Trauma and PTSD rates in an irish psychiatric population

Abstract

Although Western mental health services are increasingly finding themselves concerned with assisting traumatized individuals migrating from other countries, trauma and posttraumatic stress disorder (PTSD) are under-detected and undiagnosed in psychiatric populations. This study examined and compared rates of traumatic experiences, frequency of traumatic events, trauma symptomatology levels, rates of torture, rates of PTSD and chart documentation of trauma and PTSD between (a) Irish and migrant service-users and (b) forced migrant and voluntary migrant service-users in Dublin, Ireland. Data were gathered from 178 psychiatric outpatients attending using a sociodemographic questionnaire, the Harvard Trauma Questionnaire-Revised Cambodian Version and the SCID-I/P. A substantial number of service-users had experienced at least one lifetime trauma (71.3%), and a high percentage of both the Irish (47.4%) and migrant groups (70.3%) of service-users had experienced two or more events. Overall, analyses comparing rates between Irish, forced migrant and voluntary migrant service-users found that forced migrants displayed more traumatic life events, posttraumatic symptoms, and higher levels of PTSD than their voluntary migrant and Irish counterparts, with over 50% experiencing torture prior to arrival in Ireland. The lifetime rate of PTSD in the overall sample was 15.7% but only 53.57% of cases were documented in patient charts. The results of this study are informative about the nature and extent of the problem of trauma and PTSD among migrant mental health service users as well as highlighting the under-detected levels of trauma among native-born service users.

ICD-11 PTSD and CPTSD: Implications for the rehabilitation of survivors of torture seeking international protection

“…Rates of PTSD and CPTSD among the current sample of treatment-seeking survivors of serious harm and torture were significantly higher than those reported in general population studies (Karatzias et al, 2019). This is not unexpected given the refugee experience is often marked by compounding instances of trauma throughout the migration journey (Crumlish & Bracken, 2011;Wilson et al, 2013). It is worth noting however, that rates of both PTSD and CPTSD were higher in the current sample than those previously observed within other treatment-seeking refugee samples still living in a refugee camp (Vallières et al, 2018), but lower than that observed in a sample of refugees resettled in the host country (Vang et al, 2019), and among resettled refugees in Switzerland (Nickerson et al, 2016).…”

“…Notably, and as outlined in the United Nations Committee on the Elimination of Racial Discrimination, in their 2011 report entitled 'The Policy of Direct Provision', Ireland's inordinate delay in the processing of asylum seeker's applications and the final outcomes of their appeals and reviews, as well as poor living conditions characteristic of Direct Provision Centres, can suffer health and psychological problems that in certain cases lead to serious mental illness (UNCERD, 2011). Given that, in Ireland, up to 50% of forced migrants have suffered torture (Wilson et al, 2013), and that the physical and psychological impact of torture is often compounded by further trauma experienced during transit and on arrival in the host country, with the impact of post-transit trauma increasing over time (Beiser & Hou, 2001), the impact of the host-country experience and the psychological impact of torture often present as intertwined.…”

“…In view of the high rates of torture among refugees, including up to 50% of forced migrants in Ireland (Wilson, Hennessy, Dooley, Kelly, & Ryan, 2013), understanding the psychological impact of torture as part of the forced migrant experience remains an important and underserved area. Specifically, understanding whether forced migrants who have experienced torture are at a higher risk of meeting a diagnosis of CPTSD.…”

Trauma-informed servant leadership in health and social care settings

“…In a study of a mental health clinic in Australia, 88% of the service users assessed reported that they had experienced at least one traumatic event, with 79% reporting experiencing two or more incidence (Phipps et al, 2019). This is not a unique occurrence with other international research reflecting these findings (Kleber, 2019;Wilson et al, 2013).…”

Refugees, the asylum system and mental healthcare in Ireland

“…A study set in inner-city Dublin reported a lifetime prevalence of PTSD of 6% in a native Irish group and 47% in a group of refugees and asylum seekers (Wilson et al , 2013 ). A 2009 cross-sectional study of 88 asylum seekers and refugees living in the west of Ireland found that asylum seekers were six times more likely than refugees to report symptoms of PTSD and depression or anxiety (Toar et al , 2009 ).…”