Source
Early Intervention in Psychosis Team, Paterson Centre, 20 South Wharf Road, London W2 1PD, UK. helenmccoll@nhs.net
Abstract
BACKGROUND:
Asylum seekers and refugees may have substantial needs for mental health care, to which both pre-migration and post-migration traumas are likely to contribute. However, there is a paucity of data available to guide appropriate service development.
AIMS:
To ascertain numbers and describe the characteristics and needs of asylum seekers and refugees in contact with London Community Mental Health Teams (CMHTs).
METHOD:
Data were obtained from staff and clinical records regarding socio-demographic and clinical characteristics and service use. Camberwell Assessment of Need Short Appraisal Schedule (CANSAS) and Health of the Nation Outcome Scales (HoNOS) were completed.
RESULTS:
A total of 104 (11%) of the CMHT population were asylum seekers or refugees. Co-morbidity was frequent, and psychiatrists reported significant diagnostic uncertainty for 30%. The most common diagnoses were depression (50%) and post-traumatic stress disorder (PTSD) (41%), and just over half had a psychotic diagnosis (53%). Social isolation was common, levels of unmet need were high (mean of 6.8 unmet needs each using CANSAS) and the group used few services other than CMHTs.
CONCLUSIONS:
The combination of high levels of need and limited service use suggests a need to develop more effective services. High rates of diagnostic uncertainty suggest a need for a clearer understanding of the complex clinical syndromes afflicting this group.