Mental disorders, disability and health service use amongst Vietnamese refugees and the host Australian population (original) (raw)
Related papers
Mental Health and the Refugee Experience
Southeast Asian Mental Health: Treatment, Prevention, Services, Training, and Research, 1985
Rumbaut's chapter provides a pioneering example of the fruits that can be harvested through a well-designed and adequately funded research project. He describes a large project that is comprehensively examining the adaptive experiences of a random sample of families from each of the four major Southeast Asian ethnic groups--Hmong, Khmer, ethnic Chinese, and Vietnamese--residing in San Diego. Rumbaut's findings are manifold, but three conclusions stand out: (1) Southeast Asians are a highly heterogeneous population,and among them the Hmong and Khmer groups appear to be at significantly greater risk on their affective measures of happiness and depression; (2) the second year of residence in the United States appears to be a period of significantly heightened demoralization and psychological stress for refugees--a finding with import-ant implications for preventive intervention program activities; and (3) while the psychological experiences of exiles are complex and multidimensional, they are also patterned and, to a degree, predictable.
Long-term mental health of Vietnamese refugees in the aftermath of trauma
The British Journal of Psychiatry, 2010
To our knowledge no prospective longitudinal study has followed an adult refugee cohort for more than 10 years. We report findings from the third interview phase of a longitudinal prospective community cohort study of Vietnamese refugees settled in Norway. They were included in the study upon their arrival in Norway in 1982 (T 1 ) and followed up in 1985 (T 2 ). 1 The earlier findings, of stable and high levels of mental health problems after 3 years in exile, 2 are consistent with other subsequent short-term follow-up studies among refugees. [3][4][5] The aims of the study reported here were to investigate the long-term course and outcome of these individuals' mental status, and to identify which early resettlement factors were relevant to predicting levels of psychological distress over 20 years later.
Measuring psychiatric disorder among Southeast Asian refugees
Psychological Medicine, 1986
SYNOPSIS Four measures of mental health-Panic, Depression, Somatization and Well-Beinghave been developed for use in a population of Southeast Asian refugees. The scales, a product of work with 1348 refugees, demonstrate conceptual significance, good reliability, concurrent validity and stability of structure across samples. They are culturally sensitive, enabling intra-cultural study as well as screening for clinical purposes. The measures also permit comparisons, for research purposes, with non-Asians.
Appendix 10: Depression: evidence review for newly arriving i mmigrants and refugees
2011
Division of Social and Transcultural Psychiatry (Kirmayer), McGill University, and the Culture & Mental Health Research Unit, Sir Mortimer B. Davis-Jewish General Hospital, Montreal; PRAIDA Clinic, CSSS de la Montagne site Cotes-des-Neiges (Narasiah), Montreal; Department of Psychology (Ryder), Concordia University, Culture & Mental Health Research Unit, Jewish General Hospital, Montreal; Department of Sociology (Burgos), McGill University; Department of Psychiatry (Zelkowitz), McGill University, and Department of Psychiatry, Jewish General Hospital, Montreal; Departments of Family Medicine and Epidemiology and Community Medicine, Centre for Global Health, Institute of Population Health and C.T. Lamont Primary Health Care Research Centre, Elisabeth Bruyere Research Institute (Pottie), University of Ottawa; Department of Psychiatry (Kutcher), Dalhousie University. Canadian Collaboration for Immigrant and Refugee Health (CCIRH) Full Text
Policy-oriented research has tended to focus on objective dimensions of the refugee adaptation process (such as economic “self-sufficiency”, employment, and welfare dependency rates) than on subjective factors that are not only more difficult to measure but more often than not are seen as epiphenomenal (such as migration motives, acculturative attitudes, and mental health). Yet refugee “mental health” is no mere epiphenomenon: it both shapes and is shaped by those objective realities and as such, needs to be taken seriously into account by refugee policy. This paper seeks to contribute to our understanding of subjective aspects of the Southeast Asian refugee experience and of their import for refugee policy. Specifically, the paper reports on findings from a longitudinal survey (IHARP) of a representative sample of Vietnamese, Cambodian, and Laotian men and women in the San Diego metropolitan area, site of one of the largest Indochinese refugee concentrations in the United States. A general model of migration, adaptation, and mental health is proposed and tested with the survey data. A typology of motives is developed empirically from a diverse set of open-ended responses, distinguishing between “targets,” “rebels,” “victims,” and seekers.” Rates of psychological well-being and distress were measured at two points in time. The paper examines the varying effects of a wide range of pre-arrival and post-arrival factors on their adaptive responses over time. The refugees’ changing levels of psychological distress and of satisfaction with various areas of their lives in the United States – which serve, respectively, as affective and cognitive indicators of their “mental health” – are analyzed as principal outcome variables in this study. Adult mental health outcomes, in turn, are shown to be independent variables in their own right, affecting other aspects of the refugee adaptation process – from their economic self-sufficiency, to pregnancy outcomes of refugee mothers, and even the educational attainment of their children several years later – and thus medical, educational and economic policy goals.
