Psychiatric Emergencies of Asylum Seekers; Descriptive Analysis and Comparison with Immigrants of Warranted Residence

Abstract

Background: The aim of our study was to assess utilization patterns of psychiatric services by asylum seekers. Methods: We included 119 adults who presented themselves at the University Emergency Department between 1 March 2012 and 1 January 2017 for psychiatric consultation. Descriptive data were compared with a control group of non-Swiss individuals with warranted residence permits using Mann-Whitney-U and chi square (χ2) tests. Results: Patients were mainly single, male, residing in reception centers, and presented themselves most frequently due to suicidal ideation. Almost 60% of the patients were assigned to inpatient treatments, with 28 involuntary cases. Compared to the control group, asylum seekers were younger and more often men (p < 0.001 for both). Further, they less often had family in Switzerland (χ2 = 9.91, p = 0.007). The proportion of patients coming in as walk-ins was significantly higher in the control group than in asylum seekers (χ2 = 37.0, p < 0.001). Asylum seekers were more frequently referred due to suicidal ideation and aggressive behavior than participants in the control group (χ2 = 80.07, p < 0.001). Diagnoses for asylum seekers infrequently included mood, as they often reported stress-related disorders (χ2 = 19.6, p = 0.021) and they were infrequently released home (χ2 = 9.19, p = 0.027). Conclusion: Asylum seekers more frequently demonstrated severe symptoms such as suicidal ideation and aggressive behavior and they were mainly treated as inpatients, potentially due to minimal social resources.

Self‐harming behaviours of asylum seekers and refugees in Europe: A systematic review

“…Similarly, Schoretsanitis et al (2018) analysed the clinical folders of a Swiss emergency service, and discovered higher suicide attempts, aggressive behaviour, psychotic symptoms, stress as well as self‐aggressive behaviours, including self‐harm, in asylum seekers compared to the native population.…”

Upon Rejection: Psychiatric Emergencies of Failed Asylum Seekers

“…Regarding the referral outcomes, patients were mainly treated as inpatients ( n = 28, 73.7%); in 12 of these cases (31.6%), treatment was voluntary. A detailed description of sociodemographic and clinical characteristics of the patients with a pending application (control group) is provided elsewhere [ 28 ]. No association was detected between interpretation (by interpreting service or person from the patient’s environment) and compulsory treatment ( p = 0.58 for Fisher exact test).…”

“…Note that 7 out of 8 rejected asylum seekers receiving the diagnosis of acute stress reaction were referred shortly (within 24 h) after the negative asylum decision. Because severe symptoms have been reported in many claimants even during the determination process [ 28 ], we posit that the decision may have aggravated pre-existing symptoms, rather than triggering them. Here, we have to consider the possible adverse effects of the pending status as well.…”

“…Consulting clinicians are mainly resident doctors under the supervision of senior doctors. The screening process of the medical records is described in detail in a previous paper [ 28 ].…”

Health of Refugees and Migrants—Where Do We Stand and What Directions Should We Take?

“…Prevention and treatment are essential. High rates of mental health issues are likely impacted by the trauma experienced during crises, travel time to the host country and the many different challenges related to migrant experiences, including separation from family, difficulties in proper use of the health services as a result of cultural differences, lack of knowledge of the new health system, and language barriers [20,21,22,23,24,25].…”