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Vukčević Marković M, Bobić A, Živanović M. The effects of traumatic experiences during transit and pushback on the mental health of refugees, asylum seekers, and migrants. Eur J Psychotraumatol 2023; 14. [PMID: 37052104 PMCID: PMC9873274 DOI: 10.1080/20008066.2022.2163064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Background: There are 26 million people recognised as refugees worldwide. Many of them spent a prolonged period of time in transit - time after they leave their country of origin and before they reach the receiving country. Transit brings numerous protection and mental health risks refugees are exposed to.Objective: The aim of this study was to assess the stressful and traumatic experiences refugees are exposed to during transit, with a special focus on the experience of pushback - the denial of access to the territory to foreign nationals and forcible return to countries of origin or neighbouring countries without an assessment of their rights to international protection, as well as the impact of these experiences on refugees' mental health and well-being.Method: 201 refugees currently residing in Serbia completed the Stressful and Traumatic Experiences in Transit questionnaire - short version (SET-SF), questionnaire for assessing stressful and traumatic experiences during pushback (SET-SF PB), Refugee Health Screener (RHS-15), and Well-being index (WHO-5).Results: The results showed that refugees experience a large number of stressful and traumatic events (M = 10.27, SD = 4.85). In addition, half of the participants experience severe symptoms of depression (50.7%), while about a third of the participants experience severe symptoms of anxiety (37.8%) and post-traumatic stress disorder (PTSD) (32.3%). Refugees who experienced pushback showed overall higher levels of depression, anxiety, and PTSD. Traumatic experiences during transit and pushback were positively related to the severity of depression, anxiety, and PTSD. In addition, traumatic experiences during pushback showed an incremental contribution in predicting refugees' mental health difficulties over and above traumatic experiences in transit.Conclusions: This study provides valuable insights into the multiple risks refugees are exposed to and emphasise the need for the provision of adequate protection and support.
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Smith KA, Ostinelli EG, Ede R, Allard L, Thomson M, Hewitt K, Brown P, Zangani C, Jenkins M, Hinze V, Ma G, Pothulu P, Henshall C, Malhi GS, Every-Palmer S, Cipriani A. Assessing the Impact of Evidence-Based Mental Health Guidance During the COVID-19 Pandemic: Systematic Review and Qualitative Evaluation. JMIR Ment Health 2023; 10:e52901. [PMID: 38133912 PMCID: PMC10760515 DOI: 10.2196/52901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 10/30/2023] [Accepted: 11/03/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND During the COVID-19 pandemic, the Oxford Precision Psychiatry Lab (OxPPL) developed open-access web-based summaries of mental health care guidelines (OxPPL guidance) in key areas such as digital approaches and telepsychiatry, suicide and self-harm, domestic violence and abuse, perinatal care, and vaccine hesitancy and prioritization in the context of mental illness, to inform timely clinical decision-making. OBJECTIVE This study aimed to evaluate the practice of creating evidence-based health guidelines during health emergencies using the OxPPL guidance as an example. An international network of clinical sites and colleagues (in Australia, New Zealand, and the United Kingdom) including clinicians, researchers, and experts by experience aimed to (1) evaluate the clinical impact of the OxPPL guidance, as an example of an evidence-based summary of guidelines; (2) review the literature for other evidence-based summaries of COVID-19 guidelines regarding mental health care; and (3) produce a framework for response to future global health emergencies. METHODS The impact and clinical utility of the OxPPL guidance were assessed using clinicians' feedback via an international survey and focus groups. A systematic review (protocol registered on Open Science Framework) identified summaries or syntheses of guidelines for mental health care during and after the COVID-19 pandemic and assessed the accuracy of the methods used in the OxPPL guidance by identifying any resources that the guidance had not included. RESULTS Overall, 80.2% (146/182) of the clinicians agreed or strongly agreed that the OxPPL guidance answered important clinical questions, 73.1% (133/182) stated that the guidance was relevant to their service, 59.3% (108/182) said that the guidelines had or would have a positive impact on their clinical practice, 42.9% (78/182) that they had shared or would share the guidance, and 80.2% (146/182) stated that the methodology could be used during future health crises. The focus groups found that the combination of evidence-based knowledge, clinical viewpoint, and visibility was crucial for clinical implementation. The systematic review identified 2543 records, of which 2 syntheses of guidelines met all the inclusion criteria, but only 1 (the OxPPL guidance) used evidence-based methodology. The review showed that the OxPPL guidance had included the majority of eligible guidelines, but 6 were identified that had not been included. CONCLUSIONS The study identified an unmet need for web-based, evidence-based mental health care guidance during the COVID-19 pandemic. The OxPPL guidance was evaluated by clinicians as having a real-world clinical impact. Robust evidence-based methodology and expertise in mental health are necessary, but easy accessibility is also needed, and digital technology can materially help. Further health emergencies are inevitable and now is the ideal time to prepare, including addressing the training needs of clinicians, patients, and carers, especially in areas such as telepsychiatry and digital mental health. For future planning, guidance should be widely disseminated on an international platform, with allocated resources to support adaptive updates.
