EPA Guidance Mental Health Care of Migrants

Bhugra, Dinesh; Gupta, Susham; Schouler‐Ocak, Meryam; Graeff-Calliess, I.; Deakin, Nicholas; Qureshi, Adil; Dales, Jolyon; Moussaoui, Driss; Kastrup, Marianne; Tarricone, Ilaria; Till, Alex; Bassi, Mariano; Carta, Mauro Giovanni

doi:10.1016/j.eurpsy.2014.01.003

Cited by 160 publications

(128 citation statements)

References 101 publications

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“…In review of literatur, it is seen than national and international studies on psychiatric disorders in urban and rural area can be in conflict with each other (37)(38)(39). There are studies in literature indicating that diagnosis of depression and psychotic disorders in both men and women are more due to rapid urbanization (7,40).…”

Section: Discussionmentioning

confidence: 99%

Psychiatric diagnosis and sociodemographic characteristics of patients admitted to psychiatry clinic in a rural area

Üçkardeş¹

2015

Dusunen Adam

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Psychiatric diagnosis and sociodemographic characteristics of patients admitted to psychiatry clinic in a rural areaObjective: There is little published literature about the characteristics of patients with mental disorders in rural hospitals. The aim of this study is to determine the mental illness and the demographics of the patients who admit to the outpatient policlinic that offers psychiatric health service for the first time in a rural state hospital. Method:The semi-structured interview consisting DSM-IV diagnostic criterias were used for the patients who admitted to the psychiatry policlinic of Kutahya Gediz State Hospital in a 6-month-period.Sociodemographic data were collected from 555 people aged over 18.Results: Mean age of the patients was 44.7. The rate of women was 67.2% (n=373) and male was 32.8% (n=182). The most frequent DSM-IV diagnoses were mood disorders (n=249, 44%), anxiety disorders (n=179, 32.5%), psychotic disorders (n=52, 9.4%), adjustment disorders (n=26, 4.7%) and somatoform disorders (n=21, 3.8%). Twenty of people had subthreshold symptoms and could not be diagnosed.Comorbidities including diabetes mellitus, hypertension and hypothyroid were frequently observed in psychiatric patients (n=163, 29.4%). Adjustment disorders were mostly seen at younger ages. Psychiatric disorders were most common in married people. Conclusion:The mean age of the patients were found older than previous studies. Women were more commonly admitting to the outpatient psychiatric policlinic. It's remarkable that marriage and psychiatric disorders have a strong association in the rural setting. Clinicians also should consider about comorbid somatic diseases.Key words: Psychiatric disorders, rural area, sociodemographic features, somatic comorbidity ÖZET Kırsal bir bölgede psikiyatri polikliniğine başvuran olguların psikiyatrik tanı dağılımı ve sosyo-demografik özellikleri Amaç: Ülkemizde kırsal bölgelerde bulunan hastanelere başvuran psikiyatri hastalarının özellikleri hakkında yapılmış araştırma sayısı çok azdır. Çalışmamızda, ilk kez psikiyatri polikliniği hizmeti alan kırsal bir bölgede psikiyatrik bozuklukların tanı dağılımları ve tanıların sosyo-demografik özelliklerle ilişkisini saptamak amaçlanmıştır.Yöntem: 6 aylık bir süreçte Kütahya Gediz İlçe Devlet Hastanesi psikiyatri polikliniğine ilk başvurusu olan hastaların DSM-IV tanı ölçütlerini kapsayan yarı-yapılandırılmış görüşme ile muayeneleri yapılmış, hastaların sosyo-demografik verileri toplanmıştır. 18 yaş üstü 555 kişi değerlendirilmeye alınmıştır.Bulgular: Polikliniğe başvuranların yaş ortalaması 44.7 olarak bulunmuştur. Başvuranların %67.2'si (n=373) kadın, %32.8'i erkektir (n=182). Başvuran hastaların 20'sine ilk başvuruda tanı konulamamış olup belirtiler eşik altı olarak değerlendirilmiştir. Kalan 535 kişide ise en sık konulan tanı duygudurum bozukluklarıdır (n=249, %44).Bundan sonra en sık görülen psikiyatrik rahatsızlıklar sırasıyla anksiyete bozuklukları (n=179, %32.5), psikotik bozukluklar (n=52, %9.4), uyum bozuklukları (n=26, %4.7...

