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Mental health among children seeking asylum in Denmark – the effect of length of stay and number of relocations: a cross-sectional study
Signe S Nielsen, Marie Norredam, Karen L Christiansen, Carsten Obel, J?rgen Hilden, Allan Krasnik
BMC Public Health , 2008, DOI: 10.1186/1471-2458-8-293
Abstract: The population included all 260 parent-accompanied asylum-seeking children aged 4–16 years living in the asylum centres managed by the Danish Red Cross in October–December 2006. Mental health was evaluated using the Strengths and Difficulties Questionnaire. School teachers evaluated children aged 4–16; and the 11–16-year-olds completed the self-report version. To assess the association between organisational factors and mental health, binary logistic regression analyses were done using backwards elimination. We received responses for 246 children equivalent to 95% of the study population.Using teachers' reports, we found that children who had been asylum-seeking for more than one year in Denmark had an increased risk of having mental difficulties (odds ratio 5.5, 95% CI 1.8–16.3); four or more relocations in the asylum system were also associated with a higher risk (3.0, 1.4–6.7). When the self-report data were included, the associations were even stronger.Protracted stays at asylum centres and multiple relocations within the asylum system appear to have an adverse effect on asylum-seeking children's mental health. A limit to the duration of the children's stay in the asylum system should be ensured. Follow-up studies with inclusion of other conditions, such as parental mental health and the children's previous trauma, are needed to clarify the influence of the different factors and their interactions.Children seeking asylum not only suffer mentally from conflict-related exposures before migration, during the process of seeking asylum the organisational conditions in the host country may also adversely affect their mental health [1-3]. The literature shows several environmental risk factors for mental illness in refugee children, such as number of transitions, time taken for immigration status to be determined, time spent in the host country, and cultural isolation [1,2,4,5]. In particular, prolonged stay within the asylum system, including detention, has shown to h
Reception of asylum seekers with disabilities in Europe  [cached]
Ana Beduschi-Orti
Forced Migration Review , 2010,
Abstract: With regard to the reception of asylum seekers in the European Union, provisions for the protection of people with disabilities are found in a wide range of regulatory sources.
Temporary geographies of the city: the experienced spaces of asylum seekers in the City of Turku, Finland  [cached]
P?ivi Kym?l?inen,Paulina Nordstr?m
Fennia : International Journal of Geography , 2010,
Abstract: Temporarity has a significant role in today’s urban spaces and peoples’ experiences of them. The city is often understood through stable material structures, while less attention is paid to such aspects of urban space that are there only for a limited time such as markets, events, manifestations and construction sites, for instance. Experiences of momentarity may be related to these kinds of elements of the city, but equally to personal feelings of not belonging to the city. In this paper we discuss, firstly, temporary geographies and their importance in today’s urban studies. Debates on relational spaces and moving geographies have directed attention towards the temporary aspects of urban spaces. Temporarity itself has mostly been discussed in relation to urban planning while less attention has been paid to other aspects of everyday life. Secondly, the theoretical aspects of temporary geographies in this paper will be illustrated with empirical material collected among young asylum seekers in the City of Turku in Finland in 2008–2009. The asylum seekers were interviewed and they kept photo diaries about their urban experiences. The material tells about the feelings of momentarity in urban space as the asylum seekers’ uses of the city were coloured by uncertainty while they were waiting for the decision about permission to stay in the country.
