Abstract
Background: The status of a refugee or asylum seeker is only recognised after legal processes. The uncertainty of these procedures or the rejection itself may severely impact mental well-being. Methods: We surveyed the patterns of psychiatric services used by patients whose applications for asylum had been rejected. In a retrospective investigation of admissions to the University Emergency Department in Bern, Switzerland between 1 March 2012 and 28 February 2017, we studied patients receiving a psychiatric consultation after their applications had been rejected. The primary endpoint was based on the comparison of these individuals with controls who were asylum seekers with pending asylum applications using the Mann-Whitney U test and the chi-square test (χ2) with a significance level of 0.05. Results: Thirty-eight cases were identified. There were more men than women and the mean age was 30.08 ± 9.62 years. Patients predominantly presented as walk-in patients (n = 16, 42.1%), most frequently due to suicidal ideation (n = 16, 42.1%). Stress-related disorders were the most common diagnosis (n = 29, 76.3%) and patients were mainly referred to inpatient treatment (n = 28, 73.7%). Patients with rejected applications were less likely to be living in reception centres than patients with a pending application (χ2 = 17.98, p < 0.001). Conclusion: The profile of asylum seekers whose applications had been rejected reflects individuals with high-stress levels, potentially aggravated by the negative asylum decision.
Highlights
Immigrants and asylum seekers comprise a highly vulnerable group exposed to factors that may increase their risk of developing mental health problems [1,2]
In 31 cases, the patients were informed of the application outcome within 2 weeks prior to the psychiatric consultation (81.6%); 3 patients had previously presented at least once at UNZ shortly after the outcome of the application (7.89%); 3 patients had presented due to other triggers (7.89%); 1 patient presented shortly before the deportation day (2.6%)
One out of three failed asylum seekers was given a diagnosis of adjustment disorders, which is in alignment with previous data reporting high-stress levels and depressive symptoms for patients with rejected applications [7,10,22]
Summary
Immigrants and asylum seekers comprise a highly vulnerable group exposed to factors that may increase their risk of developing mental health problems [1,2]. Over the past few years, there has been an extensive study of factors mediating the negative effects of migration on mental health. These factors are often classified as pre-, peri- or post-migration adversities [3,4,5]. The status of a refugee or asylum seeker is only recognised after legal processes. The uncertainty of these procedures or the rejection itself may severely impact mental well-being.
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