Kiat Naama, Youngmann Rafael, Lurie Ido
Ruppin Academic Center.
Tel Aviv University.
Transcult Psychiatry. 2017 Oct-Dec;54(5-6):575-594. doi: 10.1177/1363461517746313.
Israel has become a destination for asylum seekers. Asylum seekers often experience emotional distress, but have limited access to health services and rarely use psychiatric services. This study sought to understand and characterize the use of psychiatric versus medical services by asylum seekers in Israel. We compared the emotional distress, stressful life events and previous treatment consultations of 21 psychiatric service users (PSU) and 55 medical service users (MSU) at the Open Clinic of Physicians for Human Rights in Tel-Aviv. Participants completed a socio-demographic questionnaire, the General Health Questionnaire (GHQ-12), the Stressful Life Events Scale and the Health Care Utilization Questionnaire. PSU and MSU did not have significantly different levels of emotional distress. PSU reported significantly more stressful life events during the past year than MSU ( M = 5.81, SD 3.47 vs. M = 3.8, SD 2.35, p < 0.01). In comparison to MSU, PSU utilized more medical ( M = 4.33, SD 2.28) and non-medical ( M = 2.38, SD 1.92) services ( p < 0.001) than MSU. Asylum seekers who consulted multiple treatment agencies in the last year were 1.55 times more likely to seek psychiatric treatment than those who had consulted only a few treatment agencies. Emotional distress in asylum seekers appears to be under-diagnosed in the Open Clinic and under-treated by mental health professionals. To better detect this distress, a thorough screening is recommended at assessment. Collaboration with mental health professionals and community and religious leaders consulted in the past is important and can contribute to good health care outcomes in this population.
以色列已成为寻求庇护者的目的地。寻求庇护者常常经历情绪困扰,但获得医疗服务的机会有限,很少使用精神科服务。本研究旨在了解并描述以色列寻求庇护者使用精神科服务与医疗服务的情况。我们比较了特拉维夫人权医生开放诊所中21名精神科服务使用者(PSU)和55名医疗服务使用者(MSU)的情绪困扰、压力性生活事件及既往治疗咨询情况。参与者完成了一份社会人口学问卷、一般健康问卷(GHQ - 12)、压力性生活事件量表及医疗服务利用问卷。PSU和MSU的情绪困扰水平无显著差异。PSU报告称过去一年中经历的压力性生活事件显著多于MSU(M = 5.81,标准差3.47 vs. M = 3.8,标准差2.35,p < 0.01)。与MSU相比,PSU使用了更多的医疗服务(M = 4.33,标准差2.28)和非医疗服务(M = 2.38,标准差1.92)(p < 0.001)。去年咨询过多个治疗机构的寻求庇护者寻求精神科治疗的可能性是只咨询过少数治疗机构者的1.55倍。在开放诊所中,寻求庇护者的情绪困扰似乎未得到充分诊断,心理健康专业人员对其治疗不足。为了更好地发现这种困扰,建议在评估时进行全面筛查。与过去咨询过的心理健康专业人员以及社区和宗教领袖合作很重要,这有助于为这一人群带来良好的医疗保健结果。