Suicide death and hospital-treated suicidal behaviour in asylum seekers in the Netherlands: a national registry-based study
Simone Goosen, Anton E Kunst, Karien Stronks, Irene EA van Oostrum, Daan G Uitenbroek, Ad JFM Kerkhof
BMC Public Health , 2011, DOI: 10.1186/1471-2458-11-484
Abstract: We obtained data on cases of suicide and suicidal behaviour from all asylum seeker reception centres in the Netherlands (period 2002-2007, age 15+). The suicide death rates in this population and in subgroups by sex, age and region of origin were compared with the rate in the Dutch population; the rates of hospital-treated suicidal behaviour were compared with that in the population of The Hague using indirect age group standardization.The study included 35 suicide deaths and 290 cases of hospital-treated suicidal behaviour. The suicide death rate and the incidence of hospital-treated suicidal behaviour differed between subgroups by sex and region of origin. For male asylum seekers, the suicide death rate was higher than that of the Dutch population (N = 32; RR = 2.0, 95%CI 1.37-2.83). No difference was found between suicide mortality in female asylum seekers and in the female general population of the Netherlands (N = 3; RR = 0.73; 95%CI 0.15-2.07). The incidence of hospital-treated suicidal behaviour was high in comparison with the population of The Hague for males and females from Europe and the Middle East/South West Asia, and low for males and females from Africa. Health professionals knew about mental health problems prior to the suicidal behaviour for 80% of the hospital-treated suicidal behaviour cases in asylum seekers.In this study the suicide death rate was higher in male asylum seekers than in males in the reference population. The incidence of hospital-treated suicidal behaviour was higher in several subgroups of asylum seekers than that in the reference population. We conclude that measures to prevent suicide and suicidal behaviour among asylum seekers in the Netherlands are indicated.In 2008 an estimated 383 000 asylum applications were recorded in 51 Western countries, including most European countries, the USA and Canada [1]. Asylum seekers are people who have left their country of origin, applied for protection as a refugee in another country, and
Multimorbidity in Adult Asylum Seekers: A First Overview  [PDF]
Carmen A. Pfortmueller, Manuela Stotz, Gregor Lindner, Thomas Müller, Nicolas Rodondi, Aristomenis K. Exadaktylos
PLOS ONE , 2013, DOI: 10.1371/journal.pone.0082671
Abstract: Principals Over the last two decades, the total annual number of applications for asylum in the countries of the European Union has increased from 15,000 to more than 300,000 people. The aim of this study was to give a first overview on multimorbidity of adult asylum seekers. Methods Our retrospective Swiss single center data analysis examined multimorbidity of adult asylums seekers admitted to our ED between 1 January 2000 and 31 December 2012. Results A total of 3170 patients were eligible for the study; they were predominantly male (2392 male, 75.5% versus 778 female, 24.5). The median age of the patients was 28 years (range 28–82). The most common region of origin was Africa (1544, 48.7%), followed by the Middle East (736, 23.6%). 2144 (67.6%) of all patients were not multimorbid. A total of 1183 (37.7%) of our patients were multimorbid. The mean Charlson comorbidity index was 0.25 (SD 1.1, range 0–12). 634 (20%) of all patients sufferem from psychiatric diseases, followed by chronic medical conditions (12.6%, 399) and infectious diseases (4.7%, 150). Overall, 11% (349) of our patients presented as a direct consequence of prior violence. Patients from Sri Lanka/India most often suffered from addictions problems (50/240, 20.8%, p<0.0001). Infectious diseases were most frequent in patients from Africa (6.6%), followed by the Balkans and Eastern Europe/Russia (each 3.8%). Conclusion The health care problems of asylum seekers are manifold. More than 60% of the study population assessed in our study did not suffer from more than one disease. Nevertheless a significant percentage of asylum seekers is multimorbid and exhibits underlying psychiatric, infectious or chronic medical conditions despite their young age.
