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

Abstract

The special issue of the European Journal of Psychotraumatology released on 7 November 2017 focused on traumatized refugees and on the mental health burden, screening instruments and interventions in different groups of refugees. This contribution takes up this discussion on the needs and challenges for mental healthcare of traumatized refugees from the point of view of the practitioners. It reports on the findings of a survey on the treatment situation and the delivery reality of healthcare for refugees in 14 European countries, identifies treatment gaps, and sets recommendations for action at the political and therapeutic levels. The survey was conducted by the Federal Chamber of Psychotherapists with the assistance of the Network for Psychotherapeutic Care in Europe. The findings underline the need for appropriate mental healthcare for this population.

Experiences of psychotherapists working with refugees in Germany: a qualitative study

“…Although it remains unclear whether due to a lack in offer or rather in uptake thereof, this mirrors observations by others [e.g. 28 , 45 ]. Similarly, our findings imply that well-trained translators are in short supply.…”

“…However, this does not mean that no challenges in working with this group exist. In contrast to the fairly elaborate literature on barriers in access to psychotherapy and on the general effectiveness of psychotherapy with refugees, little research has been done on how psychotherapists, who often are not specifically trained in working with refugee clients [ 28 ], experience the cross-cultural psychotherapeutic process, which we define as a therapeutic encounter between a psychotherapist and a client of different cultural backgrounds. The little available research highlights issues such as communication difficulties, differences in illness attribution belief systems, differences in expectations towards treatment, and issues related to trust as main challenges [ 15 , 26 , 31 – 33 ].…”

A decennial review of psychotraumatology: what did we learn and where are we going?

“…The large influx of traumatized refugees from Syria and other countries has challenged health-care systems in Europe and trauma researchers have been involved in shaping policies to address their mental health needs (Munz & Melcop, 2018;Sijbrandij et al, 2017; see section 7 on refugees).…”

‘Only God can promise healing.’: help-seeking intentions and lay beliefs about cures for post-traumatic stress disorder among Sub-Saharan African asylum seekers in Germany

“…These circumstances, as well as post-migration stressors in the receiving countries, seem to have a strong detrimental impact on their mental health (Carta, Bernal, Hardoy, & Haro-Abad, 2005;Mewes, Reich, Skoluda, Seele, & Nater, 2017). Although high rates of post-traumatic stress disorder (PTSD) and other mental disorders have been found among asylum seekers from Sub-Saharan Africa (Kolassa et al, 2010;Neuner et al, 2004;Onyut et al, 2009;Slobodin & de Jong, 2015;Ssenyonga, Owens, & Olema, 2013;Tempany, 2009), too few receive support and professional help (Munz & Melcop, 2018;Sijbrandij et al, 2017).…”

“…Disparities in help-seeking behaviour have been documented between refugee populations and populations without a migration background, with asylum seekers and refugees being less likely than native-born populations to seek or be referred to mental health services, even when they experience comparable levels of distress (Kirmayer et al, 2011). In part, these disparities have been attributed to structural barriers, as the provision of appropriate mental health care for refugees and asylum seekers has been described as a challenge for the health care systems of host countries (Munz & Melcop, 2018;Sijbrandij et al, 2017;Sturm, Baubet, & Moro, 2010). In addition, the refugees themselves might suffer from a lack of knowledge regarding available mental health care services (Donnelly et al, 2011), unfamiliarity with such services (Ellis et al, 2010;Palmer, 2006), concerns regarding the confidentiality of professional interpreters (Bhatia & Wallace, 2007), and fears that their problems will not be understood by practitioners due to a lack of cultural competence (De Anstiss & Ziaian, 2010;Sandhu et al, 2013).…”