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Section: Discussionmentioning

confidence: 99%

Psychiatric diagnosis and sociodemographic characteristics of patients admitted to psychiatry clinic in a rural area

Üçkardeş¹

2015

Dusunen Adam

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“…We do not propose to go into greater detail about migration and mental health in this document as an accompanying guidance paper on the mental health of immigrants covers these issues in depth [7]. It is well known that factors such as poverty, persecution or violence may play a role in migration.…”

Section: Migration Minorities and Mental Healthmentioning

confidence: 97%

“…As rates of psychiatric disorders vary in different minority groups, it is vital that culturally sensitive psychiatric care is provided [1,7,8,25,52,77], e.g. psychotic disorders in ethnic minorities in different countries (UK, Denmark, Netherlands) [83,118].…”

Section: Introductionmentioning

confidence: 99%

EPA guidance on cultural competence training

et al. 2015

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The stress of migration as well as social factors and changes related to the receiving society may lead to the manifestation of psychiatric disorders in vulnerable individuals after migration. The diversity of cultures, ethnicities, races and reasons for migration poses a challenge for those seeking to understand how illness is experienced by immigrants whose backgrounds differ significantly from their clinicians. Cultural competence represents good clinical practice and can be defined as such that a clinician regards each patient in the context of the patient's own culture as well as from the perspective of the clinician's cultural values and prejudices. The EPA Guidance on cultural competence training outlines some of the key issues related to cultural competence and how to deal with these. It points out that cultural competence represents a comprehensive response to the mental health care needs of immigrant patients and requires knowledge, skills and attitudes which can improve the effectiveness of psychiatric treatment. To reach these aims, both individual and organizational competence are needed, as well as teaching competence in terms of educational leadership. The WPA Guidance on Mental Health and Mental Health Care for Migrants and the EPA Guidance on Mental Health Care for Migrants list a series of recommendations for policy makers, service providers and clinicians; these are aimed at improving mental health care for immigrants. The authors of this paper would like to underline these recommendations and, focusing on cultural competency and training, believe that they will be of positive value.

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“…Barriers may include a state of irregularity, poor understanding of local language, and differences in cultural background, which should be the target of specific strategies at individual, local and national policy levels [9,[11][12][13][14][15][16].…”

Section: Introductionmentioning

confidence: 99%

Immigrants’ Pathways to Outpatient Mental Health: Are there Differences with the Native Population?

Gramaglia

Gambaro

Rossi

et al. 2015

J Immigrant Minority Health

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A poor use of mental health services has been described in immigrants. We compared the sociodemographic, clinical and treatment features of immigrants and natives attending a Community Mental Health Centre (CMHC). 191 immigrants and 191 randomly selected natives applying to the Borgomanero CMHC between 1 January 2003 and 31 August 2013 were compared. Our sample consisted mainly of the so-called "economic" immigrant. Adjustment disorders and reaction to stress were the most frequent diagnoses; in most cases symptoms onset occurred after migration. Although treatment features overlapped in the two groups (duration, number of contacts), immigrants showed a higher frequency of treatment dropout. While it is necessary to improve access to mental health services for immigrants, for the "economic" immigrant it may be more important to focus on establishing a therapeutic relationship that can be experienced as reliable and trustworthy. The finding of similar pathways to access the CMHC in natives and immigrants is encouraging.

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EPA Guidance Mental Health Care of Migrants

Cited by 160 publications

References 101 publications

Psychiatric diagnosis and sociodemographic characteristics of patients admitted to psychiatry clinic in a rural area

Psychiatric diagnosis and sociodemographic characteristics of patients admitted to psychiatry clinic in a rural area

EPA guidance on cultural competence training

Immigrants’ Pathways to Outpatient Mental Health: Are there Differences with the Native Population?

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