Health and health care utilisation among asylum seekers and refugees in the Netherlands: design of a study
Annette AM Gerritsen, Inge Bramsen, Walter Devillé, Loes HM van Willigen, Johannes E Hovens, Henk M van der Ploeg
BMC Public Health , 2004, DOI: 10.1186/1471-2458-4-7
Abstract: The study will include random samples of adult asylum seekers and refugees from Afghanistan, Iran and Somali (total planned sample of 600), as these are among the largest groups within the reception centres and municipalities in the Netherlands.The questionnaire that will be used will include questions on physical health (chronic and acute diseases and somatization), mental health (Hopkins Symptoms Checklist-25 and Harvard Trauma Questionnaire), utilisation of health care services, pre- and post-migratory traumatic experiences, life-style, acculturation, social support and socio-demographic background. The questionnaire has gone through a translation process (translation and back-translation, several checks and a pilot-study) and cross-cultural adaptation. Respondents will be interviewed by bilingual and bicultural interviewers who will be specifically trained for this purpose.This article discusses the selection of the study population, the chosen outcome measures, the translation and cross-cultural adaptation of the measurement instrument, the training of the interviewers and the practical execution of the study. The information provided may be useful for other researchers in this relatively new field of epidemiological research among various groups of asylum seekers and refugees.In the Netherlands, health surveys are frequently conducted to assess the health of the population and the utilisation of health care services [1,2]. Due to language and cultural problems these surveys often exclude (first generation) immigrants. However, in recent years, much research has focused on the four largest immigrant groups, i.e. people from Surinam, the Netherlands Antilles, Turkey and Morocco [1,3]. Although refugees have been coming to the Netherlands since the eighties, their numbers were not large enough and their backgrounds were too diverse for them to be the subject of large-scale epidemiological research. However, it is important that research also focuses on these grou
Experiences of refugees and asylum seekers in general practice: a qualitative study
Ravi Bhatia, Paul Wallace
BMC Family Practice , 2007, DOI: 10.1186/1471-2296-8-48
Abstract: Qualitative study of adult asylum seekers and refugees who had entered the UK in the last 10 years. The study was set in Barnet Refugee Walk in Service, London. 11 Semi structured interviews were conducted and analysed using framework analysis.Access to GPs may be more difficult for failed asylum seekers and those without support from refugee agencies or family. There may be concerns amongst some in the refugee community regarding the access to and confidentiality of professional interpreters. Most participants stated their preference for GPs who offered advice rather than prescriptions. The stigma associated with refugee status in the UK may have led to some refugees altering their help seeking behaviour.The problem of poor access for those with inadequate support may be improved by better education and support for GPs in how to provide for refugees. Primary Care Trusts could also supply information to newly arrived refugees on how to access services. GPs should be aware that, in some situations, professional interpreters may not always be desired and that instead, it may be advisable to reach a consensus as to who should be used as an interpreter. A better doctor-patient experience resulting from improvements in access and communication may help to reduce the stigma associated with refugee status and lead to more appropriate help seeking behaviour. Given the small nature of our investigation, larger studies need to be conducted to confirm and to quantify these results.The increasing refugee [throughout this report, the term "refugee" is used to denote "refugee and asylum seeker"] population in the UK has led to increased research and debate about their health and social needs [1]. Most studies have been based on health professionals' views of how refugees should be managed and the problems encountered by these professionals when dealing with them. They have exposed how healthcare for refugees is patchy and often inappropriate [2] with inequalities in relation to a
The role of entry screening in case finding of tuberculosis among asylum seekers in Norway
Ingunn Harstad, Geir W Jacobsen, Einar Heldal, Brita A Winje, Saeed Vahedi, Anne-Sofie Helvik, Sigurd L Steinshamn, Helge Gar?sen
BMC Public Health , 2010, DOI: 10.1186/1471-2458-10-670
