Skip to main content
Top
Published in: International Journal of Mental Health Systems 1/2017

Open Access 01-12-2017 | Research

The mental health and help-seeking behaviour of resettled Afghan refugees in Australia

Authors: Shameran Slewa-Younan, Anisa Yaser, Maria Gabriela Uribe Guajardo, Haider Mannan, Caroline A. Smith, Jonathan M. Mond

Published in: International Journal of Mental Health Systems | Issue 1/2017

Login to get access

Abstract

Background

Psychological trauma, in particular, posttraumatic stress disorder (PTSD) and depression, are highly prevalent among resettled refugees. However, little is known regarding the mental health status and associated help-seeking behaviour of resettled Afghan refugees in Australia.

Methods

A sample of 150 resettled Afghan refugees (74 males; mean age 32.8 years, SD = 12.2) living in Adelaide, South Australia were recruited. Self-reported measures of PTSD, depression, exposure to traumatic events, functional impairment, self-recognition of PTSD symptomatology and help-seeking behaviours were completed. Multivariate analysis of variables associated with help-seeking was conducted.

Results

Forty-four percent of participants met criteria for clinically significant PTSD symptoms and all but one participant reported being exposed to 1 or more traumatic and/or conflict related events, such as ‘losing your property and wealth’. Moreover, 14.7% of participants had symptoms suggestive of clinically significant depression. General practitioners were the most common source of help in relation to mental health problems, with very few participants (4.6%) seeking help from specialist trauma and torture mental health services. Self-recognition of having a PTSD related mental health problem and functional impairment levels were both found to be independent predictors of help-seeking (p ≤ .05).

