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

Abstract

Despite a seemingly higher need, refugees in Europe tend to underuse mental health (MH) services. To better understand this underuse, it is important to understand refugees' willingness and ability to seek help from their general practitioner (GP) when experiencing MH problems. We employed a combined vignette and survey design to explore how the GP fits into the larger context of help-seeking preferences among a sample of Syrian refugees in Norway (n = 92), and what barriers they perceive in accessing help from the GP. We also examined how indicators of integration relate to seeking help from the GP. We take an exploratory approach. Participants were presented a vignette of an individual with symptoms in line with ICD-10 and DSM-5 criteria for depression. Participants were somewhat likely to seek help from the GP; however, seeking help from one's relationship with Allah/God and one's partner was preferred. Furthermore, while the GP was rated a somewhat likely help-seeking source, most participants indicated an average of two barriers to seeking help from the GP. Finally, social ties to the majority population in the form of social integration and feelings of connectedness with the host country (psychological integration) were positively correlated with likelihood of seeking help from the GP. Taken together, these findings suggest that the GP is considered a viable source of help among Syrians with a refugee background in the current sample, but that this may be influenced by perceived barriers and social as well as psychological integration. Addressing these barriers and promoting psychosocial integration with the host country are key to facilitating access and usage amongst refugees in need of MH services.

The Institutional and Social Support Survey (ISS‐10): Quantifying international faculty language support

“…Although sufficient internal consistency has been achieved through Rasch rating scale analysis and EFA, the predictive power of the ISS‐10 against external measures has not yet been substantiated. To fill this gap, the questionnaire was administered a second time to compare the ISS‐10 against the baseline of the IPL‐12 which is an instrument that has seen widespread use in a variety of contexts for quantifying integration (Emeriau et al., 2022; Harder et al., 2018; Harris et al., 2021; Kunwar, 2020; Teng et al., 2022). The results from the first administration were not compared to the IPL‐12 as the goal of that administration was instrument refinement.…”

“…The instrument was then analysed with exploratory factor analysis (EFA; Plonsky, 2015) to investigate the individual factors underpinning the overarching construct of linguistic support within the instrument. Third, the instrument was then administered to a second sample of international faculty, and the results were compared to those from an established baseline, the IPL‐12, a 12‐item survey instrument developed by the Immigration Policy Lab and used in a number of contexts to measure the degree of integration of migration populations (Emeriau et al., 2022; Harder et al., 2018; Harris et al., 2021; Kunwar, 2020; Teng et al., 2022), using LME regression analyses (Faraway, 2016).…”

Building a home in Chicago: Integration and mental health in a newcomer Rohingya refugee community.

“…Aspects of integration into U.S. American society (economic, linguistic, navigational, psychological, social) were asked using questions from the Immigration Policy Lab Integration Index (IPL-12; Harder et al, 2018). This multidimensional scale of integration scale has been used and validated with other refugee populations (Aksoy et al, 2020; Harris et al, 2021). The following items were removed from analysis due to construct or measurement issues.…”

Psychological distress among Afghan refugees in Norway as a function of their integration

“…These dimensions capture different aspects relevant for strengthening the capacity of migrants to establishing a fulfilled life in the new society. With the aid of these dimensions, several studies have been conducted regarding inclusion, assessing the level of integration and help-seeking behaviors among migrants, including refugees ( Harder et al, 2018b ; Kunwar, 2020 ; Harris et al, 2021 ; Passani et al, 2022 ). To our knowledge, studies using these measures of integration in relation to psychological distress among refugee groups have not yet been conducted in Norway, and hence the focus on the present study.…”