Abstract
BackgroundRefugees and asylum seekers have high rates of risk factors for mental disorders. In recent years, Australia has experienced a rapid increase in asylum seeker arrivals, creating new challenges for services in areas with high settlement numbers. This paper describes the design, including analytic framework, of a project set in a refugee health service in the state of Victoria, Australia, as part of their response to meeting the mental health needs of their burgeoning local population of refugees and asylum seekers. In order to assist service planning, the primary aim of this study is to determine: 1) an overall estimate of the prevalence of psychiatric disorders; 2) the specific prevalence of post-traumatic stress disorder 3) the perceived need and unmet need for mental health treatment. The secondary aim of the study is to establish matched risk ratios based on an Australian-born matched comparison group from the 2007 National Survey of Mental Health and Well-Being.Methods/DesignA cross-sectional survey is used to estimate the prevalence of psychiatric disorders in refugees and asylum seekers attending a local refugee health service. Measures include the Kessler Psychological Distress Scale-10, the Post-Traumatic Stress Disorder-8, the General-practice User’s Perceived-need Inventory together with service utilisation questions from the National Survey of Mental Health and Well-Being. Data collected from refugees and asylum seekers (n = 130) is matched to existing data from Australian-born residents drawn from the 2007 National Survey of Mental Health and Well-Being (n = 520) to produce estimates of the risk ratio.DiscussionThe paper describes a prototype for what is possible within regular services seeking to plan for and deliver high quality mental health care to refugees and asylum seekers. A novel project output will be the development and dissemination of an epidemiological methodology to reliably compare mental health status in a relatively small target sample with a matched comparator group.
Highlights
Refugees and asylum seekers have high rates of risk factors for mental disorders
The paper describes a prototype for what is possible within regular services seeking to plan for and deliver high quality mental health care to refugees and asylum seekers
While refugees make for only a small proportion of the estimated resident population (ERP), Australia has experienced a significant increase in asylum-seeker arrivals over the past few years creating new challenges in areas with high settlement numbers
Summary
The UNHCR entitled their 2012 report “Displacement: The New 21st Century Challenge” and noted in the opening paragraph that “The year 2012 was marked by refugee crises reaching levels unseen in the previous decade...An average of 3000 people per day became refugees in 2012, five times more than in 2010” ([45], p. 11). A novel project output will be the development and dissemination of an epidemiological methodology to reliably compare mental health status in a relatively small target sample (refugees and asylum seekers in our case) with multiple matched participants from the NSMHWB. Large national data sets, such as the NSMHWB, are potential rich sources to draw matched subject data for use in observational studies It might be noted, for example, that the K10 has been used in the Australian NSMHWB, it has being used in multiple WHO (World Health Organisation) World Mental Health Surveys across 28 countries [46]. Feedback from our cultural advisors who conducted the field testing indicated that, with the use of elaborations for potentially ambiguous terms, questionnaire items were understood by informants Despite these limitations, this design offers a very practical and inexpensive method for providing a meaningful estimate of relative risk. Authors’ contributions All authors participated in the design of this project and approved the final manuscript
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