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Affiliation(s)
- Katharine A Smith
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
- Oxford Health NHS Foundation Trust, Oxford, United Kingdom
- Oxford Precision Psychiatry Lab, NIHR Oxford Health Biomedical Research Centre, Oxford, United Kingdom
| | - Edoardo G Ostinelli
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
- Oxford Precision Psychiatry Lab, NIHR Oxford Health Biomedical Research Centre, Oxford, United Kingdom
| | - Roger Ede
- Oxford Health NHS Foundation Trust, Oxford, United Kingdom
| | - Lisa Allard
- Pharmacy Department, Royal Brisbane and Women's Hospital, Brisbane, Australia
| | | | - Kiran Hewitt
- Lincolnshire Partnership NHS Foundation Trust, Lincoln, United Kingdom
| | - Petra Brown
- Pennine Care NHS Foundation Trust, Manchester, United Kingdom
- Department of Pharmacy and Optometry, University of Manchester, Manchester, United Kingdom
| | - Caroline Zangani
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
- Oxford Health NHS Foundation Trust, Oxford, United Kingdom
- Oxford Precision Psychiatry Lab, NIHR Oxford Health Biomedical Research Centre, Oxford, United Kingdom
| | - Matthew Jenkins
- Department of Psychological Medicine, University of Otago, Wellington, New Zealand
| | - Verena Hinze
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
- Oxford Precision Psychiatry Lab, NIHR Oxford Health Biomedical Research Centre, Oxford, United Kingdom
| | - George Ma
- Pharmacy Department, The Prince Charles Hospital, Metro North Health, Brisbane, Australia
| | - Prajnesh Pothulu
- Pharmacy Department, Princess Alexandra Hospital, Brisbane, Australia
| | - Catherine Henshall
- Oxford Health NHS Foundation Trust, Oxford, United Kingdom
- Oxford Institute of Applied Health Research, Oxford Brookes University, Oxford, United Kingdom
- Nursing and Midwifery Office, National Institute for Health and Care Research, London, United Kingdom
| | - Gin S Malhi
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
- Academic Department of Psychiatry, Faculty of Medicine and Health, Kolling Institute, Northern Clinical School, The University of Sydney, Sydney, Australia
- CADE Clinic and Mood-T, Royal North Shore Hospital, Northern Sydney Local Health District, St. Leonards, New South Wales, Australia
| | - Susanna Every-Palmer
- Department of Psychological Medicine, University of Otago, Wellington, New Zealand
| | - Andrea Cipriani
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
- Oxford Health NHS Foundation Trust, Oxford, United Kingdom
- Oxford Precision Psychiatry Lab, NIHR Oxford Health Biomedical Research Centre, Oxford, United Kingdom
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Li L, Taeihagh A, Tan SY. A scoping review of the impacts of COVID-19 physical distancing measures on vulnerable population groups. Nat Commun 2023; 14:599. [PMID: 36737447 PMCID: PMC9897623 DOI: 10.1038/s41467-023-36267-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 01/23/2023] [Indexed: 02/05/2023] Open
Abstract
Most governments have enacted physical or social distancing measures to control COVID-19 transmission. Yet little is known about the socio-economic trade-offs of these measures, especially for vulnerable populations, who are exposed to increased risks and are susceptible to adverse health outcomes. To examine the impacts of physical distancing measures on the most vulnerable in society, this scoping review screened 39,816 records and synthesised results from 265 studies worldwide documenting the negative impacts of physical distancing on older people, children/students, low-income populations, migrant workers, people in prison, people with disabilities, sex workers, victims of domestic violence, refugees, ethnic minorities, and people from sexual and gender minorities. We show that prolonged loneliness, mental distress, unemployment, income loss, food insecurity, widened inequality and disruption of access to social support and health services were unintended consequences of physical distancing that impacted these vulnerable groups and highlight that physical distancing measures exacerbated the vulnerabilities of different vulnerable populations.
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Affiliation(s)
- Lili Li
- Policy Systems Group, Lee Kuan Yew School of Public Policy, National University of Singapore, Singapore, Singapore
| | - Araz Taeihagh
- Policy Systems Group, Lee Kuan Yew School of Public Policy, National University of Singapore, Singapore, Singapore.
| | - Si Ying Tan
- Alexandra Research Centre for Healthcare in The Virtual Environment (ARCHIVE), Department of Healthcare Redesign, Alexandra Hospital, National University Health System, Singapore, Singapore
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Blay Benzaken Y, Zohar S, Yuval K, Aizik-Reebs A, Gebremariam SG, Bernstein A. COVID-19 and Mental Health Among People Who Are Forcibly Displaced: The Role of Socioeconomic Insecurity. Psychiatr Serv 2023; 74:158-165. [PMID: 35833254 DOI: 10.1176/appi.ps.202200052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Forcibly displaced persons may be at elevated risk for poor mental health outcomes because of the COVID-19 pandemic. This study sought to examine associations between COVID-19-related socioeconomic insecurity and mental health outcomes among asylum seekers. METHODS The authors evaluated the association between the degree of food, housing, and income insecurity related to the pandemic and mental health outcomes among East African asylum seekers in a high-risk, postdisplacement setting in the Middle East (i.e., Israel). RESULTS Anxiety symptom severity (p=0.03) as well as the rate of suicidal ideation among women (odds ratio [OR]=2.81, p=0.016) were significantly elevated in a community sample of asylum seekers during the COVID-19 pandemic (N=66) relative to a similar sample (N=158) from the same community and context assessed before the pandemic. No differences between the two groups were observed for severity or rate of probable depression or posttraumatic stress disorders. In addition, among the sample assessed during the pandemic, socioeconomic insecurity due to the pandemic was strongly associated with elevated symptom severity and probable anxiety, depression, and posttraumatic stress disorders as well as suicidal ideation (R2 range=0.19-0.35; OR range=4.54-5.46). CONCLUSIONS Findings are consistent with growing evidence of a mental health crisis among asylum seekers that is linked to COVID-19 control policies and residential status policies. The results highlight the risk for suicidal ideation linked to intersectional marginalization among female asylum seekers. These findings may inform postdisplacement policy making, social justice advocacy, humanitarian aid, and clinical science and practice to mitigate poor mental health outcomes associated with COVID-19 among forcibly displaced persons.
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Affiliation(s)
| | - Shani Zohar
- Department of Psychology, University of Haifa, Haifa, Israel
| | - Kim Yuval
- Department of Psychology, University of Haifa, Haifa, Israel
| | | | | | - Amit Bernstein
- Department of Psychology, University of Haifa, Haifa, Israel
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Garrido R, Paloma V, Benítez I, Skovdal M, Verelst A, Derluyn I. Impact of COVID-19 pandemic on the psychological well-being of migrants and refugees settled in Spain. Ethn Health 2023; 28:257-280. [PMID: 35138212 DOI: 10.1080/13557858.2022.2035692] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 01/24/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVES The COVID-19 pandemic has exacerbated health inequalities worldwide, having a disproportionately harsh impact on unprivileged populations such as migrants and refugees. These populations are often more exposed to the virus, but less protected, while at the same time being at higher risk of suffering from poor living and working conditions, limited access to healthcare, and discrimination by the host society, all of which is challenging to their mental health. Empirical evidence on how the COVID-19 pandemic is affecting migrants and refugees is required to design effective actions aimed at ensuring health equity. Therefore, this paper aims to analyse how the pandemic has impacted the psychological well-being of migrants and refugees living in Spain. DESIGN This study was carried out within the framework of the ApartTogether study sponsored by the World Health Organization. Data collection was carried out during March-November 2020, through an online survey completed by 241 participants (age: M = 37 years; 129 women). RESULTS The results indicate that 78.7% of participants had suffered a decrease in their psychological well-being since the onset of the COVID-19 pandemic, with number of difficulties and worries experienced being the best individual predictors of this outcome. Enjoying social connections and perceiving positive treatment from the host society were positively associated with psychological well-being at a relational and community level, respectively. CONCLUSION Based on these findings, we outline priority areas of psychosocial interventions aimed at guaranteeing the mental health of migrants and refugees in the face of the pandemic in Spain.
