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How to Best Help Mental Patients Among Migrants

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Mental Health, Mental Illness and Migration

Part of the book series: Mental Health and Illness Worldwide ((MHIW))

Abstract

According to the latest figures from the UNHCR, we are now witnessing the highest number of displaced people in modern times. These displaced people have not only lost the security of familiar surroundings and kinship networks, but also many are leaving war-torn societies and have witnessed or experienced extremes of violence and abuse. It is not surprising, therefore, that mental illness is frequent in these populations. The first and universal help that can be given is with basic needs for survival and adjustment to the new reality. Only then are more targeted psychological and pharmacological therapies likely to be helpful. The current research evidence for the efficacy of these is reviewed and presented here. By and large, psychological interventions have the best evidence for efficacy in trauma-related conditions but require therapist training and are labor intensive. Also, the evidence for their efficacy comes largely from studies carried out by experts with settled populations accessing western-style service structures. A handful of interesting adaptations of these approaches for countries with less well-developed services are described.

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References

  • Akullu E, Persson I, Bertilsson L, Johansson I, Rodrigues F, Ingelman-Sundberg M (1996) Frequent distribution of ultrarapid metabolizers of debrisoquine in an Ethiopian population carrying duplicated and multiduplicated functional CYP2D6 alleles. J Pharmacol Exp Ther 278:441–446

    Google Scholar 

  • American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders, 5th edn. American Psychiatric Association, Washington, DC

    Google Scholar 

  • Bhugra D, Hilwig M, Hossein B, Marceau H, Neehall J, Leff J et al (1996) First contact incidence rates of schizophrenia in Trinidad and one year follow-up. Br J Psychiatry 169:587–592

    Article  CAS  Google Scholar 

  • Bisson J, Ehlers A, Matthews R, Pilling S, Richards D, Turner S (2007) Psychological treatments for chronic post-traumatic stress disorder. Systematic review and meta-analysis. Br J Psychiatry 190:97–104

    Article  Google Scholar 

  • Blake DD, Weathers FW, Nagy LM, Kaloupek DG, Gusman FD, Charney DS et al (1995) The development of a clinician administered PTSD scale. J Trauma Stress 8:75–90

    Article  CAS  Google Scholar 

  • Bolton P, Bass J, Betancourt T, et al (2007) Interventions for depression symptoms amongst adolescent survivors of war and displacement in Northern Uganda: a randomized controlled trial. JAMA 298:519–527

    Google Scholar 

  • Boydell J, Van Os J, McKenzie K, Allardyce J, Goel R, McCreadie RG et al (2001) Incidence of schizophrenia in ethnic minorities in London: ecological study into interactions with environment. BMJ 323:1–4

    Article  Google Scholar 

  • Branch R, Salih S, Homeida M (1978) Racial differences in drug metabolizing ability: a study with antipyrine in the Sudan. Clin Pharmacol Ther 30:283

    Article  Google Scholar 

  • Cascorbi I (2003) Pharmacogenetics of cytochrome p4502D6: genetic background and clinical implication. Eur J Clin Invest 33(Suppl 2):17–22

    Article  CAS  Google Scholar 

  • Chaudhry IB, Neelam K, Duddu V, Husain N (2008) Ethnicity and psychopharmacology. J Psychopharmacol 22:673–680

    Article  CAS  Google Scholar 

  • Chen L, Zhang G, Hu M, Liang X (2015) Eye movement desensitization and reprocessing versus cognitive-behavioral therapy for adult posttraumatic stress disorder: systematic review and meta-analysis. J Nerv Ment Dis 203:443–451

    Article  Google Scholar 

  • d’Ardenne P, Ruaro L, Cestari L et al (2007) Does interpreter-mediated CBT with traumatized refugee people work? A comparison of patient outcomes in East London. Behav Cogn Psychother 35:293–301

    Article  Google Scholar 

  • Das-Munshi J, Leavey G, Stansfeld SA, Prince MJ (2012) Migration, social mobility and common mental disorders: critical review of the literature and meta-analysis. Ethn Health 17:17–53

    Article  CAS  Google Scholar 

  • Fazel M, Wheeler J, Danesh J (2005) Prevalence of serious mental disorders in 7000 refugees resettled in Western countries: a systematic review. Lancet 365:1309–1314

