Al-Soleiti Majd, Abu Adi Mahmoud, Nashwan Ayat, Rafla-Yuan Eric
School of Medicine, The University of Jordan, Amman, Jordan.
CIVIC Social Enterprise, Amman, Jordan.
Glob Ment Health (Camb). 2021 Sep 28;8:e38. doi: 10.1017/gmh.2021.36. eCollection 2021.
Jordan has received more than three million refugees from bordering countries during times of conflict, including over 600 000 Syrian refugees between 2011 and 2021. Amidst this humanitarian crisis, a new mental health system for Syrian refugees has developed in Jordan, with most clinical services administered through non-governmental organizations. Prior studies have identified increased risk of psychiatric disorders in refugee populations and significant barriers for Syrian refugees seeking mental health treatment, but few have reviewed the organization or ability of local systems to meet the needs of this refugee population.
Qualitative interviews of mental health professionals working with refugees in Jordan were conducted and thematically analyzed to assess efficacy and organizational dynamics.
Interviewees described barriers to care inherent in many refugee settings, including financial limitations, shortages of mental health professionals, disparate geographic accessibility, stigma, and limited or absent screening protocols. Additional barriers not previously described in Jordan were identified, including clinician burnout, organizational metrics restricting services, insufficient visibility of services, and security restrictions. Advantages of the Jordanian system were also identified, including a receptive sociopolitical response fostering coordination and collaboration, open-door policies for accessing care, the presence of community and grassroots approaches, and improvements to health care infrastructure benefiting the local populace.
These findings highlight opportunities and pitfalls for program development in Jordan and other middle- and low-income countries. Leveraging clinician input can promote health system efficacy and improve mental health outcomes for refugee patients.
在冲突时期，约旦接收了来自周边国家的300多万难民，其中2011年至2021年间有超过60万叙利亚难民。在这场人道主义危机中，约旦为叙利亚难民建立了一个新的心理健康系统，大多数临床服务由非政府组织提供。先前的研究已经确定难民群体中精神疾病风险增加，以及叙利亚难民寻求心理健康治疗的重大障碍，但很少有人审查当地系统满足这一难民群体需求的组织情况或能力。
对在约旦为难民提供服务的心理健康专业人员进行定性访谈，并进行主题分析，以评估疗效和组织动态。
受访者描述了许多难民环境中固有的护理障碍，包括经济限制、心理健康专业人员短缺、地理可及性差异、耻辱感以及筛查方案有限或缺乏。还发现了约旦此前未描述过的其他障碍，包括临床医生倦怠、限制服务的组织指标、服务可见度不足以及安全限制。也确定了约旦系统的优势，包括有利于协调与合作的积极社会政治反应、获得护理的开放政策、社区和基层方法的存在，以及改善使当地民众受益的医疗基础设施。
这些发现突出了约旦以及其他中低收入国家项目发展的机遇和陷阱。利用临床医生的意见可以提高卫生系统的疗效，并改善难民患者的心理健康结果。
