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Mohnani K, Seery P, Jayadel H, Raghunanan S, Cardoso Pinto AM, Mathias F, Hargreaves D, Foster C. Mental health screening in unaccompanied asylum-seeking children: screening tool selection and feasibility in the UK National Health Service. Prim Health Care Res Dev 2025; 26:e37. [PMID: 40207558 PMCID: PMC12037346 DOI: 10.1017/s1463423624000586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 04/14/2024] [Accepted: 10/10/2024] [Indexed: 04/11/2025] Open
Abstract
There has been an increasing number of applications from unaccompanied asylum-seeking children (UASC) in the United Kingdom in recent years. It is well-known that this population is at high-risk of developing mental health disorders, which require early detection and intervention to facilitate successful integration. This paper describes the introduction of mental health screening for unaccompanied asylum-seeking children in a National Health Service (NHS) outpatient clinic in central London. This follows the results of a two-year retrospective analysis of the health needs of the population in our clinic, which identified a high incidence of disturbance to mood and sleep. We describe the selection process for a culturally appropriate and validated screening tool, piloting the Refugee Health Screener (RHS) tool with 20 UASC in clinic, and using preliminary findings to inform a more targeted referral to community Child and Adolescent Mental Health Services (CAMHS). We conclude that implementation of the RHS-13 is feasible for widespread mental health screening for UASC in an NHS setting, and provide suggestions for future research directions within this field.
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Affiliation(s)
- Krsna Mohnani
- Department of Paediatric Infectious Diseases, Imperial College Healthcare NHS Trust, London, UK
| | - Paula Seery
- Department of Paediatric Infectious Diseases, Imperial College Healthcare NHS Trust, London, UK
| | - Hana Jayadel
- Department of Paediatric Infectious Diseases, Imperial College Healthcare NHS Trust, London, UK
| | - Sophie Raghunanan
- Department of Paediatric Infectious Diseases, Imperial College Healthcare NHS Trust, London, UK
| | | | - Francesca Mathias
- Department of Paediatric Infectious Diseases, Imperial College Healthcare NHS Trust, London, UK
| | | | - Caroline Foster
- Department of Paediatric Infectious Diseases, Imperial College Healthcare NHS Trust, London, UK
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Siddiq H, Ajrouch K, Elhaija A, Kayali N, Heilemann M. Addressing the mental health needs of older adult refugees: Perspectives of multi-sector community key informants. SSM. QUALITATIVE RESEARCH IN HEALTH 2023; 3:100269. [PMID: 37811357 PMCID: PMC10559761 DOI: 10.1016/j.ssmqr.2023.100269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 10/10/2023]
Affiliation(s)
| | | | - Ahmad Elhaija
- University of California, School of Medicine, Los Angeles, USA
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Straiton ML, Liefbroer AC, Hollander AC, Hauge LJ. Outpatient mental health service use following contact with primary health care among migrants in Norway: A national register study. Soc Sci Med 2022; 294:114725. [DOI: 10.1016/j.socscimed.2022.114725] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 10/31/2021] [Accepted: 01/12/2022] [Indexed: 10/19/2022]
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Health screenings administered during the domestic medical examination of refugees and other eligible immigrants in nine US states, 2014-2016: A cross-sectional analysis. PLoS Med 2020; 17:e1003065. [PMID: 32231391 PMCID: PMC7108694 DOI: 10.1371/journal.pmed.1003065] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 02/21/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Refugees and other select visa holders are recommended to receive a domestic medical examination within 90 days after arrival to the United States. Limited data have been published on the coverage of screenings offered during this examination across multiple resettlement states, preventing evaluation of this voluntary program's potential impact on postarrival refugee health. This analysis sought to calculate and compare screening proportions among refugees and other eligible populations to assess the domestic medical examination's impact on screening coverage resulting from this examination. METHODS AND FINDINGS We conducted a cross-sectional analysis to summarize and compare domestic medical examination data from January 2014 to December 2016 from persons receiving a domestic medical examination in seven states (California, Colorado, Minnesota, New York, Kentucky, Illinois, and Texas); one county (Marion County, Indiana); and one academic medical center in Philadelphia, Pennsylvania. We analyzed screening coverage by sex, age, nationality, and country of last residence of persons and compared the proportions of persons receiving recommended screenings by those characteristics. We received data on disease screenings for 105,541 individuals who received a domestic medical examination; 47% were female and 51.5% were between the ages of 18 and 44. The proportions of people undergoing screening tests for infectious diseases were high, including for tuberculosis (91.6% screened), hepatitis B (95.8% screened), and human immunodeficiency virus (HIV; 80.3% screened). Screening rates for other health conditions were lower, including mental health (36.8% screened). The main limitation of our analysis was reliance on data that were collected primarily for programmatic rather than surveillance purposes. CONCLUSIONS In this analysis, we observed high rates of screening coverage for tuberculosis, hepatitis B, and HIV during the domestic medical examination and lower screening coverage for mental health. This analysis provided evidence that the domestic medical examination is an opportunity to ensure newly arrived refugees and other eligible populations receive recommended health screenings and are connected to the US healthcare system. We also identified knowledge gaps on how screenings are conducted for some conditions, notably mental health, identifying directions for future research.
