Bogatzki Lea, Miredin Julia, Millet Sophie, Lipinski Leonie, Molle Madlen, Rockstroh Brigitte, Mier Daniela, Odenwald Michael
Universität Konstanz, Konstanz, Deutschland.
vivo international e. V., Konstanz, Deutschland.
Nervenarzt. 2023 Nov;94(11):1026-1033. doi: 10.1007/s00115-023-01524-1. Epub 2023 Aug 11.
Refugees with mental disorders are confronted with access barriers to the psychiatric and psychotherapeutic care system. In order to counter these barriers, a model project to support the health care and integration of mentally distressed refugees was established in the district of Konstanz (coordinated psychotherapeutic treatment involving trained peer support; KOBEG) and evaluated in an initial 3‑year model phase. A coordination center refers the patients to local certified psychotherapists. Language and culturally sensitive trained mentors (peers) support and accompany the refugees during the therapy. The utilization of the refered therapy and the experiences of the participating therapists serve as indicators for the effectiveness of the peer-supported therapy referral. The effectiveness of therapeutic measures and support by trained peers was evaluated on the basis of the psychological symptom burden (symptom checklist 27) and functional impairment (work and social adjustment scale) before and after an average of 10 months of project participation. The study focuses on the refugees (use of services and mental distress) and the psychotherapists (reported experiences). Initial results showed an above-average stress level among the refugees at the time of the initial interview, a high participation rate and a low drop-out rate. The follow-up survey showed significant improvements in terms of psychological symptom burden as well as functional impairments. The (qualitative) survey among psychotherapists underlines the effectiveness of KOBEG, 93% of the therapists intend to continue working with refugees within the framework of the project.
患有精神障碍的难民在获取精神科和心理治疗护理系统方面面临障碍。为了克服这些障碍，在康斯坦茨地区建立了一个支持精神痛苦难民的医疗保健和融入的示范项目（包括由经过培训的同伴提供支持的协调心理治疗；KOBEG），并在最初的3年示范阶段进行了评估。一个协调中心将患者转介给当地认证的心理治疗师。语言和文化敏感的训练有素的导师（同伴）在治疗期间支持并陪伴难民。所转介治疗的利用率以及参与治疗师的经验作为同伴支持治疗转介有效性的指标。在平均参与项目10个月前后，根据心理症状负担（症状清单27）和功能损害（工作和社会适应量表）评估了治疗措施和训练有素的同伴提供支持的有效性。该研究关注难民（服务使用情况和精神痛苦）和心理治疗师（报告的经验）。初步结果显示，在初次访谈时，难民的压力水平高于平均水平，参与率高且退出率低。随访调查显示，在心理症状负担和功能损害方面有显著改善。对心理治疗师的（定性）调查强调了KOBEG的有效性，93%的治疗师打算在该项目框架内继续为难民提供服务。