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Affiliation(s)
- Rocío Garrido
- Department of Social Psychology, Universidad de Sevilla, Sevilla, Spain
| | - Virginia Paloma
- Department of Social Psychology, Universidad de Sevilla, Sevilla, Spain
| | - Isabel Benítez
- Department of Methodology of Behavioral Sciences, Universidad de Granada, Granda, Spain
| | - Morten Skovdal
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - An Verelst
- Department of Social Work and Social Pedagogy, Ghent University, Gent, Belgium
| | - Ilse Derluyn
- Department of Social Work and Social Pedagogy, Ghent University, Gent, Belgium
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Jamal Z, ElKhatib Z, AlBaik S, Horino M, Waleed M, Fawaz F, Loffreda G, Seita A, Witter S, Diaconu K. Social determinants and mental health needs of Palestine refugees and UNRWA responses in Gaza during the COVID-19 pandemic: a qualitative assessment. BMC Public Health 2022; 22:2296. [PMID: 36482403 PMCID: PMC9733234 DOI: 10.1186/s12889-022-14771-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 11/29/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Due to pre-existing difficulties, refugees are especially susceptible to the negative effects of the pandemic; nonetheless, the pandemic's effect on this group is still unclear. The purpose of this study was to determine the effects of the COVID-19 pandemic on the mental health of Palestine refugees in Gaza by identifying the role of social determinants. During the pandemic, the United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) enacted a number of policies and measures. The purpose of this research was to assess their efficacy and acceptability. METHODS This qualitative study took place between August and November 2020. Twenty-nine key-informant interviews were conducted remotely with UNRWA Headquarters, field and clinical staff in Gaza and with community members, aged ≥18 years and residing in Rafah and Jabalia camps. We sought informed consent verbally or via email. Data was coded based on the framework for social determinants of mental health. RESULTS Interview results indicated that the relationship might be unidirectional, with COVID-19 causing the degradation of living conditions and vice versa, with living conditions exacerbating the COVID-19 situation by facilitating virus transmission. In other instances, the association between mental health determinants and COVID-19 might be bidirectional. In terms of experiencing violence and anxieties, women, children, and daily-paid employees were significantly more disadvantaged than other groups in the community. UNRWA modified its service delivery techniques in order to continue providing essential services. In general, UNRWA's strategies throughout the pandemic were deemed beneficial, but insufficient to meet the needs of Gazans. CONCLUSION The pandemic highlights the need to go beyond disease treatment and prevention to address social determinants to improve refugees' health and reduce their susceptibility to future shocks. UNRWA has rapidly implemented telemedicine and mental telehealth services, making it imperative to assess the efficacy of these novel approaches to provide care at a distance. A long-term option may be to employ a hybrid strategy, which combines online and in-person therapy.
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Affiliation(s)
- Zeina Jamal
- grid.104846.fInstitute for Global Health and Development, Queen Margaret University, Musselburgh EH21 6UU Edinburgh, Scotland, UK
| | - Zoheir ElKhatib
- The United Nations for the Relief and Works Agency in the Near East (UNRWA) Field Office, Gaza, Palestine
| | - Shatha AlBaik
- grid.501184.90000 0001 2173 1062The United Nations for the Relief and Works Agency in the Near East (UNRWA) Headquarters, Amman, Jordan
| | - Masako Horino
- grid.501184.90000 0001 2173 1062The United Nations for the Relief and Works Agency in the Near East (UNRWA) Headquarters, Amman, Jordan ,grid.21107.350000 0001 2171 9311Center for Human Nutrition and Sight & Life Global Nutrition Research Institute, Dept of Int’l Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA
| | - Mohammed Waleed
- The United Nations for the Relief and Works Agency in the Near East (UNRWA) Field Office, Gaza, Palestine
| | - Farah Fawaz
- grid.501184.90000 0001 2173 1062The United Nations for the Relief and Works Agency in the Near East (UNRWA) Headquarters, Amman, Jordan
| | - Giulia Loffreda
- grid.104846.fInstitute for Global Health and Development, Queen Margaret University, Musselburgh EH21 6UU Edinburgh, Scotland, UK
| | - Akihiro Seita
- grid.501184.90000 0001 2173 1062The United Nations for the Relief and Works Agency in the Near East (UNRWA) Headquarters, Amman, Jordan
| | - Sophie Witter
- grid.104846.fInstitute for Global Health and Development, Queen Margaret University, Musselburgh EH21 6UU Edinburgh, Scotland, UK
| | - Karin Diaconu
- grid.104846.fInstitute for Global Health and Development, Queen Margaret University, Musselburgh EH21 6UU Edinburgh, Scotland, UK
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El Tatary G, Gill N. The impact of the COVID-19 pandemic on the mental health and wellbeing of refugees and asylum seekers-A Narrative Review of the Literature. Australas Psychiatry 2022; 30:728-731. [PMID: 36222224 PMCID: PMC9557269 DOI: 10.1177/10398562221131154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To identify the factors affecting refugees and asylum seekers mental health and wellbeing during the COVID-19 pandemic. METHODS A narrative review of available international research literature from January 2020 to June 2021 was conducted to identify these factors. RESULTS Seven factors were identified: pre-existing physical health vulnerabilities, pre-existing mental health vulnerabilities, environmental, social, cultural-specific, economic and legal/welfare challenges. CONCLUSION Multiple interacting bio-psycho-socio-economic-cultural-ecological factors lead to greater impact of COVID-19 pandemic on refugee and asylum seekers wellbeing than the general population.
