Mental Health and Forced Displacement: Difference between revisions

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* Changes in brain and pre-existing vulnerability and neurotoxicity as origins of brain volume reductions in PTSD.  
* Changes in brain and pre-existing vulnerability and neurotoxicity as origins of brain volume reductions in PTSD.  
* Amygdala and dorsal anterior cingulate cortex are hyper(re)active, whereas the ventral medial prefrontal cortex is hypo(re)active in PTSD and this may explain attentional bias towards the threat, impaired emotional regulation.<ref name=":6" />
* Amygdala and dorsal anterior cingulate cortex are hyper(re)active, whereas the ventral medial prefrontal cortex is hypo(re)active in PTSD and this may explain attentional bias towards the threat, impaired emotional regulation.<ref name=":6" />
The evidence showed that trauma-focused cognitive behavioural therapy or eye movement desensitisation and reprocessing should be considered in individuals with PTSD. Psychological treatments can reduce symptoms of post-traumatic stress disorder (PTSD)<ref>Bisson J, Andrew M. Psychological treatment of post‐traumatic stress disorder (PTSD). Cochrane database of systematic reviews. 2007(3).</ref>  
The evidence showed that trauma-focused cognitive behavioural therapy or eye movement desensitisation and reprocessing should be considered in individuals with PTSD. Psychological treatments can reduce symptoms of post-traumatic stress disorder (PTSD)<ref>Bisson J, Andrew M. Psychological treatment of post‐traumatic stress disorder (PTSD). Cochrane database of systematic reviews. 2007(3).</ref>


==== '''Gaps in Refugee health''' ====
This video describes the gaps in refugee health and how to bridge it.
This video describes the gaps in refugee health and how to bridge it.
{{#ev:youtube|3iogISgezbQ}}
 
=== The Refugees Mental Health ===   
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{{#ev:youtube|eRfyQl_mSGs}}                                                                                                                                                                               {{#ev:youtube|0g0S34XE2b8}}
{{#ev:youtube|3iogISgezbQ}}2-{{#ev:youtube|eRfyQl_mSGs}}3-{{#ev:youtube|0g0S34XE2b8}}


== References ==
== References ==
<references />
<references />

Revision as of 14:20, 15 April 2020

This page is currently under construction. Sorry for any inconvenience.

Original Editor - Shaimaa Eldib Top Contributors - Shaimaa Eldib, Naomi O'Reilly, Kim Jackson, Candace Goh, Jess Bell, Vidya Acharya and Carin Hunter

Introduction[edit | edit source]

Mental health illness is considered as a leading cause for disability all over the world. It accounts for around 13 %of the global burden of disease and responsible for 33% of total years lived with disability[1][2]. It is estimated that people who suffer from severe mental illness, for example, severe depression, bipolar disorder and schizophrenia[3] are more likely to die prematurely than those who have not been affected. The problems of mental health are highly prevalent globally, affecting people across all regions of the world as it is expected to affect at least 1 of 3 people all over their life time[4][5]. Also, there are major economic consequences of this high prevalence. Around $16.3 trillion was estimated to be the cost of mental ill-health globally between 2011 and 2030 [6] and this has serious implications on standers of livings and socioeconomic development[7]. There are many barriers in treating mental illness, for example, stigma, discrimination [8][3] and governmental apathy[7] which exacerbating the current state of mental healthcare all over the world.

Refugees Crisis[edit | edit source]

The UN Refugee Agency (UNHCR)[9] defines a refugee as set out in the 1951 Convention[10][11]

Refugees.jpg

The 1951 Convention and its 1967 Protocol :

The primary and universal definition of a refugee that applies to States is contained in Article 1(A)(2) of the 1951 Convention, as amended by its 1967 Protocol, defines a refugee as someone who:

"owing to a well-founded fear of being persecuted for reasons of race, religion, nationality, membership of a particular social group or political opinion, is outside the country of his nationality and is unable or, owing to such fear, is unwilling to avail himself of the protection of that country; or who, not having a nationality and being outside the country of his former habitual residence, is unable or, owing to such fear, is unwilling to return to it[10].