Conclusions

The findings provide further evidence for high rates of PTSD symptomatology and low uptake of mental care among resettled refugees. Poor self-recognition of the presence and/or adverse impact of PTSD symptoms may need to be targeted in mental health promotion programs designed to improve “mental health literacy” and thereby promote early and appropriate help-seeking where this is needed.
Literature
7.
go back to reference Steel Z, Chey T, Silove D, Marnane C, Bryant R, Ommeren M. Association of torture and other potentially traumatic events with mental health outcomes among populations exposed to mass conflict and displacement: a systematic review and meta-analysis. JAMA. 2009. doi:10.1001/jama.1132.PubMed Steel Z, Chey T, Silove D, Marnane C, Bryant R, Ommeren M. Association of torture and other potentially traumatic events with mental health outcomes among populations exposed to mass conflict and displacement: a systematic review and meta-analysis. JAMA. 2009. doi:10.​1001/​jama.​1132.PubMed
8.
go back to reference Mollica R, Wyshak G, Lavelle J. The psychosocial impact of war trauma and torture on Southeast Asian refugees. Am J Psychiatry. 1987;144:1567–72.CrossRefPubMed Mollica R, Wyshak G, Lavelle J. The psychosocial impact of war trauma and torture on Southeast Asian refugees. Am J Psychiatry. 1987;144:1567–72.CrossRefPubMed
9.
11.
go back to reference Gernaat B, Malwand D, Laban CJ, Komproe I, de Jong JT. Many psychiatric disorders in Afghan refugees with residential status in Drenthe, especially depressive disorder and post-traumatic stress disorder. Ned Tijdschr Geneeskd. 2002;146(Suppl 24):1127–31.PubMed Gernaat B, Malwand D, Laban CJ, Komproe I, de Jong JT. Many psychiatric disorders in Afghan refugees with residential status in Drenthe, especially depressive disorder and post-traumatic stress disorder. Ned Tijdschr Geneeskd. 2002;146(Suppl 24):1127–31.PubMed
12.
go back to reference Gerritsen A, Bramsen I, Deville W, Willigen L, Hovens J, Ploeg H. Physical and mental health of Afghan, Iranian and Somali asylum seekers and refugees living in the Netherlands. Soc Psychiatry Psychiatr Epidemiol. 2006. doi:10.1007/s00127-005-0003-5.PubMed Gerritsen A, Bramsen I, Deville W, Willigen L, Hovens J, Ploeg H. Physical and mental health of Afghan, Iranian and Somali asylum seekers and refugees living in the Netherlands. Soc Psychiatry Psychiatr Epidemiol. 2006. doi:10.​1007/​s00127-005-0003-5.PubMed
17.
go back to reference Correa-Velez I, Vijaya S, Brown K, et al. Hospital utilisation among people born in refugee-source countries: an analysis of hospital admissions, Victoria, 1998–2004. Med J Aust. 2007;186(Suppl 11):577–80.PubMed Correa-Velez I, Vijaya S, Brown K, et al. Hospital utilisation among people born in refugee-source countries: an analysis of hospital admissions, Victoria, 1998–2004. Med J Aust. 2007;186(Suppl 11):577–80.PubMed
18.
go back to reference Kayrouz R, Dear BF, Johnston L, Keyrouz L, Nehme E, Laube R, Titov N. Intergenerational and cross-cultural differences in emotional wellbeing, mental health service utilisation, treatment-seeking preferences and acceptability of psychological treatments for Arab Australians. Int J Soc Psychiatry. 2015. doi:10.1177/0020764014553004.PubMed Kayrouz R, Dear BF, Johnston L, Keyrouz L, Nehme E, Laube R, Titov N. Intergenerational and cross-cultural differences in emotional wellbeing, mental health service utilisation, treatment-seeking preferences and acceptability of psychological treatments for Arab Australians. Int J Soc Psychiatry. 2015. doi:10.​1177/​0020764014553004​.PubMed
19.
go back to reference Slewa-Younan S, Mond J, Bussion E, Melkonian M, Mohammad Y, Dover H, Smith M, Milosevic D, Jorm AF. Psychological trauma and help-seeking behaviour amongst resettled Iraqi refugees in attending english tuition classes in Australia. Int J Ment Health Syst. 2015. doi:10.1007/s12134-015-0441-1.PubMedPubMedCentral Slewa-Younan S, Mond J, Bussion E, Melkonian M, Mohammad Y, Dover H, Smith M, Milosevic D, Jorm AF. Psychological trauma and help-seeking behaviour amongst resettled Iraqi refugees in attending english tuition classes in Australia. Int J Ment Health Syst. 2015. doi:10.​1007/​s12134-015-0441-1.PubMedPubMedCentral
20.