Abstract: We aimed to assess the effectiveness of entry screening of a cohort of asylum seekers. Cases detected by screening were compared with cases detected later. Further we have characterized cases with active tuberculosis.All asylum seekers who arrived at the National Reception Centre between January 2005 - June 2006 with an abnormal chest X-ray or a Mantoux test ≥ 6 mm were included in the study and followed through the health care system. They were matched with the National Tuberculosis Register by the end of May 2008.Cases reported within two months after arrival were defined as being detected by screening.Of 4643 eligible asylum seekers, 2237 were included in the study. Altogether 2077 persons had a Mantoux ≥ 6 mm and 314 had an abnormal chest X-ray. Of 28 cases with tuberculosis, 15 were detected by screening, and 13 at 4-27 months after arrival. Abnormal X-rays on arrival were more prevalent among those detected by screening. Female gender and Somalian origin increased the risk for active TB.In spite of an imperfect follow-up of screening results, a reasonable number of TB cases was identified by the programme, with a predominance of pulmonary TB.In recent years most new tuberculosis (TB) cases in Norway have occurred among immigrants from high incidence countries. Rarely, new cases are due to transmission within the country [1].Low incidence countries have diverse policies on entry screening of immigrants from high incidence countries. These range from no screening at all, to pre-immigration screening or screening after arrival [2-4]. There is an ongoing discussion about the content and effectiveness of different screening programmes to control tuberculosis [5,6]. Studies of screening of tuberculosis among immigrants have given TB prevalences that range from 0.1-1.2% [7-10], that can be due to differences in the characteristics of the populations and the screening programmes.Previous studies have shown differences between cases detected by or outside the screening
Representation of Refugees, Asylum-Seekers and Refugee Affairs In Hungarian Dailies  [PDF]
Lilla VICSEK,Roland KESZI,Marcell MáRKUS
Journal of Identity and Migration Studies , 2008,
Abstract: How does the press in Hungary write about refugees, asylum-seekers and refugee affairs? We sought to answer this question. Articles appearing in 2005 and 2006 in two leading national Hungarian dailies were examined with quantitative content analysis. The results show that the articles analyzed often treat refugee affairs as an “official” political matter. The high proportion of legislation and political positions conveys the image that refugee affairs are a state or intergovernmental matter, an “official”, legal, political issue rather than for example a humanitarian question. Most of the articles published in both papers write about problems and conflicts in connection with refugee affairs. The negative media image has different significance for different topics. We argue that the question of refugee affairs is a topic where the image shown by the media is of great relevance: the media can be a more important source of information on this subject than personal contacts.
Female asylum seekers with musculoskeletal pain: the importance of diagnosis and treatment of hypovitaminosis D
G de Torrenté de la Jara, A Pécoud, B Favrat
BMC Family Practice , 2006, DOI: 10.1186/1471-2296-7-4
Abstract: Design: A pre- and post-intervention observational study.Setting: A network comprising an academic primary care centre and nurse practitioners.Participants: Consecutive records of 33 female asylum seekers with complaints compatible with osteomalacia and with hypovitaminosis D (serum 25-(OH) vitamin D <21 nmol/l).Treatment intervention: The patients received either two doses of 300,000 IU intramuscular cholecalciferol as well as 800 IU of cholecalciferol with 1000 mg of calcium orally, or the oral treatment only.Main outcome measures: We recorded the first diagnosis made by the physicians before the correct diagnosis of hypovitaminosis D, the duration of symptoms before diagnosis, the responders and non-responders to treatment, the duration of symptoms after treatment, and the number of medical visits and analgesic drugs prescribed 6 months before and 6 months after diagnosis.Tests: Two-sample t-tests, chi-squared tests, and logistic regression analyses were performed. Analyses were performed using SPSS 10.0.Prior to the discovery of hypovitaminosis D, diagnoses related to somatisation were evoked in 30 patients (90.9%). The mean duration of symptoms before diagnosis was 2.53 years (SD 3.20). Twenty-two patients (66.7%) responded completely to treatment; the remaining patients were considered to be non-responders. After treatment was initiated, the responders' symptoms disappeared completely after 2.84 months. The mean number of emergency medical visits fell from 0.88 (SD 1.08) six months before diagnosis to 0.39 (SD 0.83) after (P = 0.027). The mean number of analgesic drugs that were prescribed also decreased from 1.67 (SD 1.5) to 0.85 (SD 1) (P = 0.001).Hypovitaminosis D in female asylum seekers may remain undiagnosed, with a prolonged duration of chronic symptoms. The potential pitfall is a diagnosis of somatisation. Treatment leads to a rapid resolution of symptoms, a reduction in the use of medical services, and the prescription of analgesic drugs in this vulne
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