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Affiliation(s)
- Ghassan El Tatary
- Advanced trainee in Child & Adolescent Psychiatry, Royal Australian and New Zealand College of Psychiatrists, Gold Coast, QLD, Australia.,585497Lives Lived Well, headspace Early Psychosis, Gold Coast, QLD, Australia
| | - Neeraj Gill
- Mental Health and Specialist Services, Gold Coast Health, Gold Coast, QLD, Australia.,School of Medicine and Dentistry, 97562Griffith University, Southport, QLD, Australia.,Health Research Institute, University of Canberra, Canberra, ACT, Australia
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Hart PL, Zahos H, Salt N, Schofield R, Mahroof-Shaffi S, Simonek T, Harkensee C. Lessons to learn from the analysis of routine health data from Moria Refugee Camp on Lesvos, Greece. J Public Health (Oxf) 2022:6840101. [DOI: 10.1093/pubmed/fdac127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 06/04/2022] [Accepted: 10/11/2022] [Indexed: 11/24/2022] Open
Abstract
Abstract
Background
Refugees in humanitarian settings commonly experience many health needs and barriers to access healthcare; health data from these settings are infrequently reported, preventing effective healthcare provision. This report describes health needs of refugees in Moria Camp on Lesvos, Greece—Europe’s largest refugee camp.
Methods
A set of routinely collected service data of 18 131 consultations of 11 938 patients, attending a primary care clinic in the camp over 6 months in 2019–20, was analysed retrospectively, focusing on chronic health conditions.
Results
The most frequent chronic conditions were musculoskeletal pain (25.1%), mental health (15.9%), cardiac (12.7%) and endocrine conditions (8.9%). In all, 70.4% of consultations were for acute health problems, with high rates of injuries and wounds (20.8%), respiratory infections (12.5%), gastroenteritis (10.7%) and skin problems (9.7%), particularly scabies.
Conclusions
The prevalence of acute and chronic health problems is high in this setting, with some likely attributable to the deplorable living conditions in the camp. Despite its magnitude, the interpretability of routine health data is limited. A research agenda is identified, and a framework for chronic disease management in refugee camps is proposed.
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Affiliation(s)
- Paul L Hart
- 22603 Esplanada Circle W, Boca Raton , FL 33433 , USA
| | - Helen Zahos
- Griffith University School of Nursing and Midwifery, , Gold Coast, 1 Hospital Boulevard, Southport, QLD 4215 , Australia
| | - Nicola Salt
- Wandsworth Care Commissioning Group Balham Park Surgery, , 236 Balham High Road, London, SW17 7AW , UK
| | - Roger Schofield
- Shalom House Palliative Care Centre , St David’s, Pembrokeshire, SA62 6BP , UK
| | | | | | - Christian Harkensee
- Gateshead Health NHS Foundation Trust , Queen Elizabeth Avenue, Gateshead, NE9 6SX , UK
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Rzepka I, Zehetmair C, Roether E, Kindermann D, Cranz A, Junne F, Friederich HC, Nikendei C. Impact of and Coping with Post-Traumatic Symptoms of Refugees in Temporary Accommodations in Germany: A Qualitative Analysis. Int J Environ Res Public Health 2022; 19:10893. [PMID: 36078608 PMCID: PMC9518066 DOI: 10.3390/ijerph191710893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 08/24/2022] [Accepted: 08/30/2022] [Indexed: 06/15/2023]
Abstract
Due to pre-, peri- and post-migratory stress factors, refugees often experience higher levels of psychological stress than the general population. Post-traumatic stress disorder, in particular, has an increased prevalence in the refugee population. However, living conditions in the early post-migratory phase are characterized by many challenges. In the present qualitative study, 14 refugees with symptoms of PTSD from temporary accommodations in Germany were interviewed in semi-structured interviews about their individual experiences of the impact of their trauma sequelae symptoms on their current living conditions and interactions. Participants reported dealing with post-traumatic symptoms primarily through distraction strategies, such as working or learning the language or social interaction. Many reported a sense of mistrust as a result of traumatic experiences. Current stress factors cited included uncertain asylum status, worry about family members and lack of ability to influence living situations. The interactions between the post-traumatic symptoms and the living conditions of the refugees were highlighted. The effects of the symptomatology of trauma sequelae and the framework conditions under which refugees live can lead to aggravated psychological distress. Therefore, special attention must be paid to refugee mental health care.
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Affiliation(s)
- Irja Rzepka
- Center for Psychosocial Medicine, Department for General Internal Medicine and Psychosomatics, Heidelberg University Hospital, 69120 Heidelberg, Germany
| | - Catharina Zehetmair
- Center for Psychosocial Medicine, Department for General Internal Medicine and Psychosomatics, Heidelberg University Hospital, 69120 Heidelberg, Germany
| | - Emma Roether
- Center for Psychosocial Medicine, Department for General Internal Medicine and Psychosomatics, Heidelberg University Hospital, 69120 Heidelberg, Germany
| | - David Kindermann
- Center for Psychosocial Medicine, Department for General Internal Medicine and Psychosomatics, Heidelberg University Hospital, 69120 Heidelberg, Germany
| | - Anna Cranz
- Center for Psychosocial Medicine, Department for General Internal Medicine and Psychosomatics, Heidelberg University Hospital, 69120 Heidelberg, Germany
| | - Florian Junne
- Department of Psychosomatic Medicine and Psychotherapy, Magdeburg University Hospital, 39120 Magdeburg, Germany
| | - Hans-Christoph Friederich
- Center for Psychosocial Medicine, Department for General Internal Medicine and Psychosomatics, Heidelberg University Hospital, 69120 Heidelberg, Germany
| | - Christoph Nikendei
- Center for Psychosocial Medicine, Department for General Internal Medicine and Psychosomatics, Heidelberg University Hospital, 69120 Heidelberg, Germany
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De Jesus M, Moumni Z, Sougui ZH, Biswas N, Kubicz R, Pourtau L. "Living in Confinement, Stopped in Time": Migrant Social Vulnerability, Coping and Health during the COVID-19 Pandemic Lockdown in France. Int J Environ Res Public Health 2022; 19:10084. [PMID: 36011730 PMCID: PMC9408687 DOI: 10.3390/ijerph191610084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Revised: 08/03/2022] [Accepted: 08/09/2022] [Indexed: 06/15/2023]
Abstract
The COVID-19 pandemic has exposed health and social inequities among migrant populations. Less empirical evidence exists about the impact of COVID-19 lockdown measures on migrants. This study aimed to investigate the impact of the first lockdown in France between March and May 2020 on migrants' lives and livelihoods. We adopted a social vulnerability framework to conceptualize how the pandemic and the consequential lockdown in France contributed to a 'compounded crisis' for asylum seekers and undocumented migrants. This crisis encompassed health, protection, and socio-economic challenges for migrants and exposed the shortcomings of existing government policies that exclude migrants and do not address the root causes of health inequities. The study draws on in-depth qualitative interviews conducted with 75 asylum seekers and undocumented migrants during the pandemic lockdown in the French regions of Auvergne-Rhône-Alpes and Île-de-France. The findings of this paper highlight the importance of implementing a cohesive pandemic response approach that views health as a fundamental inclusive right for all human beings and all policies as health policies to promote well-being for all.