    Google Scholar 

  • Fearon P, Kirkbride JK, Morgan C et al (2006) Incidence of schizophrenia and other psychoses in ethnic minority groups: results from the MRC AESOP study. Psychol Med 36:1541–1550

    Article  Google Scholar 

  • Foa EB, Yusko DA, McLean CP et al (2013) Concurrent naltrexone and prolonged exposure therapy for patients with comorbid alcohol dependence and PTSD: a randomized clinical trial. JAMA 310:488–495

    Article  CAS  Google Scholar 

  • Forman-Hoffman VL, Zolotor AJ, McKeeman JL et al (2013) Comparative effectiveness of interventions for children exposed to nonrelational traumatic events. Pediatrics 131:526–539

    Article  Google Scholar 

  • Gillies D, Taylor F, Gray C et al (2012) Psychological therapies for the treatment of post-traumatic stress disorder in children and adolescents. Cochrane Database Syst Rev 12:CD006726

    PubMed  Google Scholar 

  • Hetrick S, Purcell R, Garner B, Parslow R (2010) Combined pharmacotherapy and psychological therapies for post traumatic stress disorder (PTSD). Cochrane Database Syst Rev 7:CD007316. https://doi.org/10.1002/14651858.CD007316.pub2

    Article  Google Scholar 

  • Hickling FW, Rodgers-Johnson P (1995) The incidence of first-contact schizophrenia in Jamaica. Br J Psychiatry 167:193–196

    Article  CAS  Google Scholar 

  • Hinton DE, Chhean D, Pich V, Safren SA, Hofmann SG, Pollack MH (2005) A randomized controlled trial of cognitive-behaviour therapy for Cambodian refugees with treatment-resistant PTSD and panic attacks: a cross-over design. J Trauma Stress 18:617–629

    Article  Google Scholar 

  • Hubbard J, Pearson N (2004) Sierra Leonean refugees in Guinea: addressing the mental health effects of massive community violence. In: Miller KE, Rasco LM (eds) The mental health of refugees: ecological approaches to healing and adaptation. Erlbaum, Mahwah, pp 95–132

    Google Scholar 

  • Igreja V, Kleijn WC, Schreuder BJ, Van Dijk JA, Verschuur M (2004) Testimony method to ameliorate post-traumatic stress symptoms. Br J Psychiatry 184:251–257

    Article  Google Scholar 

  • Izzo AA, Ernst E (2001) Interactions between herbal medicines and prescribed drugs: a systematic review. Drugs 61:2163–2175

    Article  CAS  Google Scholar 

  • Jonas DE, Cusack K, Forneris CA, Wilkins TM, Sonis J, Middleton JC et al (2013) Psychological and pharmacological treatments for adults with posttraumatic stress disorder (PTSD). Comparative effectiveness review, vol 92. Agency for Healthcare Research and Quality, Rockville

    Google Scholar 

  • LaFrance WC, Lauterbach EC, Coffey CE, Salloway SP, Kaufer DI, Reeve A, Royall DR, Aylward E, Rummans TA, Lovell MR (2000) The use of herbal alternative medicines in neuropsychiatry. A report of the ANPA Committee on Research. J Neuropsychiatry Clin Neurosci 12:177–192

    Article  CAS  Google Scholar 

  • Lambert JE, Alhassoon OM (2015) Trauma focused therapy for refugees: meta-analytic findings. J Couns Psychol 62:28–37

    Article  Google Scholar 

  • Lesser IM, Zisook S, Gaynes BN, Wisniewski SR, Luther JF, Fava M, Khan A, McGrath P, Warden D, Rush AJ, Trivedi M (2011) Effects of race and ethnicity on depression treatment outcomes: the CO-MED trial. Psychiatr Serv 62:1167–1117

    Article  Google Scholar 

  • Mills KL, Teeson M, Back SE et al (2012) Integrated exposure-based therapy for co-occurring posttraumatic stress disorder and substance dependence: a randomized controlled trial. JAMA 308:690–699

    CAS  PubMed  Google Scholar 

  • Monson CM, Fredman SJ, Macdonald A, Pukay-Martin ND, Resick PA, Schnurr PP (2012) Effects of cognitive-behavioral couple therapy for PTSD. JAMA 308:700–709

    Article  CAS  Google Scholar 

  • National Institute for Clinical Excellence (2005) Clinical guideline 26: post traumatic stress disorder (PTSD): the management of PTD in adults and children in primary and secondary care. www.nice.org.uk/CG026NICEguideline

