Claus Lukas, Braakman Mario, Schouler-Ocak Meryam, Van de Vliet Laura, Sabbe Bernard, van den Ameele Seline
Collaborative Antwerp Psychiatric Research Institute (CAPRI), Universiteit Antwerpen (UA), Antwerp, Belgium.
Department of Psychiatry, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium.
BJPsych Open. 2025 Mar 19;11(2):e62. doi: 10.1192/bjo.2024.866.
Asylum seekers have difficulty gaining access to mental healthcare. Lack of understanding of asylum seekers' mental illness explanatory models appears to be an important barrier. Gaining a better understanding of these explanatory models is crucial for ensuring the inclusion of asylum seekers in healthcare services. The Cultural Formulation Interview (CFI) might help to explore asylum seekers' explanatory models of mental illness.
To analyse asylum seekers' explanatory models as elicited by the CFI.
The CFI and its first supplementary module were carried out with asylum seekers with mental health problems. Transcriptions of the interviews underwent reflexive thematic analysis within a social constructivist framework.
In the analysis of 25 illness narratives, three major themes characterising asylum seekers' explanatory models were identified: a burden of the past, a disenabling current reality, and a personal position and individual experience.
The interplay among pre-, peri- and post-migration experiences, having a continuous impact on asylum seekers' mental health, was highlighted by the themes 'a burden of the past', and 'a disenabling current reality'. The theme 'a personal position and individual experience' revealed how the CFI enables self-determination in clinical encounters by embracing uncertainty and questioning the medicalisation of distress. The analysis characterises asylum seekers' symptoms as a personal idiom of distress within socio-relational contexts. The CFI provides a clinically useful framework for exploring asylum seekers' explanatory models and fostering dynamic understanding.
寻求庇护者在获得心理保健服务方面存在困难。对寻求庇护者的精神疾病解释模型缺乏了解似乎是一个重要障碍。更好地理解这些解释模型对于确保寻求庇护者能够获得医疗服务至关重要。文化定式访谈（CFI）可能有助于探索寻求庇护者对精神疾病的解释模型。
分析由CFI引出的寻求庇护者的解释模型。
对有心理健康问题的寻求庇护者进行CFI及其第一个补充模块的访谈。访谈记录在社会建构主义框架内进行反思性主题分析。
在对25份疾病叙述的分析中，确定了表征寻求庇护者解释模型的三个主要主题：过去的负担、不利的当前现实以及个人立场和个人经历。
“过去的负担”和“不利的当前现实”这两个主题突出了移民前、移民期间和移民后的经历之间的相互作用对寻求庇护者心理健康的持续影响。“个人立场和个人经历”这一主题揭示了CFI如何通过接受不确定性和质疑痛苦的医学化来在临床接触中实现自我决定。该分析将寻求庇护者的症状描述为社会关系背景下痛苦的个人表达方式。CFI为探索寻求庇护者的解释模型和促进动态理解提供了一个临床有用的框架。
