Entwicklung und Implementierung einer Medizinischen Ambulanz in einer Erstaufnahmeeinrichtung für Asylsuchende des Landes Baden-Württemberg

Nikendei, Christoph; Hühn, Daniel; Adler, Guido; Rose, Peta Becker von; Eckstein, Torsten M.; Fuchs, Birgit Maria; Gewalt, Sandra Claudia; Greiner, Bernhard; Günther, Thomas; Herzog, Wolfgang; Junghanss, Thomas; Krczal, Thomas; Lorenzen, Detlef; Lutz, Thomas; Manigault, Meryl A.; Reinhart, Nico; Rodenberg, Michiko; Schelletter, Iris; Szécsényi, Joachim; Steen, Rainer; Straßner, Cornelia; Thomsen, Mirjam; Wahedi, Katharina; Bozorgmehr, Kayvan

doi:10.1016/j.zefq.2017.07.011

Cited by 20 publications

(18 citation statements)

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“…Over a period of one year (from the end of May 2017 to the end of April 2018), refugees that consulted the psychosocial outpatient clinic ( 30 , 31 ) in the reception center “Patrick Henry Village” (PHV) in Heidelberg Kirchheim, Germany, and met the inclusion criteria were referred to our imaginative stabilization group therapy sessions. All participating refugees had either applied for asylum in Germany before the intervention or were in the middle of the application process during the intervention.…”

Section: Methodsmentioning

confidence: 99%

“…This requires a safe, stable, and continuous psychotherapeutic setting. However, upon arrival in their countries of destination, refugees are often initially sheltered in reception centers where psychosocial and psychiatric evaluation and mental health care provision is sparse, although urgently needed ( 5 , 7 , 14 , 30 , 31 ). The implementation of interventions for traumatized refugees is further limited through the redistribution to collective or municipal accommodations.…”

Section: Introductionmentioning

confidence: 99%

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Psychotherapeutic Group Intervention for Traumatized Male Refugees Using Imaginative Stabilization Techniques—A Pilot Study in a German Reception Center

et al. 2018

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Background: Due to persecution, human rights violations and armed conflicts, the prevalence of post-traumatic stress disorder (PTSD) is high in refugee populations. Previous studies indicate that trauma-focused treatments are highly effective in treating PTSD in refugees. However, these approaches rely on the stability of the therapeutic setting, treatment continuity, and safe housing. Although early treatment of PTSD is recommended, these requirements are not met in reception centers. Therefore, we conducted a pilot study to examine the effect of imaginative stabilization techniques derived from psychodynamic psychotraumatology therapy for the early stabilization of traumatized refugees in a reception center.Methods: From May 2017 to April 2018, 86 imaginative stabilization group therapy sessions have taken place. A sample of 43 out of 46 traumatized refugees completed self-report questionnaires assessing PTSD, depression, and anxiety symptoms prior to attending open imaginative stabilization group therapy sessions. Furthermore, participants filled in self-report questionnaires on distress and emotional state (valence/arousal/dominance) before and after each session. After having participated in four consecutive sessions, a sub-group of 17 participants completed a follow-up assessment of PTSD, depression, and anxiety symptoms. Follow-up interviews were conducted with 25 participants 2 weeks after their last session attendance to explore self-practice habits post intervention.Results: The pre-post-intervention comparison of scores indicated a significant reduction of distress (z = −3.35, p < 0.001, r = −0.51) and an improvement of affective reports for valence (z = −4.79, p < 0.001, r = −0.82) and dominance (z = −3.89, p < 0.001, r = −0.59), whereas arousal scores were not affected. We found a significant reduction of anxiety symptoms (z = −2.04, p < 0.05, r = −0.49), whereas PTSD and depression scores remained unchanged. Follow-up interviews revealed that 80% of the participants continued to practice the imaginative stabilization techniques after redistribution to other accommodation.Conclusion: The results indicate that imaginative stabilization techniques are a promising and feasible approach to treat refugees in unstable reception center settings. In regular imaginative stabilization group therapy sessions, we were able to reduce the participants' distress and anxiety symptoms while strengthening their internal resources and increasing their emotional stability.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Psychotherapeutic Group Intervention for Traumatized Male Refugees Using Imaginative Stabilization Techniques—A Pilot Study in a German Reception Center

et al. 2018

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“…Zum einen erschweren verschiedene Barrieren, etwa eine mangelnde Kenntnis der Sprache und des deutschen Gesundheitssystems, den Asylsuchenden faktisch den Zugang. Zum anderen haben die geografisch nahe der AE gelegenen Praxen und Krankenhäuser häufig nicht die Kapazitäten, die Gesundheitsversorgung der Bewohner*innen zusätzlich zu übernehmen [4]. Daher wurden an vielen Standorten ärztliche Sprechstunden auf dem Gelände der AE eingerichtet [5].…”

Section: Medizinische Versorgung Von Asylsuchenden In Erstaufnahmeeinunclassified

“…Häufig entstanden solche Angebote aus dem akuten Bedarf heraus und sind daher von lokalen Akteur*innen und dem spezifischen Kontext der AE geprägt. Mangels bundes-oder landesweiter Vorgaben oder verbindlicher Standards haben sich inzwischen sehr unterschiedliche Versorgungsmodelle etabliert, über die vereinzelt in Form von "Gute-Praxis"-Modellen berichtet wurde, etwa in Hamburg [6,7], Dresden [8] und Heidelberg [4], oder es wurden deskriptive Übersichtsarbeiten darüber veröffentlicht [9].…”

