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.
Highlights
The movement of people currently observed worldwide is comparable in size to the migration during/after the Second World War [1]
The UNZ consists of an organization, which provides 24 h/day psychiatric emergency services and it is responsible for the emergency mental healthcare for the Canton Bern including asylum centers in this catchment area
Demographic characteristics and parameters related to the registered consultation were compared between the group of asylum seekers and a control group of non-Swiss patients with warranted permits: our primary hypothesis was that involuntary treatment orders would be increased in the group of asylum seekers due to issues of integration; we studied referral outcomes as a categorical variable, but we transformed referral outcomes to a dichotomous variable with ‘0’ for cases of non-compulsory treatment consisting of discharge home and voluntary admissions in the clinic
Summary
The movement of people currently observed worldwide is comparable in size to the migration during/after the Second World War [1]. Results: Patients were mainly single, male, residing in reception centers, and presented themselves most frequently due to suicidal ideation. Compared to the control group, asylum seekers were younger and more often men (p < 0.001 for both). They less often had family in Switzerland (χ2 = 9.91, p = 0.007). 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). 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
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