go back to reference Jorm AF, Korten A, Jacomb P, Christensen H, Rodgers B, Pollitt P. “Mental health literacy”: a survey of the public’s ability to recognise mental disorders and their beliefs about the effectiveness of treatment. Med J Aust. 1997;166:182–6.PubMed Jorm AF, Korten A, Jacomb P, Christensen H, Rodgers B, Pollitt P. “Mental health literacy”: a survey of the public’s ability to recognise mental disorders and their beliefs about the effectiveness of treatment. Med J Aust. 1997;166:182–6.PubMed
21.
go back to reference Jorm AF. Mental health literacy: empowering the community to take action for better mental health. Am Psychol. 2012;67(Suppl 3):231–43.CrossRefPubMed Jorm AF. Mental health literacy: empowering the community to take action for better mental health. Am Psychol. 2012;67(Suppl 3):231–43.CrossRefPubMed
22.
go back to reference Slewa-Younan S, Mond J, Bussion E, Mohammad Y, Uribe Guajardo MG, Smith M, et al. Mental health literacy of resettled Iraqi refugees in Australia: knowledge about posttraumatic stress disorder and beliefs about helpfulness of interventions. BMC Psychiatry. 2014. doi:10.1186/s12888-014-0320-x.PubMedPubMedCentral Slewa-Younan S, Mond J, Bussion E, Mohammad Y, Uribe Guajardo MG, Smith M, et al. Mental health literacy of resettled Iraqi refugees in Australia: knowledge about posttraumatic stress disorder and beliefs about helpfulness of interventions. BMC Psychiatry. 2014. doi:10.​1186/​s12888-014-0320-x.PubMedPubMedCentral
24.
go back to reference Slewa-Younan S, Uribe Guajardo G, Yaser A, Mond J, Smith M, Milosevic D, et al. Causes of and risk factors for posttraumatic stress disorder: the beliefs of Iraqi and Afghan refugees resettled in Australia. Int J Ment Health Syst. 2017. doi:10.1186/s13033-016-0109-z. Slewa-Younan S, Uribe Guajardo G, Yaser A, Mond J, Smith M, Milosevic D, et al. Causes of and risk factors for posttraumatic stress disorder: the beliefs of Iraqi and Afghan refugees resettled in Australia. Int J Ment Health Syst. 2017. doi:10.​1186/​s13033-016-0109-z.
25.
go back to reference Gratwick-Sarll K, Bentley C, Harrison C, Mond J. Poor self-recognition of disordered eating among girls with bulimic-type eating disorders: cause for concern? Early Interv Psychiatry. 2016. doi:10.1111/eip.12168.PubMed Gratwick-Sarll K, Bentley C, Harrison C, Mond J. Poor self-recognition of disordered eating among girls with bulimic-type eating disorders: cause for concern? Early Interv Psychiatry. 2016. doi:10.​1111/​eip.​12168.PubMed
27.
go back to reference Mond J, Hay P, Rodgers B, Owen C. Self-recognition of disordered eating among women with bulimic-type eating disorders: a community-based study. Int J Eat Disord. 2006;39(Suppl 8):747–53.CrossRefPubMed Mond J, Hay P, Rodgers B, Owen C. Self-recognition of disordered eating among women with bulimic-type eating disorders: a community-based study. Int J Eat Disord. 2006;39(Suppl 8):747–53.CrossRefPubMed
28.
go back to reference Mond JM, Hay PJ, Darby A, et al. Women with bulimic eating disorders: when do they receive treatment for an eating problem? J Consult Clin Psychol. 2009. doi:10.1037/a0015336.PubMed Mond JM, Hay PJ, Darby A, et al. Women with bulimic eating disorders: when do they receive treatment for an eating problem? J Consult Clin Psychol. 2009. doi:10.​1037/​a0015336.PubMed
29.
go back to reference Mollica R. Wyshak G, de-Marneffe D, Khuon F, Lavelle J. Indochinese version of the Hopkins Symptoms Checklist-25: a screening instrument for the psychiatric care of refugees. Am J Psychiatry. 1987;144:497–500.CrossRefPubMed Mollica R. Wyshak G, de-Marneffe D, Khuon F, Lavelle J. Indochinese version of the Hopkins Symptoms Checklist-25: a screening instrument for the psychiatric care of refugees. Am J Psychiatry. 1987;144:497–500.CrossRefPubMed
30.
go back to reference Thapa SB, Van Ommeren M, Sharma B, de Jong JT, Hauff E. Psychiatric disability among tortured Bhutanese refugees in Nepal. Am J Psychiatry. 2003;160(Suppl 11):2032–7.CrossRefPubMed Thapa SB, Van Ommeren M, Sharma B, de Jong JT, Hauff E. Psychiatric disability among tortured Bhutanese refugees in Nepal. Am J Psychiatry. 2003;160(Suppl 11):2032–7.CrossRefPubMed
31.
go back to reference Cardozo BL, Bilukha O, Crawford G, Shaikh I, Wolfe MI, Gerber ML, et al. Mental health, social functioning, and disability in post-war Afghanistan. JAMA. 2004;292(Suppl 5):575–84.CrossRefPubMed Cardozo BL, Bilukha O, Crawford G, Shaikh I, Wolfe MI, Gerber ML, et al. Mental health, social functioning, and disability in post-war Afghanistan. JAMA. 2004;292(Suppl 5):575–84.CrossRefPubMed
32.
