Prevalence and predictors of health service use among Iraqi asylum seekers in the Netherlands

Abstract

j Abstract Background A long asylum procedure is associated with higher prevalence rates of psychiatric disorders, lower quality of life, higher disability and more physical health problems. Additional knowledge about health seeking behavior is necessary to guide governments and health professionals in their policies. Objective To measure service use among one of the biggest asylum seekers population in the Netherlands and to assess its relationships with predisposing and need variables (including post-migration living problems). Method Two groups were randomly selected: Group 1 (n = 143), less than 6 months and Group 2 (n = 151), more than 2 years in the Netherlands. Respondents were interviewed with fully structured, culturally validated, translated questionnaires, which contained instruments to measure psychiatric disorders, quality of life, disability, physical health and post-migration living problems. Use of preventive and curative (physical and mental) health services was measured and the relationship with predisposing and need risk factors was estimated with univariate and multivariate logistic regression analyses. Results A long asylum procedure is not associated with higher service use, except for mental health service use and drug use. Use of mental health services is, however, low compared to the prevalence of psychiatric disorders. Low quality of perceived general health and functional disability are the most important predictors of services use. Psychopathology predicts use of a medical specialist (non-psychiatrist), but does not predict mental health service use. Conclusion A high percentage of asylum seekers with a psychiatric disorder is not getting adequate treatment. There is a mismatch between the type of health problem and the type of health service use. The various health services should work together in education, detection, referral and care in order to provide help to this group of patients.

The physical health status, service utilisation and barriers to accessing care for asylum seekers residing in the community: a systematic review of the literature

“…45 Compared with those who had arrived within the previous 6 months, asylum seekers with a longer length of stay had a higher level of disability, greater physical complaints, perceived lower physical health status and lower quality of life. 36,37 Longer length of stay was also associated with a lower live birth and abortion rate among asylum seekers. 33 A greater number of pre-migration traumatic events resulted in higher medical referral rates, 26 and was associated with chronic conditions and poor general health status.…”

“…[26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43] Compared with other population groups using the same outcome measures, perception of poor general health status was much worse among asylum seekers (around 60% 32,42 ) than comparative refugee samples (around 42% 32,42 ), immigrants (39% 32 ) or a general, non-immigrant population (18% 32 ).…”

“…26,28,[32][33][34]36,37,[42][43][44][45] These findings suggest that older age is associated with an increased risk of all ICD diagnostic categories (excluding reproductive health issues), 28 poorer selfreported general health status, 32 functional disability, 37 chronic conditions 32,37 and a higher medical referral rate. 26 Female gender was associated with a greater likelihood of reporting chronic conditions 32,37 and physical symptoms 26 but not with any specific ICD diagnoses.…”

Strengthening mental health care systems for Syrian refugees in Europe and the Middle East: integrating scalable psychological interventions in eight countries

“…Within Europe the large majority (80–90%) of refugees with symptoms of PTSD or other psychological problems (Laban, Gernaat, Komproe, & De Jong, 2007; Lamkaddem et al, 2014) do not visit specialized mental health care services. Other barriers include language problems (Bischoff et al, 2003), physical distance to mental health care services since refugees are often located in rural areas, and an overall lack of Arabic speaking psychologists or psychotherapists in European countries hosting Syrian refugees.…”

The psychotherapeutic care of refugees in Europe: treatment needs, delivery reality and recommendations for action

“…In the course of the 7 year follow-up period, the proportion increased to 54%, but remained relatively low (www.gezondheidsraad.nl). Another study (Laban, Gernaat, Komproe, & De Jong, 2007) in the Netherlands found that only 9% of asylum seekers with mental disorders had visited a mental health institution.…”