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Affiliation(s)
- Maria De Jesus
- Center on Health, Risk, and Society, School of International Service, American University, Washington, DC 20016, USA
- Collegium de Lyon, Université de Lyon, 69002 Lyon, France
| | - Zoubida Moumni
- Psychologie de la Santé, Université Lumière Lyon 2, 69365 Lyon, France
| | - Zara Hassan Sougui
- Santé Publique, Université Claude Bernard Lyon 1, 69100 Villeurbanne, France
| | - Neeharika Biswas
- Center on Health, Risk, and Society, School of International Service, American University, Washington, DC 20016, USA
| | - Raquel Kubicz
- Center on Health, Risk, and Society, School of International Service, American University, Washington, DC 20016, USA
| | - Lionel Pourtau
- Habitat et Humanisme, 69300 Caluire et Cuire, France
- Pôle Recherche & Innovation, Université Paul Valéry Montpellier 3, 34090 Montpellier, France
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Bojorquez I, Sepúlveda J, Lee D, Strathdee S. Interrupted transit and common mental disorders among migrants in Tijuana, Mexico. Int J Soc Psychiatry 2022; 68:1018-1025. [PMID: 35652311 PMCID: PMC10712937 DOI: 10.1177/00207640221099419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Policies of migration contention can interrupt the transit of people on the move, forcing them to remain in wait in non-destination countries. This liminal condition might impact negatively on migrants' mental health. AIMS To assess the relationship between interrupted transit and common mental disorders (CMD; symptoms of depression or anxiety), among migrants in shelters in Tijuana, Mexico. METHODS Cross-sectional survey conducted in November to December 2020 and February to April 2021. We assessed depressive symptoms with the Centers for Epidemiological Studies Depression scale (CES-D-7), and symptoms of anxiety with the Generalized Anxiety Disorder scale (GAD-2). We evaluated the association of being in interrupted transit (sent back from the United States to Mexico), as compared to having not crossed to the United States yet or planning to stay in Mexico, with having a CMD (either depressive or anxiety symptoms), as well as the association of other migration-related variables with CMD. RESULTS Being in interrupted transit (OR = 1.74, 95% CI [1.12, 2.71]), and having experienced violence during transit (OR = 2.50, 95% CI [1.63, 3.82]) were associated with CMD. CONCLUSIONS Interrupted transit is a potential risk factor for mental health problems among migrants. Migration and public health policies should consider the mental health consequences of interrupted transit, and promote initiatives to address the mental health needs of migrants on the move.
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Affiliation(s)
- Ietza Bojorquez
- Department of Population Studies, El Colegio de la Frontera Norte, Tijuana, Mexico
| | - Jaime Sepúlveda
- Institute for Global Health Sciences, University of California, San Francisco, USA
| | - Deandra Lee
- Institute for Global Health Sciences, University of California, San Francisco, USA
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12
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Mattar S, Gellatly R. Refugee mental health: Culturally relevant considerations. Curr Opin Psychol 2022; 47:101429. [DOI: 10.1016/j.copsyc.2022.101429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 07/06/2022] [Accepted: 07/11/2022] [Indexed: 11/25/2022]
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13
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Wittmann J, Groß M, Catani C, Schmidt T, Neldner S, Wilker S, May T, Ertl V, Rosner R, Zindler A, Odenwald M, Neuner F. The efficacy of Narrative Exposure Therapy for Children (KIDNET) as a treatment for traumatized young refugees versus treatment as usual: update to the study protocol for the multi-center randomized controlled trial YOURTREAT. Trials 2022; 23:360. [PMID: 35477413 PMCID: PMC9044372 DOI: 10.1186/s13063-022-06288-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 04/07/2022] [Indexed: 11/10/2022] Open
Abstract
Background The trial YOURTREAT aims to compare the pragmatic, short-term psychotherapy Narrative Exposure Therapy for Children (KIDNET) with treatment as usual (TAU) for the treatment of young refugees in Germany. This update outlines changes made to the study protocol in response to the current COVID-19 pandemic with the aim of allowing the continuation of the clinical trial while ensuring the safety of the staff and the participants, maintaining methodological quality, and ensuring compliance with legal regulations. Methods The major amendments to the original study protocol include (1) the possibility of using telehealth technology for the conduction of diagnostic and therapy sessions, (2) a reduction of the diagnostic set, and (3) an increased flexibility in the time frame of the study protocol. Discussion The adaptations to the study protocol made it feasible to continue with the trial YOURTREAT during the COVID-19 pandemic. Although the diagnostic set had to be shortened, the primary outcomes and the main secondary outcomes remain unimpaired by the amendment. Therefore, we expect the trial to provide evidence regarding effective treatment options for young refugees in Germany, a population that has received little scientific attention so far and has only very limited access to mental health care in the German health care system. In light of the current pandemic, which globally increases the risk of mental problems, the situation for young refugees is likely to aggravate further. Thus, the clinical and social relevance of the present trial YOURTREAT is even more important in these particular times. Trial registration German Clinical Trials Register (Deutsches Register Klinischer Studien; DRKS) DRKS00017222. Registered on May 15, 2019
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Affiliation(s)
- Jasmin Wittmann
- Clinical Psychology and Psychotherapy, Bielefeld University, Universitätsstraße 25, D 33615, Bielefeld, Germany.
