A Walk-In Clinic for Newly Arrived Mentally Burdened Refugees: The Patient Perspective

Abstract

Providing refugees with psychosocial support is particularly important considering the high level of mental health problems prevalent in this population. A psychosocial walk-in clinic operating within a state reception and registration center in Germany has been supporting mentally burdened refugees since 2016. This study focused on patients’ perspectives on their mental health burden, the psychosocial walk-in clinic, and future help seeking. We conducted interviews with n = 22 refugees attending the walk-in clinic from March to May 2019. Qualitative analysis focused on the following four topics: (1) mental burden from the patients’ perspective, (2) access to the psychosocial walk-in clinic, (3) perception of counseling sessions, and (4) perception of follow-up treatment. The results show that the majority of interviewees were burdened by psychological and somatic complaints, mostly attributed to past experiences and post-migratory stress. Therapeutic counseling and psychiatric medication were found to be particularly helpful. Most of the participants felt motivated to seek further psychosocial support. Key barriers to seeking psychosocial help included shame, fear of stigma, and lack of information. Overall, the psychosocial walk-in clinic is a highly valued support service for newly arrived refugees with mental health issues.

Integration Is Correlated With Mental Health Help-Seeking From the General Practitioner: Syrian Refugees' Preferences and Perceived Barriers

“…Commonly identified barriers to help-seeking, like language and waiting times (19)(20)(21)(22), are in line with our results. Our findings also mirror reports from GPs working with refugee patients with MH problems (74).…”

“…However, other common barriers identified previously, such as stigma, shame, not knowing how to contact the GP, financial concerns, and fear of being hospitalized were not mirrored in our findings (19)(20)(21)(22). With regards to shame and stigma, focus group interviews with Syrian refugees in Norway suggest that while stigma and shame influenced where individuals might seek help, they also acknowledged that stigma surrounding professional healthcare was diminished in Norway, making it easier and less stigmatized to seek professional MH help (17).…”

“…Refugees' underuse of health services in high-income countries may, in part, be due to barriers to access and use. In Germany and Austria, Syrian refugees have identified barriers to help-seeking, such as stigma and shame, not speaking the language of the host country, and lacking information about health services (19)(20)(21). Similarly, refugees in Turkey have identified barriers such as not knowing where or how to get help, financial concerns, unavailability of appointments, fear of being hospitalized, and finding the process inconvenient or time-consuming (22).…”

A Qualitative Evaluation of a Mother and Child Center Providing Psychosocial Support to Newly Arrived Female Refugees in a Registration and Reception Center in Germany

“…The refugees’ difficult living situations are well documented: the accommodation’s general condition is poor, the noise level is high, and privacy is hard to find in the shared rooms and showers [ 47 , 48 ]. Furthermore, the structural barriers to medical and psychosocial services are also known [ 49 ].…”

Professional Mental Health Help-Seeking Amongst Afghan and Iraqi Refugees in Australia: Understanding Predictors Five Years Post Resettlement

“…Alongside demographic factors, structural barriers may impede utilisation of mental health services [31,32]. Structural barriers can include poor mental health literacy, defined by Jorm et al (1997) as "the knowledge and beliefs about mental health disorders which aid their recognition, management or prevention" [33] (p. 182).…”