Ethical dilemmas of mental healthcare for migrants and refugees

Purpose of review 

This review will discuss the current development of ethical dilemmas in psychiatry in the care of migrants and refugees. The world is in times of increasing conflicts and disasters, which are leading to increased migration and flight. In dealing with patients, psychiatrists have their own codes of ethics. The purpose of developing codes of ethics is to serve educational and regulatory functions and to provide explicit and visible standards for the professional conduct of psychiatrists.

 

Recent findings 

Sexual and nonsexual violence and mental health among male refugees from the Democratic Republic of Congo residing in Kampala, Uganda : a population-based survey

We conducted a population-based survey in 2013 in Kampala, Uganda, to examine violence and mental health outcomes among self-settled male refugees from the Eastern Democratic Republic of Congo (DRC). Male DRC refugees aged 18+ years were sampled through respondent-driven sampling. Key interview domains included demographics, experiences of sexual and nonsexual violence, social support, PTSD, depression and suicide ideation.

 

Why Chaplaincy at Asylum Centers is a Good Idea : A Care Ethics Perspective on Spiritual Care for Refugees

This article argues in favor of introducing chaplaincy care at asylum centers and develops three arguments for doing so. First, chaplaincy is one way to protect the right to health of refugees and to improve their spiritual well-being. The positive contribution of chaplaincy services to mental health care is increasingly recognized, especially in the domain of PTSD. Second, chaplaincy services support asylum seekers in exercising their freedom of religion while entrusted to state care.

Historical Trauma and Cultural Scripts of Trauma among Trauma Survivors in Rwanda and East-Africa

Worldwide many people are exposed to natural disasters and man-made traumas that are known to have different short and long-term post traumatic consequences on their life. So far, Post-Traumatic Stress Disorders (PTSD) is the most well-known disorder shown by many scientists and clinicians as a result of aversive traumatic exposure. To date, its diagnostic criteria are well defined and different interventions have developed in many western countries.

The structure of ICD-11 post traumatic stress disorder in a clinical sample of refugees based on the International Trauma Interview

Background
The ICD-11 proposes fundamental changes to the PTSD diagnostic criteria, prompting thorough validation. While this is ideally carried out based on diagnostic interviews, most—and in the case of transcultural psychiatry all—studies have relied on self-reported measures. In this study, we used the International Trauma Interview (ITI) to assess the factor structure of ICD-11 PTSD symptoms in a sample of trauma-affected refugees.

 

Transdiagnostic psychosocial interventions to promote mental health in forcibly displaced persons : a systematic review and meta-analysis

Background: People forced to leave their homes, such as refugees and internally displaced persons, are exposed to various stressors during their forced displacement, putting them at risk for mental disorders.

 

Objective: To summarize evidence on the efficacy of psychosocial interventions aiming to promote mental health and/or to prevent mental symptoms by fostering transdiagnostic skills in forcibly displaced persons of all ages.

 

Culturally sensitive stepped care for adolescent refugees : efficacy and cost–utility of a multicentric randomized controlled trial

Adolescent refugees and asylum seekers (ARAS) are highly vulnerable to mental health problems. Stepped care models (SCM) and culturally sensitive therapies offer promising treatment approaches to effectively provide necessary medical and psychological support. To our knowledge, we were the first to investigate whether a culturally sensitive SCM will reduce symptoms of depression and PTSD in ARAS more effectively and efficiently than treatment as usual (TAU).

Improving family functioning and reducing violence in the home in North Kivu, Democratic Republic of Congo : a pilot cluster-randomised controlled trial of Safe at Home

Objective To test the effectiveness of the Safe at Home programme which was developed to improve family well-being and prevent multiple forms of violence in the home.

 

Design Waitlisted pilot cluster randomised controlled trial.

 

Setting North Kivu, Democratic Republic of Congo.

 

Participants 202 heterosexual couples.

 

Intervention The Safe at Home programme.

 

Refugee and Migrant Health Toolkit

What is the toolkit?

Refugee and Migrant Health Toolkit (the Toolkit) developed by WHO’s Health and Migration Programme is a comprehensive, operational and user-friendly source of information, guidance and tools supporting implementation of health and migration related activities including the Global action plan: promoting the health of refugees and migrants 2019–23 (GAP), Regional Action Plans and other initiatives having similar goals.

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