Impact of traumatic events incurred by asylum-seekers on mental health and utilization of medical services

Maya Siman-Tov,Alex Wang,Bruria Adini,Michael Alkan,Moran Bodas

doi:10.1186/s13049-019-0665-8

Abstract

BackgroundAsylum-seekers from Africa immigrate to Israel through the Sinai desert and are often exposed to traumatic events.ObjectiveTo identify the scope and types of medical services required by asylum-seekers and the relationship between delayed medical care to development of post-traumatic stress disorder (PTSD) and overutilization of medical services.MethodsAsylum-seekers that entered Israel between 2009 and 2012 who utilized the Open Clinic of Physicians for Human Rights were interviewed to record their experiences in the Sinai, and document the traumatic events they were exposed to, their medical diagnoses, and clinic visits. Linkages between diagnoses to exposure to traumatic events and period of time until presentation to the clinic were investigated.ResultsMale vs female asylum-seekers visited the clinic more times (24% vs 15% respectively, utilized > 5 visits). Higher ransom and longer periods in Sinai correlated with higher number of clinic visits and PTSD. Asylum-seekers with PTSD versus other medical complaints approached the clinic more times (> 5 visits). Asylum-seekers that approached the clinic closer to their arrival time (up to 18 months from arrival) versus a later period (> 18 months) presented a significantly lower prevalence of PTSD (3.4 and 40.5% respectively; p < 0.001) and lower utilization of clinic’s services (p < 0.001).ConclusionsPTSD among asylum-seekers appears to be associated more with length of exposure to stressful events than number/types of traumatic events and with delay in receiving medical care. Improving access to medical care may reduce asylum-seekers’ development of PTSD and lead to lower utilization of services.

Highlights

Asylum-seekers from Africa immigrate to Israel through the Sinai desert and are often exposed to traumatic events
Traumatic events among migrants and asylum-seekers have been identified as triggers for the development of both physical and mental health problems, Post-Traumatic Stress Disorder (PTSD), depression and anxiety [10,11,12,13]
These populations often suffer from psychiatric conditions, which have widely been associated with increased utilization of medical services, and may result in the host countries’ perception that their ability to provide medical services to the asylum-seekers exceeds their capacity [1, 10, 14]

Summary

Introduction

Asylum-seekers from Africa immigrate to Israel through the Sinai desert and are often exposed to traumatic events. Asylum seekers that entered Israel through the Sinai desert were often exposed to extremely stressful events, including violence, torture, and captivity [5, 7]. Marginalized populations including asylum-seekers have relatively limited access to essential medical services and difficulty integrating into healthcare systems These populations often suffer from psychiatric conditions, which have widely been associated with increased utilization of medical services, and may result in the host countries’ perception that their ability to provide medical services to the asylum-seekers exceeds their capacity [1, 10, 14]. These barriers of asylum-seekers to care may stem from fear of deportation, detainment in camps lacking in basic healthcare facilities, culture-specific barriers, ineligibility to obtain care in public services, or lack of funding to be treated in the private sector [1, 15]

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