Predictors of psychological distress among southeast Asian refugees
Social Science & Medicine, 1993
This paper analyzed data from one of the first needs assessment projects on a representative non-clinical population of Southeast Asian refugees in the United States in order to test two hypotheses: (1) whether or not premigration experiences still have an effect on psychological distress beyond the initial resettlement period and (2) whether or not interethnic group differences existed in the predictors of psychological distress between three Southeast Asian refugee groups, the Vietnamese, Cambodians and Lao. The results of the analysis of 2180 subjects supported both hypotheses. Regardless of ethnicity and the number of years in the U.S., premigration trauma events and refugee camp experiences were significant predictors of psychological distress even 5 years or more after migration and significant group differences in the types of postmigration distress predictors were also found. Acculturation concerns for the Vietnamese and Lao were influenced by both premigration and postmigration variables. In contrast, the primary concerns of the Cambodians were still related to premigration issues. The results also indicated that Vietnamese and Lao women were more likely to experience distress than their male counterparts, but no gender differences emerged for the Cambodians. Age predicted distress for Vietnamese and Cambodians, but not Lao. Similar to previous findings in the literature, Cambodians reported the highest levels of distress, followed by Lao and then Vietnamese. Interpretations of these results for this community sample are proposed.
Frontiers in Psychiatry, 2019
Background: As refugee numbers grow worldwide, understanding prevalence and determinants of mental illness in this population becomes increasingly important. Methods: We used longitudinal data to examine the initial years of resettlement in Australian refugees with a focus on ethnic-like social support. Three annual waves from a longitudinal, nationally representative cohort of 2,399 humanitarian migrants recently resettled in Australia were examined for two mental illness outcomes: post-traumatic stress disorder indicated by positive PTSD-8 screen and "high risk of severe mental illness" (HR-SMI) by Kessler Psychological Distress Scale (K6) ≥19. Generalized linear mixed models examined demographic and resettlement factors. Findings: Contrary to predictions, high prevalence of positive screens for mental illness persisted over 3 years. At baseline, 30.3% (95% CI, 28.5-32.2) screened positive for post-traumatic stress disorder (PTSD), and 15.4% (95% CI, 14.0-16.9) had HR-SMI. Over the 3 years, 52.2% met screening criteria for mental illness. PTSD was associated with older age, females, Middle Eastern birthplace, increasing traumatic events, more financial hardships, having a chronic health condition, and poor self-rated health. HR-SMI was associated with females, Middle Eastern birthplace, unstable housing, more financial hardships, having a chronic health condition, poor self-rated health, and discrimination. Also contrary to predictions, like-ethnic social support was positively associated with PTSD (OR, 1.51; 95% CI, 1.10-2.09). Interpretation: There is high prevalence of positive screens for mental illness throughout initial years of resettlement for refugees migrating to Australia. Our unexpected finding regarding like-ethnic social support raises future avenues for research. Predictors of mental illness in the post-migration context represent tangible opportunities for intervention and are likely relevant to similar resettlement settings globally.