| | - Melissa Groß
- Clinical Psychology and Psychotherapy, Bielefeld University, Universitätsstraße 25, D 33615, Bielefeld, Germany
| | - Claudia Catani
- Clinical Psychology and Psychotherapy, Bielefeld University, Universitätsstraße 25, D 33615, Bielefeld, Germany
| | - Telja Schmidt
- Clinical Psychology and Psychotherapy, Bielefeld University, Universitätsstraße 25, D 33615, Bielefeld, Germany
| | - Sina Neldner
- Clinical Psychology and Psychotherapy, Bielefeld University, Universitätsstraße 25, D 33615, Bielefeld, Germany
| | - Sarah Wilker
- Clinical Psychology and Psychotherapy, Bielefeld University, Universitätsstraße 25, D 33615, Bielefeld, Germany
| | - Theodor May
- Independent Biostatistician, Johann-Strauß-Str. 11a, D 33647, Bielefeld, Germany
| | - Verena Ertl
- Clinical Psychology and Biopsychology, Catholic University Eichstätt-Ingolstadt, D 85071, Eichstätt, Germany
| | - Rita Rosner
- Clinical Psychology and Biopsychology, Catholic University Eichstätt-Ingolstadt, D 85071, Eichstätt, Germany
| | - Areej Zindler
- Outpatient Clinic for Refugee Children and Adolescents, Medical Center Hamburg-Eppendorf, Martinistraße 52, D 20246, Hamburg, Germany
| | - Michael Odenwald
- Department of Psychology, Konstanz University, Universitätsstraße 10, D 78464, Konstanz, Germany
| | - Frank Neuner
- Clinical Psychology and Psychotherapy, Bielefeld University, Universitätsstraße 25, D 33615, Bielefeld, Germany
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14
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Wagaman B, Kerr E, Branch R, Berman SL. Identity Distress among Immigrant Students during COVID-19. Societies 2022; 12:29. [DOI: 10.3390/soc12020029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The process of identity formation is complex for many; however, for immigrant populations experiencing acculturation and acculturative stress, the process may be particularly difficult. The current study examined the impact of immigration, acculturation, social support, and acculturative stress on identity formation and identity distress during the added stress of COVID-19. Late-adolescent college students from large enrollment psychology courses completed an anonymous online survey battery for course credit (N = 462). Results indicate that identity distress was higher among first-generation immigrants than second- and third-generation; however, it was highest for those with mixed parentage (one immigrant and one native-born parent). Further, acculturative stress and COVID-19 anxiety better predicted identity distress than identity development factors alone, and acculturative stress appeared to mediate the relationship between social support and identity distress. This study highlights the need for additional resources for immigrant students, especially during the current pandemic.
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15
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Hirani SAA, Wagner J. Impact of COVID-19 on Women Who Are Refugees and Mothering: A Critical Ethnographic Study. Glob Qual Nurs Res 2022; 9:23333936221121335. [PMID: 36105717 PMCID: PMC9465568 DOI: 10.1177/23333936221121335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 06/30/2022] [Accepted: 07/07/2022] [Indexed: 11/21/2022] Open
Abstract
Refugee women often experience trauma and social disconnection in a new
country and are at risk of experiencing reduced physical, mental, and
emotional well-being. Globally, COVID-19 has affected the health and
well-being of the population at large. This critical ethnographic
study aimed to explore the effects of COVID-19 on women who are
refugees and mothering in Saskatchewan, Canada. In-depth interviews
were undertaken with 27 women who are refugees and mothering young
children aged 2 years and under. This study suggests that during
COVID-19, refugee women are at high risk of experiencing add-on
stressors due to isolation, difficulty in accessing health care,
COVID-19-related restrictions in hospitals, limited follow-up care,
limited social support, financial difficulties, and compromised
nutrition. During COVID-19, collaborative efforts by nurses, other
health-care professionals, and governmental and non-governmental
organizations are essential to provide need-based mental health
support, skills-building programs, nutritional counseling, and
follow-up care to this vulnerable group.
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16
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Gabster A, Jhangimal M, Erausquin JT, Suárez JA, Pinzón-Espinosa J, Baird M, Katz J, Beltran-Henríquez D, Cabezas-Talavero G, Henao-Martínez AF, Franco-Paredes C, Agudelo-Higuita NI, Pachar M, González JA, Rodriguez F, Pascale JM. Rapid health evaluation in migrant peoples in transit through Darien, Panama: protocol for a multimethod qualitative and quantitative study. Ther Adv Infect Dis 2021; 8:20499361211066190. [PMID: 34925828 PMCID: PMC8679050 DOI: 10.1177/20499361211066190] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 11/22/2021] [Indexed: 11/15/2022] Open
Abstract
Background: The world is currently unprepared to deal with the drastic increase in global
migration. There is an urgent need to develop programs to protect the
well-being and health of migrant peoples. Increased population movement is
already evident throughout the Americas as exemplified by the rising number
of migrant peoples who pass through the Darien neotropical moist broadleaf
forest along the border region between Panama and Colombia. The transit of
migrant peoples through this area has an increase in the last years. In
2021, an average of 9400 people entered the region per month compared with
2000–3500 people monthly in 2019. Along this trail, there is no access to
health care, food provision, potable water, or housing. To date, much of
what is known about health needs and barriers to health care within this
population is based on journalistic reports and anecdotes. There is a need
for a comprehensive approach to assess the health care needs of migrant
peoples in transit. This study aims to describe demographic characteristics,
mental and physical health status and needs, and experiences of host
communities, and to identify opportunities to improve health care provision
to migrant peoples in transit in Panama. Study design and methods: This multimethod study will include qualitative (n = 70) and
quantitative (n = 520) components. The qualitative
component includes interviews with migrant peoples in transit, national and
international nongovernmental organizations and agencies based in Panama.
The quantitative component is a rapid epidemiological study which includes a
questionnaire and four clinical screenings: mental health, sexual and
reproductive health, general and tropical medicine, and nutrition. Conclusion: This study will contribute to a better understanding of the health status and
needs of migrant peoples in transit through the region. Findings will be
used to allocate resources and provide targeted health care interventions
for migrant peoples in transit through Darien, Panama.