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Fox SD, Griffin RH, Pachankis JE. Minority stress, social integration, and the mental health needs of LGBTQ asylum seekers in North America. Soc Sci Med 2020; 246:112727. [DOI: 10.1016/j.socscimed.2019.112727] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 11/28/2019] [Accepted: 12/06/2019] [Indexed: 11/29/2022]
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Brandenberger J, Tylleskär T, Sontag K, Peterhans B, Ritz N. A systematic literature review of reported challenges in health care delivery to migrants and refugees in high-income countries - the 3C model. BMC Public Health 2019; 19:755. [PMID: 31200684 PMCID: PMC6567460 DOI: 10.1186/s12889-019-7049-x] [Citation(s) in RCA: 122] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 05/27/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Migrants and refugees have important health needs and face inequalities in their health status. Health care delivery to this patient group has become a challenging public health focus in high income countries. This paper summarizes current knowledge on health care delivery to migrants and refugees in high-income countries from multiple perspectives. METHODS We performed a systematic literature review including primary source qualitative and quantitative studies between 2000 and 2017. Articles were excluded if the study setting was in low- or middle-income countries or focused on skilled migration. Quality assessment was done for qualitative and quantitative studies separately. Predefined variables were extracted in a standardized form. Authors were approached to provide missing information. RESULTS Of 185 identified articles, 35 were included in the final analysis. We identified three main topics of challenges in health care delivery: communication, continuity of care and confidence. All but one study included at least one of the three main topics and in 21/35 (60%) all three topics were mentioned. We further developed the 3C model and elaborated the interrelatedness of the three topics. Additional topics identified showed that the specific regional context with legal, financial, geographical and cultural aspects is important and further influences the 3C model. CONCLUSIONS The 3C model gives a simple and comprehensive, patient-centered summary of key challenges in health care delivery for refugees and migrants. This concept is relevant to support clinicians in their day to day practice and in guiding stakeholders in priority setting for refugee and migrant health policies.
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Affiliation(s)
- Julia Brandenberger
- University Children's Hospital Basel, Migrant Health Service, University of Basel, Spitalstr.33, Basel, Postbox CH 4031, Switzerland. .,Swiss Tropical and Public Health Institute, P.O. Box, CH-4002, Basel, Switzerland. .,University of Basel, P.O. Box, CH-4003,, Basel, Switzerland. .,Paediatric Emergency Department, Inselspital, University of Bern, Bern, Switzerland.
| | | | - Katrin Sontag
- University of Basel, P.O. Box, CH-4003,, Basel, Switzerland.,Department of Social Sciences, Subject Area Cultural Anthropology, University of Basel, Basel, Switzerland
| | - Bernadette Peterhans
- Swiss Tropical and Public Health Institute, P.O. Box, CH-4002, Basel, Switzerland.,University of Basel, P.O. Box, CH-4003,, Basel, Switzerland
| | - Nicole Ritz
- University Children's Hospital Basel, Migrant Health Service, University of Basel, Spitalstr.33, Basel, Postbox CH 4031, Switzerland.,University of Basel, P.O. Box, CH-4003,, Basel, Switzerland.,University Children's Hospital Basel, Pediatric Infectious Disease and Vaccinology, University of Basel, Basel, Switzerland.,Royal Children's Hospital Melbourne, Department of Pediatrics, University of Melbourne, Parkville, Australia
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