Profiling the Trauma Related Symptoms of Bosnian Refugees Who Have not Sought Mental Health Services

Abstract

The objective of this study was to profile trauma related psychiatric symptoms in a group of refugees not seeking mental health services and to consider the services implications. The study involved research assessments of two groups of Bosnian refugees: those who have not presented for mental health services and those who have. A total of 28 of 41 nonpresenters (70%) met symptom criteria for posttraumatic stress disorder (PTSD) diagnosis. All service presenters (N = 29) met symptom criteria for PTSD diagnosis. The group that did not present for services reported substantial but lower trauma exposure, PTSD symptom severity, and depression symptom severity. They had significant differences on all subscales of the MOS SF-36, indicating better health status. We concluded that those who do not seek services have substantial symptom levels, but their self-concept appears to be less oriented toward illness and help seeking. Innovative access, engagement, and preventive interventions are needed to address those who have symptoms but do not readily seek help for trauma mental health services.

Symptom severity and lifetime and prospective health service use among military veterans evaluated for PTSD

“…Specifically, and not surprisingly, health problems were related to prospective medical care use, consistent with two previous studies of Vietnam veterans inquiring about (albeit, previous) medical care use [Marshall et al, 1997[Marshall et al, , 1998]. However, health status did not mediate the relationship between lifetime MH treatment use and prospective health care use, which is inconsistent with a study of combat veterans [Solomon, 1989] and another with refugees [Weine et al, 2000], both of which found relations between previous MH care use and current health status. Thus, from these studies we may only suggest that among trauma survivors health problems are related to medical care use.…”

“…Specifically, studies demonstrate that a PTSD diagnosis predicts a greater likelihood (and intensity) of MH [Boscarino et al, 2002;New and Berliner, 2000;Zhang et al, 2004] and medical services [Fagan et al, 2003;Zhang et al, 2004]. Three investigations also reveal that PTSD severity increases the likelihood of MH care use [Calhoun et al, 2002;Goto et al, 2002;Weine et al, 2000], whereas two studies fail to support this finding [Elhai et al, 2004;Schwarz and Kowalski, 1992].…”

“…Health-related problems among trauma survivors were associated with increased MH service use in studies of military soldiers and refugees [Solomon, 1989;Weine et al, 2000], and greater medical care use in studies of military veterans [Marshall et al, 1997[Marshall et al, , 1998]. Thus, health problems can also explain health service use patterns in trauma survivors.…”

Improving access to and engagement with mental health services among young people from refugee backgrounds: service user and provider perspectives

“…Low or 'lower than expected' levels of service use may in part reflect reduced levels of need for service and a great degree of resilience (e.g. (Siriwardhana et al, 2014;Steel, Silove, Chey, Bauman, & Phan, 2005;Weine et al, 2000)). Nevertheless, studies that have measured mental health needs and service utilisation levels have found that the majority of young refugees who have significant mental health needs do not access services (e.g., (Bean, Eurelings-Bontekoe, Mooijaart, & Spinhoven, 2006;Ziaian, 2013).…”

What Does Not Kill Us Makes Us Stronger: Implications for Bosnian Refugees' Coping Skills during a Natural Disaster

“…Given the Bosnian refugees' strong personality and emotional independence, it is likely that they can underestimate their own emotional and mental health needs in the aftermath of a disaster. Previous literature has repeatedly demonstrated the severity of mental health outcomes, including PTSD, major depression, and major anxiety, among Bosnian refugees after the Bosnian war [36][37][38], and this should be closely considered in the wake of above findings.…”