugees and existing systems collaborate to achieve mutual goals. This paper describes the application of this framework and concludes with a discussion of lessons to support replication of the framework in other settings. Lessons learned include: equalizing power, paying attention to relationships and roles, engaging in deep cultural adaption of interventions, and building individual and organizational capacity to support partners.

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Mental health and drug and alcohol comorbidity in young people of refugee background: a review of the literature

Cited by 33 publications

References 28 publications

Epidemiology of Substance Use among Forced Migrants: A Global Systematic Review

Epidemiology of Substance Use among Forced Migrants: A Global Systematic Review

Risk and blood‐borne virus testing among men who inject image and performance enhancing drugs, Sydney, Australia

The Karen Chemical Dependency Collaboration: Lessons Learned in Using a Collaborative Framework to Promote Refugee Integration

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