A Central Clearing Clinic to Provide Mental Health Services for Refugees in Germany.

Malek Bajbouj,Dimitris Repantis,Joachim Seybold,Ulrike Kluge,Andreas Heinz,Max Benedikt Burger,Eric Hahn,Stefanie Schreiter,Sibylle-Maria Winter,Patricia Panneck,Carlos Ajami,Igor Sutej,Marion Aichberger,Jihad Alabdullah,Isabella Heuser,Armin Hoyer,Anja Haberlandner

doi:10.3389/fpubh.2021.635474

Abstract

Objective: To determine migration related distress pattern in refugees and feasibility of a de novo established, central low-threshold outpatient clinic serving more than 80,000 newly arrived refugees in the metropole of Berlin.Methods: In an observational cohort study the relative prevalence of major psychiatric disorders by age, place of living within berlin, language and region of origin were assessed in a refugee cohort from 63 nationalities speaking 36 languages.Findings: Within 18 months, a total of 3,096 cases with a mean age of 29.7 years (11.7) have been referred from all 12 districts and 165 of 182 subdistricts of Berlin to the CCC. 33.7% of the patients were female. The three most frequent diagnoses were unipolar depression (40.4%), posttraumatic stress disorder (24.3%), and adjustment disorder (19.6%).Conclusion: The present data gives insight into the distribution of mental disorders in a large sample of refugees and provides evidence that a CCC is an effective service to quickly and broadly provide psychiatric consultations and thus to overcome classical barriers refugees usually experience in the host communities. In Berlin, Germany, and Europe treatment resources for this population should focus on stress and trauma related disorders.

Highlights

As a consequence of armed conflicts in embattled countries, more than sixty million people worldwide had been forced to leave their home countries according to recent UNHCR assessments [1]
While the exact response pattern to stress and trauma experiences in this specific population after more than 2 years still remain unclear, it is beyond all questions that the overall demand in mental health services surmounted the capacities available within the existing German health care structures [9, 10]
All assessments were performed in the central clearing clinic, which is centrally located and situated in an area well-known to refugees since it hosted the registration authority for all newly arrived refugees in Berlin until May 2016

Summary

Introduction

As a consequence of armed conflicts in embattled countries, more than sixty million people worldwide had been forced to leave their home countries according to recent UNHCR assessments [1]. The process of resettlement in a novel environment with unfamiliar habits, norms and expectations, restrictive policies in regard to residence status, limited access to main stream health services, the lack of other basic infrastructures and the living conditions in provisional shelters all increase insecurity and uncertainty among the newcomers, often leading to ethnic discrimination and social exclusion [4] This in sum leads to an accumulation of emotional distress presumably resulting in increased prevalence rates of mental disorders within the group of refugees as compared to the general population [5,6,7,8]. While the exact response pattern to stress and trauma experiences in this specific population after more than 2 years still remain unclear, it is beyond all questions that the overall demand in mental health services surmounted the capacities available within the existing German health care structures [9, 10]

Methods

Discussion

Conclusion