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Affiliation(s)
- Amanda Gabster
- Instituto Conmemorativo Gorgas de Estudios de la Salud, Ave Justo Arosemena, Calle 36 Ciudad de Panamá, Panama City, Panamá
| | - Monica Jhangimal
- Instituto Conmemorativo Gorgas de Estudios de la Salud, Panama City, Panamá
| | | | | | | | | | - Jennifer Katz
- Community Development Network of the Americas, Panama City, Panamá
| | | | | | | | | | | | | | | | - Fátima Rodriguez
- Instituto Conmemorativo Gorgas de Estudios de la Salud, Panama City, Panamá
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17
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Özlü-Erkilic Z, Kothgassner OD, Wenzel T, Goreis A, Chen A, Ceri V, Fakhr Mousawi A, Akkaya-Kalayci T. Does the Progression of the COVID-19 Pandemic Have an Influence on the Mental Health and Well-Being of Young People? A Cross-Sectional Multicenter Study. Int J Environ Res Public Health 2021; 18:12795. [PMID: 34886520 PMCID: PMC8657101 DOI: 10.3390/ijerph182312795] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 11/29/2021] [Accepted: 12/01/2021] [Indexed: 01/10/2023]
Abstract
The COVID-19 pandemic has been shown to have impaired the mental health and well-being of young people. This study, for the first time, explores these aspects in young people with and without a migratory background during the extended course of the pandemic and restrictive measures, comparing two countries with a high COVID-19 prevalence: Austria and Turkey. METHODS The authors used the "Psychological General Well-being" index as part of an anonymous online survey with 3665 participants (ages 15-25), recruited from both countries during the first and the second waves of the pandemic, collecting data on individual experiences and problems encountered during the pandemic. RESULTS Mental health (b = 0.06, p < 0.023) and general psychological well-being worsened with the progression of the pandemic. Participants with financial problems had the most severe negative effect on mental health (b = 0.12, p < 0.001). Furthermore, females living in Turkey, both natives (b = -0.21, p < 0.001) and migrants (b = 0.25, p < 0.001), reported a more deteriorated mental health status over time. CONCLUSIONS The extended pandemic duration and resultant "lockdown" restrictions have negatively affected the mental health of young people to varying degrees, depending on country of residence and migration background. A strong "recovery plan" that considers group-specific needs and vulnerabilities is urgently needed.
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Affiliation(s)
- Zeliha Özlü-Erkilic
- Outpatient Clinic of Transcultural Psychiatry and Migration Induced Disorders in Childhood and Adolescence, Department of Child and Adolescent Psychiatry, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria;
- Postgraduate University Program Transcultural Medicine and Diversity Care, Medical University of Vienna, Spitalgasse 23, 1090 Vienna, Austria;
| | - Oswald D. Kothgassner
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria;
| | - Thomas Wenzel
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria;
- Scientific Section on Psychological Aspects of Torture and Persecution, World Psychiatric Association (WPA), 1226 Thônex, Switzerland;
| | - Andreas Goreis
- Department of Clinical and Health Psychology, Faculty of Psychology, University of Vienna, 1010 Vienna, Austria;
- Outpatient Unit for Research, Teaching and Practice, Faculty of Psychology, University of Vienna, 1010 Vienna, Austria
| | - Anthony Chen
- Scientific Section on Psychological Aspects of Torture and Persecution, World Psychiatric Association (WPA), 1226 Thônex, Switzerland;
| | - Veysi Ceri
- Department of Child Development, Faculty of Health Sciences, Batman University, Merkez Kampüsü, Batman 72060, Turkey;
| | - Aylin Fakhr Mousawi
- Postgraduate University Program Transcultural Medicine and Diversity Care, Medical University of Vienna, Spitalgasse 23, 1090 Vienna, Austria;
| | - Türkan Akkaya-Kalayci
- Outpatient Clinic of Transcultural Psychiatry and Migration Induced Disorders in Childhood and Adolescence, Department of Child and Adolescent Psychiatry, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria;
- Postgraduate University Program Transcultural Medicine and Diversity Care, Medical University of Vienna, Spitalgasse 23, 1090 Vienna, Austria;
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18
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Acar B, Acar İH, Alhiraki OA, Fahham O, Erim Y, Acarturk C. The Role of Coping Strategies in Post-Traumatic Growth among Syrian Refugees: A Structural Equation Model. Int J Environ Res Public Health 2021; 18:8829. [PMID: 34444576 PMCID: PMC8394351 DOI: 10.3390/ijerph18168829] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 08/13/2021] [Accepted: 08/18/2021] [Indexed: 11/16/2022]
Abstract
The Syrian conflict has led to a mass migration of Syrians to other countries and exposed them to many possible traumatic events and stressors in their country of origin and in the resettlement process. The possibility of positive psychological effects of adverse life events is less documented among Syrian refugees. Thus, the current study aimed to develop preliminary evidence for the identifying factors: traumatic experiences, post-migration stressors and coping strategies that are associated with post-traumatic growth (PTG) of Syrian refugees residing in Turkey. Structural equation modeling (SEM) was used in the current study to assess the associations among these factors. Data were obtained from Syrian refugees residing in the governorates of Hatay and Mardin. A total of 528 Syrians, aged between 18-77 years (M = 35.60, SD = 11.65) participated in this cross-sectional study. Results from the SEM indicated that past traumatic experiences and post-migration stressors were indirectly related to PTG. The results from the current study provide support for that the association between refugees' traumatic experiences, post-migration stressors and PTG appear to be explained through the presence of coping strategies which could be addressed in the psychotherapies and psychosocial interventions for refugees to promote positive psychological change. Future studies should address the effects of post-migration stressors on PTG in detail.
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Affiliation(s)
- Busra Acar
- Department of Psychology, Koç University, 34450 Istanbul, Turkey;
- Department of Psychology, Ozyegin University, 34794 Istanbul, Turkey;
| | - İbrahim H. Acar
- Department of Psychology, Ozyegin University, 34794 Istanbul, Turkey;
| | - Omar A. Alhiraki
- Department of Surgery, Bab Al-Hawa Hospital, Idlib, Syria; (O.A.A.); (O.F.)
| | - Ola Fahham
- Department of Surgery, Bab Al-Hawa Hospital, Idlib, Syria; (O.A.A.); (O.F.)
| | - Yesim Erim
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany;
| | - Ceren Acarturk
- Department of Psychology, Koç University, 34450 Istanbul, Turkey;
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Tzoraki O, Dimitrova S, Barzakov M, Yaseen S, Gavalas V, Harb H, Haidari A, Cahill BP, Ćulibrk A, Nikolarea E, Andrianopulu E, Trajanovic M. The Impact of the COVID-19 Pandemic on the Working Conditions, Employment, Career Development and Well-Being of Refugee Researchers. Societies 2021; 11:71. [DOI: 10.3390/soc11030071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
The ongoing ‘refugee crisis’ of the past years has led to the migration of refugee researchers (RRs) to European countries. Due to the COVID-19 pandemic, RRs often had to work from home and/or to continue their social, cultural and economic integration process under new conditions. An online survey carried out to explore the impact of the pandemic on the refugee researchers showed that RRs found it difficult to adapt their everyday working life to the ‘home’ setting. The majority have had neither a suitable work environment at home nor the appropriate technology. Although they stated that they are rather pleased with the measures taken by the public authorities, they expressed concern about their vulnerability due to their precarious contracts and the bureaucratic asylum procedures, as the pandemic has had a negative impact on these major issues. The majority of RRs working in academia seem not to have been affected at all as far as their income is concerned, while the majority of those employed in other sectors became unemployed during the pandemic (58%). Recommendations are provided to the public authorities and policy makers to assist RRs to mitigate the consequences of the pandemic on their life.
