Alshabani Nuha, Price Kathryn, Kennedy Helena, Haws James K, Kimball Sarah L
Chobanian & Avedisian School of Medicine, Boston University, Boston, United States.
Department of Psychiatry, Boston Medical Center, Boston, United States.
J Immigr Minor Health. 2025 Oct;27(5):877-881. doi: 10.1007/s10903-025-01746-2. Epub 2025 Aug 5.
We share findings from a needs assessment to understand barriers to posttraumatic stress disorder (PTSD) treatment for immigrants and refugees (IR) in primary care settings. Providing culturally responsive and accessible PTSD treatment to IR patients is critical. The study conducted qualitative interviews with 15 interprofessional staff and providers (e.g., primary care physicians, behavioral health clinicians, case manager, and a nurse practitioner) as well as two focus groups with physician residents serving IR patients. Results from qualitative analysis revealed several key barriers to integrating PTSD treatment for IR in primary care settings, including training gaps, mental health literacy and stigma, poor social determinants of health (i.e., food insecurity, housing stability, economic security, transportation), and lack of PTSD screening. Our findings suggest that reducing barriers to PTSD treatment for IRs may be addressed through multilevel changes and interventions for providers (e.g., training in culturally responsive trauma-informed intervention) and patients (e.g., addressing the intersection of stigma, trauma, and social determinants of health).
我们分享了一项需求评估的结果，以了解在初级保健机构中，移民和难民（IR）接受创伤后应激障碍（PTSD）治疗的障碍。为IR患者提供具有文化适应性且可及的PTSD治疗至关重要。该研究对15名跨专业工作人员和提供者（如初级保健医生、行为健康临床医生、个案经理和一名执业护士）进行了定性访谈，并与为IR患者服务的住院医师进行了两个焦点小组讨论。定性分析结果揭示了在初级保健机构中为IR患者整合PTSD治疗的几个关键障碍，包括培训差距、心理健康素养和耻辱感、健康的社会决定因素差（即粮食不安全、住房稳定性、经济安全、交通）以及缺乏PTSD筛查。我们的研究结果表明，减少IR患者PTSD治疗的障碍可能需要通过针对提供者（如进行具有文化适应性的创伤知情干预培训）和患者（如解决耻辱感、创伤和健康的社会决定因素之间的交叉问题）的多层次变革和干预来实现。
