Mental health and refugees

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Original Editor - Shaimaa Eldib Top Contributors - Shaimaa Eldib

Introduction

Mental health illness is considered as a leading cause for disability all over the world.It accounts for around 13 %of the global burden of disease and responsible for 33% of total years lived with disability[1][2]. It is estimated that people who suffer from sever mental illness for example, severe depression,bipolar disorder and schizophrenia[3] are more likely to die prematurely than those who are not affected.The problems of mental health are highly prevalent globally, affecting people across all regions of the world as it is expected to affect at least 1 of 3 people all over their life time[4][5]. Also

there are major economic consequences of this high prevalence.Around $16.3 trillion was estimated to be the cost of mental ill- health globally between 2011 and 2030 [6] and this has serious implications on standers of livings and socioeconomic development[7]. There are many barriers in treating mental illness for example,stigma,discrimination [8][3] and governmental apathy[7] which exacerbating the current state of mental healthcare all over the world.

Refugees Crisis

The UN Refugee Agency (UNHCR)[9] defines refugee as set out in the 1951 Convention[10][11]
Refugees.jpg
The 1951 Convention and its 1967 Protocol :

The primary and universal definition of a refugee that applies to States is contained in Article 1(A)(2) of the 1951 Convention, as amended by its 1967 Protocol, defining a refugee as someone who:

"owing to well-founded fear of being persecuted for reasons of race, religion, nationality, membership of a particular social group or political opinion, is outside the country of his nationality and is unable or, owing to such fear, is unwilling to avail himself of the protection of that country; or who, not having a nationality and being outside the country of his former habitual residence, is unable or, owing to such fear, is unwilling to return to it[10].

According to the United Nations Refugee Agency (UNHCR), 65.6 million people have been forcibly displaced worldwide[12].There were 20 people newly displaced every minute of 2016[13].Europe Initially welcomed more than a million refugees and forced migrants between 2015 and 2016 [14]. Those who forced to leave their home countries,lived in over crowded reception facilities that have ,in effect, turned into long term detention centers with poor health and safety conditions[15] while waiting for resettlement or asylum decisions[14]. All these conditions created medical challenges and excessive need to the usage of heath systems[16].

Refugees Health

The healthcare professionals should be aware that there are several factors that have a major influence on asylum seekers health:

This video describes the gaps in refugee heath and how to bridge it.

The Refugees Mental Health

References

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  2. Funk M. Global burden of mental disorders and the need for a comprehensive, coordinated response from health and social sectors at the country level. Retrieved on. 2016 Oct;30.
  3. 3.0 3.1 Thornicroft G, Brohan E, Rose D, Sartorius N, Leese M, INDIGO Study Group. Global pattern of experienced and anticipated discrimination against people with schizophrenia: a cross-sectional survey. The Lancet. 2009 Jan 31;373(9661):408-15.
  4. Steel Z, Marnane C, Iranpour C, Chey T, Jackson JW, Patel V, Silove D. The global prevalence of common mental disorders: a systematic review and meta-analysis 1980–2013. International journal of epidemiology. 2014 Apr 1;43(2):476-93.
  5. Vigo D, Thornicroft G, Atun R. Estimating the true global burden of mental illness. The Lancet Psychiatry. 2016 Feb 1;3(2):171-8.
  6. Bloom DE, Cafiero E, Jané-Llopis E, Abrahams-Gessel S, Bloom LR, Fathima S, Feigl AB, Gaziano T, Hamandi A, Mowafi M, O’Farrell D. The global economic burden of noncommunicable diseases. Program on the Global Demography of Aging; 2012 Jan.
  7. 7.0 7.1 Caulfield A, Vatansever D, Lambert G, Van Bortel T. WHO guidance on mental health training: a systematic review of the progress for non-specialist health workers. BMJ open. 2019 Jan 1;9(1):bmjopen-2018.
  8. Lasalvia A, Zoppei S, Van Bortel T, Bonetto C, Cristofalo D, Wahlbeck K, Bacle SV, Van Audenhove C, Van Weeghel J, Reneses B, Germanavicius A. Global pattern of experienced and anticipated discrimination reported by people with major depressive disorder: a cross-sectional survey. The Lancet. 2013 Jan 5;381(9860):55-62.
  9. https://emergency.unhcr.org/entry/55772/refugee-definition
  10. 10.0 10.1 Fitzpatrick J. Revitalizing the 1951 refugee convention. Harv. Hum. Rts. J.. 1996;9:229.
  11. Zimmermann A, Dörschner J, Machts F, editors. The 1951 Convention relating to the status of refugees and its 1967 protocol: A commentary. Oxford University Press; 2011 Jan 27.
  12. 12.0 12.1 Müller M, Khamis D, Srivastava D, Exadaktylos AK, Pfortmueller CA. Understanding refugees' health. InSeminars in neurology 2018 Apr (Vol. 38, No. 02, pp. 152-162). Thieme Medical Publishers.
  13. 13.0 13.1 Ellis BH, Winer JP, Murray K, Barrett C. Understanding the mental health of refugees: Trauma, stress, and the cultural context. InThe Massachusetts General Hospital textbook on diversity and cultural sensitivity in mental health 2019 (pp. 253-273). Humana, Cham.
  14. 14.0 14.1 Fotaki M. A crisis of humanitarianism: refugees at the gates of Europe. International journal of health policy and management. 2019 Jun;8(6):321.
  15. Blitz BK, d’Angelo A, Kofman E, Montagna N. Health challenges in refugee reception: dateline Europe 2016. International journal of environmental research and public health. 2017 Dec;14(12):1484.
  16. Kotsiou OS, Kotsios P, Srivastava DS, Kotsios V, Gourgoulianis KI, Exadaktylos AK. Impact of the refugee crisis on the Greek healthcare system: A long road to Ithaca. International journal of environmental research and public health. 2018 Aug;15(8):1790.
  17. Wångdahl J, Lytsy P, Mårtensson L, Westerling R. Health literacy among refugees in Sweden–a cross-sectional study. BMC public health. 2014 Dec 1;14(1):1030.
  18. Uba L. Cultural barriers to health care for southeast Asian refugees. Public health reports. 1992 Sep;107(5):544.
  19. Dadzie GM. Healthcare Accessibility for Syrian Refugees: Understanding Trends, Host Countries’ Responses and Impacts on Refugees’ Health.