Section: Medizinische Versorgung Von Asylsuchenden In Erstaufnahmeeinunclassified

Medizinische Versorgung von Asylsuchenden in Erstaufnahmeeinrichtungen

Wahedi

Biddle

Jahn

et al. 2020

Bundesgesundheitsbl

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ZusammenfassungIm Zuge der gestiegenen Zahlen Asylsuchender in den Jahren 2015/2016 haben sich in Deutschland, geprägt durch lokale Akteur*innen, sehr unterschiedliche Konzepte zur medizinischen Versorgung in Aufnahmeeinrichtungen (AE) etabliert. Ziel unserer Studie war es, unterschiedliche Versorgungskonzepte in AE abzubilden und die Herausforderungen der Verstetigung bedarfsgerechter medizinischer Versorgungsstrukturen herauszuarbeiten.Daten wurden aus 13 semistrukturierten Interviews und im Rahmen einer Fachtagung mit Workshops und Gruppendiskussionen erhoben und durch eine qualitative Inhaltsanalyse ausgewertet. Teilnehmer*innen waren Akteur*innen der medizinischen Versorgung in AE, darunter ärztliches und Gesundheitsfachpersonal, Verwaltungsbeauftragte, Vertreter*innen des öffentlichen Gesundheitsdienstes und Wissenschaftler*innen.Als Antwort auf die gesundheitlichen Bedarfe von Asylsuchenden und die komplexen Rahmenbedingungen der Versorgung haben sich unterschiedliche Ambulanzkonzepte gebildet, deren Zweck, Organisation und Management in vielen Aspekten über das Angebot einer ärztlichen Sprechstunde hinausgehen. Die Ambulanzen unterschieden sich in organisationsbezogenen Aspekten z. B. hinsichtlich des Betreibers, der Personalstruktur und des Umfangs der Versorgung. Gemeinsame Herausforderungen stellen eine adäquate Bedarfsplanung, der Mangel einheitlicher Leitlinien und fehlende Schnittstellen zwischen den in der Ambulanz tätigen Akteur*innen dar. Dringender Handlungsbedarf im Sinne eines strukturierten und kontinuierlichen Erfahrungsaustauschs sowie in der Implementierung bundesweiter Standards ist geboten, um Ad-hoc-Initiativen in resiliente Ambulanzstrukturen zu überführen. Die erarbeiteten Handlungsbedarfe und Lösungsvorschläge können hierfür als Grundlage dienen.

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“…In this outpatient clinic, asylum seekers are provided with health care services by registered physicians from Heidelberg and physicians from Heidelberg University Hospital. In the psychosocial outpatient clinic, medical doctors and psychologists from the Center of Psychosocial Medicine, as part of the University Hospital Heidelberg, offer consultations twice a week (34).…”

Section: Medical Health Care Provision In a State Registration And Rementioning

confidence: 99%

Predictors of Asylum Seekers’ Health Care Utilization in the Early Phase of Resettlement

et al. 2020

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Background: Asylum seekers display high prevalence rates of posttraumatic stress disorder, depression, anxiety, and panic disorder due to pre-, peri-, and post-migration stressors. In contrast to the high mental health burden, health care utilization among asylum seekers in the early phase of resettlement is low. However, the early stages after migration are a particularly vulnerable phase in which psychosocial support measures are needed to prevent mental disorders from becoming chronic. Objective: To identify predictors of asylum seekers' health care utilization in the early stages of resettlement. Methods: Using hierarchical logistic regression analysis, the variance explanation of the (1) general utilization of health care services as well as the individual utilization of (2) outpatient psychiatrists, (3) counselling centers, and (4) general practitioners was analyzed in n = 65 asylum seekers. A structured interview on health care utilization took place between three to five months after assessment of possible predictors. We defined the following three groups of predictors a) the sociodemographic variables gender, age, number of children, religion, language proficiency, b) the psychological variables sense of coherence and emotion regulation as well as c) the asylum seekers' psychiatric diagnoses. Results: Individual sociodemographic factors, such as gender, age, and number of children as well as the emotion regulation strategy of expressive suppression and sense of coherence were shown to be predictive for the utilization of health care services among asylum seekers. Conclusions: Low-threshold, culture-sensitive treatment offers for asylum seekers should be established in the early phase after migration. General practitioners should be a central hub for further referrals to disorder-specific treatments.

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Entwicklung und Implementierung einer Medizinischen Ambulanz in einer Erstaufnahmeeinrichtung für Asylsuchende des Landes Baden-Württemberg

Cited by 20 publications

References 13 publications

Psychotherapeutic Group Intervention for Traumatized Male Refugees Using Imaginative Stabilization Techniques—A Pilot Study in a German Reception Center

Psychotherapeutic Group Intervention for Traumatized Male Refugees Using Imaginative Stabilization Techniques—A Pilot Study in a German Reception Center

Medizinische Versorgung von Asylsuchenden in Erstaufnahmeeinrichtungen

Predictors of Asylum Seekers’ Health Care Utilization in the Early Phase of Resettlement

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