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Journal Article

Citation

Kiselev N, Pfaltz M, Haas F, Schick M, Kappen M, Sijbrandij M, de Graaff AM, Bird M, Hansen P, Ventevogel P, Fuhr DC, Schnyder U, Morina N. Eur. J. Psychotraumatol. 2020; 11(1): e1717825.

Affiliation

Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, Zurich, Switzerland.

Copyright

(Copyright © 2020, The Author(s), Publisher Co-action Publishing)

DOI

10.1080/20008198.2020.1717825

PMID

32128044

PMCID

PMC7034440

Abstract

Background: Due to their experiences of major stressful life events, including post-displacement stressors, refugees and asylum seekers are vulnerable to developing mental health problems. Yet, despite the availability of specialized mental health services in Western European host countries, refugees and asylum seekers display low mental healthcare utilization. Objective: The aim of this study was to explore structural and socio-cultural barriers to accessing mental healthcare among Syrian refugees and asylum seekers in Switzerland. Method: In this qualitative study, key-informant (KI) interviews with Syrian refugees and asylum seekers, Swiss healthcare providers and other stakeholders (e.g. refugee coordinators or leaders) were conducted in the German-speaking part of Switzerland. Participants were recruited using snowball sampling. Interviews were audiotaped and transcribed, and then analysed using thematic analysis, combining deductive and inductive coding. Results: Findings show that Syrian refugees and asylum seekers face multiple structural and socio-cultural barriers, with socio-cultural barriers being perceived as more pronounced. Syrian key informants, healthcare providers, and other stakeholders identified language, gatekeeper-associated problems, lack of resources, lack of awareness, fear of stigma and a mismatch between the local health system and perceived needs of Syrian refugees and asylum seekers as key barriers to accessing care. Conclusions: The results show that for Syrian refugees and asylum seekers in Switzerland several barriers exist. This is in line with previous findings. A possible solution for the current situation might be to increase the agility of the service system in general and to improve the willingness to embrace innovative paths, rather than adapting mental healthcare services regarding single barriers and needs of a new target population.

© 2020 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.


Language: en


Revista Europea de PsicotraumatologíaAntecedentes: Debido a sus experiencias de eventos vitales estresantes mayores, incluidos los estresores posteriores al desplazamiento, los refugiados y solicitantes de asilo son vulnerables a desarrollar problemas de salud mental. Sin embargo, a pesar de la disponibilidad de servicios especializados de salud mental en los países hospedadores de Europa occidental, los refugiados y los solicitantes de asilo muestran una baja utilización de cuidados salud mental.Objetivo: El objetivo de este estudio fue explorar las barreras estructurales y socioculturales para acceder a cuidados de salud mental para refugiados y solicitantes de asilo sirios, en Suiza.Método: En este estudio cualitativo, se realizaron entrevistas informante-clave (IC) con refugiados y solicitantes de asilo sirios, proveedores de cuidados de salud suizos y otros grupos de interes (por ejemplo, coordinadores o líderes de refugiados) en la parte de habla alemana de Suiza. Los participantes fueron reclutados mediante muestreo de bola de nieve. Las entrevistas fueron grabadas en audio y transcritas, y luego analizadas mediante análisis temático, combinando codificación deductiva e inductiva.Resultados: Los resultados muestran que los refugiados y solicitantes de asilo sirios, enfrentan múltiples barreras estructurales y socioculturales, siendo las socio-culturales percibidas como más pronunciadas. Los informantes-clave sirios, los proveedores de cuidados de salud y otras grupos de interes, identificaron el idioma, problemas asociados con la puerta de entrada a las instituciones, falta de recursos, falta de conciencia, miedo al estigma y discordancia entre el sistema de salud local y las necesidades percibidas de los sirios refugiados y solicitantes de asilo como barreras clave para acceder a la atención.Conclusiones: Los resultados muestran que para los refugiados y solicitantes de asilo sirios en Suiza existen varias barreras. Esto está en línea con hallazgos previos. Una posible solución para la situación actual podría ser aumentar la agilidad del sistema de servicios en general y mejorar la disposición a adoptar caminos innovadores, en lugar de adaptar los servicios de salud mental con respecto a las barreras y necesidades individuales de una nueva población objetivo.


Language: es


背景: 由于经历过重大应激生活事件, 包括流离失所的应激源, 难民和寻求庇护者很容易出现心理健康问题。然而, 尽管西欧东道国提供了专门的精神保健服务, 但难民和寻求庇护者的精神保健利用率较低。目标: 本研究旨在探究瑞士的叙利亚难民和寻求庇护者获得精神保健的结构性和社会文化障碍。方法: 在这项定性研究中, 在瑞士德语区对叙利亚难民和寻求庇护者, 瑞士医疗保健提供者以及其他利益相关者 (例如, 难民协调员或领导者) 进行了关键信息 (KI) 访谈。使用滚雪球采样招募参与者。对访谈进行录音和转录, 然后使用主题分析, 结合演绎和归纳编码进行分析。结果: 结果发现, 叙利亚难民和寻求庇护者面临多重结构性和社会文化障碍, 人们认为社会文化障碍更为明显。叙利亚主要信息提供者, 医疗保健提供者和其他利益相关者认为, 语言, 与门卫相关的问题, 资源不足, 认识不足, 对污名的恐惧以及当地卫生系统与叙利亚难民和寻求庇护者感知需求之间的不匹配, 是获取护理的主要障碍。结论: 结果表明, 对于瑞士的叙利亚难民和寻求庇护者, 存在一些障碍。这符合以前的发现。当前情况的一个可能解决方案可能是提高服务系统的整体灵活性, 并提高采用创新途径的意愿, 而不是针对单个障碍和新目标人群的需求调整精神保健服务。Abbreviations: AMHRG: Applied Mental Health Research Group; BASEC: Business Administration System for Ethics Committees; DIME: Design, Implementation, Monitoring, and Evaluation; HCP: Healthcare Provider; KI: Key-Informant; PM+: Problem Management Plus; PTSD: Posttraumatic Stress Disorder; SEM: State Secretariat for Migration; SH: Stakeholder; SKI: Syrian Key-Informant; STRENGTHS: Syrian REfuGees mental healTHcare Systems; UNHCR: United Nations High Commissioner for Refugees; WHO: World Health Organization.


Language: zh

Keywords

Mental healthcare services; Switzerland; Syrian refugees and asylum seekers; barriers; qualitative study; refugee mental health; • Barriers to mental health care specific for Syrian refugees and asylum seekers in Switzerland were explored in a qualitative study.• Findings show that Syrian refugees and asylum seekers face multiple barriers such as language, gatekeeper associated problems, lack of resources, lack of awareness, fear of stigma and a mismatch between the local health system and perceived needs of Syrian refugees and asylum seekers.• The results of the study confirm previous research findings and show that the barriers to accessing mental healthcare for refugees and asylum seekers in Switzerland still exist and have not improved over years and decades.

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