  • Neuner F, Schauer M, Klaschik C, et al (2004) A comparison of narrative exposure therapy, supportive counselling and psychoeducation for treating posttraumatic stress disorder in an African refugee settlement. J Couns Clin Psychol 72:579–587

    Google Scholar 

  • O’Callaghan P, McMullen J, Shannon C, Rafferty H, Black A (2013) A randomized controlled trial of trauma-focused cognitive behavioral therapy for sexually exploited, war-affected Congolese girls. J Am Acad Child Adolesc Psychiatry 52:359–336

    Article  Google Scholar 

  • Panagioti M, Gooding PA, Tarrier N (2012) A meta-analysis of the association between posttraumatic stress disorder and suicidality: the role of comorbid depression. Compr Psychiatry 53:915–913

    Article  Google Scholar 

  • Porter M, Haslam N (2005) Predisplacement and postdisplacement factors associated with mental health of refugees and internally displaced persons: a meta-analysis. JAMA 294:602–611

    Article  CAS  Google Scholar 

  • Rothbaum BO, Kearns MC, Price M et al (2012) Early intervention may prevent the development of posttraumatic stress disorder: a randomized pilot civilian study with modified prolonged exposure. Biol Psychiatry 72:957–963

    Article  Google Scholar 

  • Schauer M, Neuner F, Elbert T (2011) Narrative exposure therapy: a short term treatment for traumatic stress disorders, 2nd edn. Hogrefe Publishing, Cambridge, MA

    Google Scholar 

  • Schofield P, Ashworth M, Jones P (2011) Ethnic isolation and psychosis: re-examining the ethnic density effect. Psychol Med 41:1263–1269

    Article  CAS  Google Scholar 

  • Steel Z, Chey T, Silove D, Marnane C, Bryant R, van Ommeren M (2009) 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 302:537–549

    Article  CAS  Google Scholar 

  • Stein D, Ipser J, Seedat S (2006) Pharmacotherapy for posttraumatic stress disorder. Cochrane Database Syst Rev. https://doi.org/10.1002/14651858.CD002795

  • Stein DJ, Koenen KC, Friedman MJ, Hil E, McLaughlin KA, Petukhova M et al (2013) Dissociation in posttraumatic stress disorder: evidence from the world mental health surveys. Biol Psychiatry 73:302–312

    Google Scholar 

  • Stenmark H, Catani C, Neuner F, Elbert T, Holen A (2013) Treating PTSD in refugees and asylum seekers within the general health care system. A randomized controlled multi-center study. Behav Res Ther 51:641–647

    Article  Google Scholar 

  • Tribe R, Raval H (2003) Working with interpreters in mental health. Brunner-Routledge, Hove

    Google Scholar 

  • Tuckey MR, Scott JE (2014) Group critical incident stress debriefing with emergency services personnel: a randomized controlled trial. Anxiety Stress Coping 27:38–54. https://doi.org/10.1080/10615806.2013.809421

    Article  PubMed  Google Scholar 

  • United Nations High Commissioner for Refugees (UNHCR) (2015) http://www.unhcr.org/uk/figures-at-a-glance.html. Accessed 22 Aug 2016

  • Watts BV, Schnurr PP, Mayo L et al (2013) Meta-analysis of the efficacy of treatments for posttraumatic stress disorder. J Clin Psychiatry 74:e541–e550

    Article  Google Scholar 

  • Weine S, Kulauzovic Y, Klebic A, Besic S, Mujagic A, Spahovic D et al (2008) Evaluating a multiple-family group access intervention for refugees with PTSD. J Marital Fam Ther 34:149–164

    Article  Google Scholar 

  • Wolf EJ, Miller MW, Reardon AF, Ryabchenko KA, Castillo D, Freund R (2012) A latent class analysis of dissociation and posttraumatic stress disorder: evidence for a dissociative subtype. Arch Gen Psychiatry 69:698–705

    Article  Google Scholar 

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Correspondence to Tom K. J. Craig .

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Craig, T.K.J. (2021). How to Best Help Mental Patients Among Migrants. In: Moussaoui, D., Bhugra, D., Tribe, R., Ventriglio, A. (eds) Mental Health, Mental Illness and Migration. Mental Health and Illness Worldwide. Springer, Singapore. https://doi.org/10.1007/978-981-10-2366-8_13

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