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20
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Hayward SE, Deal A, Cheng C, Crawshaw A, Orcutt M, Vandrevala TF, Norredam M, Carballo M, Ciftci Y, Requena-Méndez A, Greenaway C, Carter J, Knights F, Mehrotra A, Seedat F, Bozorgmehr K, Veizis A, Campos-Matos I, Wurie F, McKee M, Kumar B, Hargreaves S. Clinical outcomes and risk factors for COVID-19 among migrant populations in high-income countries: A systematic review. J Migr Health 2021; 3:100041. [PMID: 33903857 PMCID: PMC8061095 DOI: 10.1016/j.jmh.2021.100041] [Citation(s) in RCA: 142] [Impact Index Per Article: 47.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 04/07/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Migrants in high-income countries may be at increased risk of COVID-19 due to their health and social circumstances, yet the extent to which they are affected and their predisposing risk factors are not clearly understood. We did a systematic review to assess clinical outcomes of COVID-19 in migrant populations, indirect health and social impacts, and to determine key risk factors. METHODS We did a systematic review following PRISMA guidelines (PROSPERO CRD42020222135). We searched multiple databases to 18/11/2020 for peer-reviewed and grey literature on migrants (foreign-born) and COVID-19 in 82 high-income countries. We used our international networks to source national datasets and grey literature. Data were extracted on primary outcomes (cases, hospitalisations, deaths) and we evaluated secondary outcomes on indirect health and social impacts and risk factors using narrative synthesis. RESULTS 3016 data sources were screened with 158 from 15 countries included in the analysis (35 data sources for primary outcomes: cases [21], hospitalisations [4]; deaths [15]; 123 for secondary outcomes). We found that migrants are at increased risk of infection and are disproportionately represented among COVID-19 cases. Available datasets suggest a similarly disproportionate representation of migrants in reported COVID-19 deaths, as well as increased all-cause mortality in migrants in some countries in 2020. Undocumented migrants, migrant health and care workers, and migrants housed in camps have been especially affected. Migrants experience risk factors including high-risk occupations, overcrowded accommodation, and barriers to healthcare including inadequate information, language barriers, and reduced entitlement. CONCLUSIONS Migrants in high-income countries are at high risk of exposure to, and infection with, COVID-19. These data are of immediate relevance to national public health and policy responses to the pandemic. Robust data on testing uptake and clinical outcomes in migrants, and barriers and facilitators to COVID-19 vaccination, are urgently needed, alongside strengthening engagement with diverse migrant groups.
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Affiliation(s)
- Sally E Hayward
- Institute for Infection and Immunity, St George's University of London, London, UK
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Anna Deal
- Institute for Infection and Immunity, St George's University of London, London, UK
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Cherie Cheng
- Institute for Infection and Immunity, St George's University of London, London, UK
| | - Alison Crawshaw
- Institute for Infection and Immunity, St George's University of London, London, UK
| | - Miriam Orcutt
- Institute for Global Health, University College London, London, UK
| | | | - Marie Norredam
- Danish Research Centre for Migration, Ethnicity and Health, University of Copenhagen; Department of Infectious Diseases at Copenhagen University Hospital, Amager and Hvidovre, Copenhagen, Denmark
| | - Manuel Carballo
- International Centre for Migration, Health, and Development, Geneva, Switzerland
| | | | - Ana Requena-Méndez
- Department of Medicine, Karolinska Insitutet, Solna, Sweden; and Barcelona Insitute for Global Health (ISGlobal), University of Barcelona, Barcelona, Spain
| | | | - Jessica Carter
- Institute for Infection and Immunity, St George's University of London, London, UK
| | - Felicity Knights
- Institute for Infection and Immunity, St George's University of London, London, UK
| | - Anushka Mehrotra
- Institute for Infection and Immunity, St George's University of London, London, UK
| | | | - Kayvan Bozorgmehr
- Department of Population Medicine and Health and Health Services Research, School of Public Health, Bielefeld University, Bielefeld, Germany; Section for Health Equity Studies & Migration, Heidelberg University Hospital, Heidelberg, Germany
| | | | - Ines Campos-Matos
- Public Health England; and UCL Collaborative Centre for Inclusion Health, London, UK
| | - Fatima Wurie
- Public Health England; and UCL Research Department of Epidemiology and Public Health, London, UK
| | - Martin McKee
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | | | - Sally Hargreaves
- Institute for Infection and Immunity, St George's University of London, London, UK
| | - on behalf of the ESCMID Study Group for Infections in Travellers and Migrants (ESGITM)
- Institute for Infection and Immunity, St George's University of London, London, UK
- Institute for Global Health, University College London, London, UK
- Faculty of Business and Social Sciences, Kingston University, London, UK
- Danish Research Centre for Migration, Ethnicity and Health, University of Copenhagen; Department of Infectious Diseases at Copenhagen University Hospital, Amager and Hvidovre, Copenhagen, Denmark
- International Centre for Migration, Health, and Development, Geneva, Switzerland
- Doctors of the World UK, London, UK
- Department of Medicine, Karolinska Insitutet, Solna, Sweden; and Barcelona Insitute for Global Health (ISGlobal), University of Barcelona, Barcelona, Spain
- Department of Medicine, McGill University, Montreal, Canada
- Department of Population Medicine and Health and Health Services Research, School of Public Health, Bielefeld University, Bielefeld, Germany; Section for Health Equity Studies & Migration, Heidelberg University Hospital, Heidelberg, Germany
- Medecins Sans Frontieres Greece, Athens, Greece
- Public Health England, London, UK
- Public Health England; and UCL Collaborative Centre for Inclusion Health, London, UK
- Public Health England; and UCL Research Department of Epidemiology and Public Health, London, UK
- Norwegian Institute of Public Health, Oslo, Norway
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
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