go back to reference Scholte WF, Olff M, Ventevogel P, de Vries G, Jansveld E, Cardozo BL, et al. Mental health symptoms following war and repression in eastern Afghanistan. JAMA. 2004;292(Suppl 5):585–93.CrossRefPubMed Scholte WF, Olff M, Ventevogel P, de Vries G, Jansveld E, Cardozo BL, et al. Mental health symptoms following war and repression in eastern Afghanistan. JAMA. 2004;292(Suppl 5):585–93.CrossRefPubMed
33.
go back to reference Miller K, Omidian P, Samad A, Quraishy N, Nader M, Nasiry S, et al. The Afghan symptom checklist: a culturally grounded approach to mental health assessment in a conflict zone. Am J Orthopsychiatr. 2006. doi:10.1037/0002-9432.76.4.423. Miller K, Omidian P, Samad A, Quraishy N, Nader M, Nasiry S, et al. The Afghan symptom checklist: a culturally grounded approach to mental health assessment in a conflict zone. Am J Orthopsychiatr. 2006. doi:10.​1037/​0002-9432.​76.​4.​423.
34.
go back to reference Weiss D, Marmar C. The impact of event scale—revised. In: Wilson JP, Keane TM, editors. Assessing psychological trauma and PTSD: a handbook for Practitioners. New York: Guilford Press; 1997. p. 399–411. Weiss D, Marmar C. The impact of event scale—revised. In: Wilson JP, Keane TM, editors. Assessing psychological trauma and PTSD: a handbook for Practitioners. New York: Guilford Press; 1997. p. 399–411.
35.
go back to reference Creamer M, Bell R, Failla S. Psychometric properties of the impact of event scale—revised. Behav Res Ther. 2003;41(Suppl 12):1489–96.CrossRefPubMed Creamer M, Bell R, Failla S. Psychometric properties of the impact of event scale—revised. Behav Res Ther. 2003;41(Suppl 12):1489–96.CrossRefPubMed
38.
go back to reference SAS Institute Inc. Language reference concepts. 6th ed. Cary: SAS Institute Inc.; 2016. SAS Institute Inc. Language reference concepts. 6th ed. Cary: SAS Institute Inc.; 2016.
39.
go back to reference Firth D. Bias reduction of maximum likelihood estimates. Biometrika. 1993;80(Suppl 1):27–38.CrossRef Firth D. Bias reduction of maximum likelihood estimates. Biometrika. 1993;80(Suppl 1):27–38.CrossRef
40.
go back to reference Allison P. Logistic Regression Using SAS: Theory and Application. 2nd ed. North Carolina: SAS Institute Inc; 2012. Allison P. Logistic Regression Using SAS: Theory and Application. 2nd ed. North Carolina: SAS Institute Inc; 2012.
41.
go back to reference McFadden D. Conditional logit analysis of qualitative choice behavior. Front Econom. 1974:105–42. McFadden D. Conditional logit analysis of qualitative choice behavior. Front Econom. 1974:105–42.
42.
go back to reference Kvalseth T. Cautionary note about R2. Am Stat. 1985;39:279–85. Kvalseth T. Cautionary note about R2. Am Stat. 1985;39:279–85.
45.
go back to reference Kirmayer L, Narasiah L, Munoz M, Rashid M, Ryder R, Guzder J, et al. Common mental health problems in immigrants and refugees: general approach in primary care. CMAJ. 2011. doi:10.1503/cmaj.090292. Kirmayer L, Narasiah L, Munoz M, Rashid M, Ryder R, Guzder J, et al. Common mental health problems in immigrants and refugees: general approach in primary care. CMAJ. 2011. doi:10.​1503/​cmaj.​090292.
46.
go back to reference Andrews G. Meeting the unmet need with disease management. In: Andrews G, Henderson S, editors. Unmet need in psychiatry. Cambridge: Cambridge University Press; 2000. p. 11–36.CrossRef Andrews G. Meeting the unmet need with disease management. In: Andrews G, Henderson S, editors. Unmet need in psychiatry. Cambridge: Cambridge University Press; 2000. p. 11–36.CrossRef
47.
go back to reference Uribe Guajardo MG, Slewa-Younan S, Santalucia Y, Jorm AF. Important considerations when providing mental health first aid to Iraqi refugees in Australia: a Delphi study. Int J Ment Health Syst. 2016. doi:10.1186/s13033-016-0087-1. Uribe Guajardo MG, Slewa-Younan S, Santalucia Y, Jorm AF. Important considerations when providing mental health first aid to Iraqi refugees in Australia: a Delphi study. Int J Ment Health Syst. 2016. doi:10.​1186/​s13033-016-0087-1.
Metadata
Title
The mental health and help-seeking behaviour of resettled Afghan refugees in Australia
Authors
Shameran Slewa-Younan
Anisa Yaser
Maria Gabriela Uribe Guajardo
Haider Mannan
Caroline A. Smith
Jonathan M. Mond
Publication date
01-12-2017
Publisher
BioMed Central
Published in
International Journal of Mental Health Systems / Issue 1/2017
Electronic ISSN: 1752-4458
DOI
https://doi.org/10.1186/s13033-017-0157-z

Other articles of this Issue 1/2017

International Journal of Mental Health Systems 1/2017 Go to the issue