According to the United Nations Refugee Agency (UNHCR), 65.6 million people have been forcibly displaced worldwide[12]. There were 20 people newly displaced every minute of 2016[13]. Europe Initially welcomed more than a million refugees and forced migrants between 2015 and 2016 [14]. Those who forced to leave their home countries lived in overcrowded reception facilities that have an effect, turned into long term detention centres with poor health and safety conditions[15] while waiting for resettlement or asylum decisions[14]. All these conditions created medical challenges and excessive need for the usage of health systems[16].

Refugees Mental Health[edit | edit source]

Most of the refugees suffer from post-traumatic stress disorder( PSTD) due to the circumstances that they faced which might affect the quality of life.[17]

Healthcare professionals should be aware that there are several factors that have a major influence on asylum seekers health:

Post-traumatic stress disorder[edit | edit source]

This disorder is considered the only major mental disorder that may have a known cause, as the person physical integrity is threatened as a result there are reactions like fear, horror, and helplessness.[21] The prevalence of traumatic experiences is common, as more than two-thirds of persons in the general population may experience a significant traumatic event at some point in their lives.[22]

Some studies explored the biological effect of this disorder, the findings showed :

  • Higher heart rate to sudden loud tones which suggests central sensitization.
  • Diminished the volumes of the hippocampus and anterior cingulate cortex which may explain conditions like: depression and substance abuse.[21]
  • Changes in brain and pre-existing vulnerability and neurotoxicity as origins of brain volume reductions in PTSD.
  • Amygdala and dorsal anterior cingulate cortex are hyper(re)active, whereas the ventral medial prefrontal cortex is hypo(re)active in PTSD and this may explain attentional bias towards the threat, impaired emotional regulation.[21]

The evidence showed that trauma-focused cognitive behavioural therapy or eye movement desensitisation and reprocessing should be considered in individuals with PTSD. Psychological treatments can reduce symptoms of post-traumatic stress disorder (PTSD)[23]

Gaps in Refugee health[edit | edit source]

This video describes the gaps in refugee health and how to bridge it.

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References[edit | edit source]

  1. ↑ Murray CJ, Vos T, Lozano R, Naghavi M, Flaxman AD, Michaud C, Ezzati M, Shibuya K, Salomon JA, Abdalla S, Aboyans V. Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. The lancet. 2012 Dec 15;380(9859):2197-223
  2. ↑ Funk M. Global burden of mental disorders and the need for a comprehensive, coordinated response from health and social sectors at the country level. Retrieved on. 2016 Oct;30.
  3. ↑ 3.0 3.1 Thornicroft G, Brohan E, Rose D, Sartorius N, Leese M, INDIGO Study Group. Global pattern of experienced and anticipated discrimination against people with schizophrenia: a cross-sectional survey. The Lancet. 2009 Jan 31;373(9661):408-15.
  4. ↑ Steel Z, Marnane C, Iranpour C, Chey T, Jackson JW, Patel V, Silove D. The global prevalence of common mental disorders: a systematic review and meta-analysis 1980–2013. International journal of epidemiology. 2014 Apr 1;43(2):476-93.
  5. ↑ Vigo D, Thornicroft G, Atun R. Estimating the true global burden of mental illness. The Lancet Psychiatry. 2016 Feb 1;3(2):171-8.
  6. ↑ Bloom DE, Cafiero E, Jané-Llopis E, Abrahams-Gessel S, Bloom LR, Fathima S, Feigl AB, Gaziano T, Hamandi A, Mowafi M, O’Farrell D. The global economic burden of noncommunicable diseases. Program on the Global Demography of Aging; 2012 Jan.
  7. ↑ 7.0 7.1 Caulfield A, Vatansever D, Lambert G, Van Bortel T. WHO guidance on mental health training: a systematic review of the progress for non-specialist health workers. BMJ open. 2019 Jan 1;9(1):bmjopen-2018.
  8. ↑ Lasalvia A, Zoppei S, Van Bortel T, Bonetto C, Cristofalo D, Wahlbeck K, Bacle SV, Van Audenhove C, Van Weeghel J, Reneses B, Germanavicius A. Global pattern of experienced and anticipated discrimination reported by people with major depressive disorder: a cross-sectional survey. The Lancet. 2013 Jan 5;381(9860):55-62.
  9. ↑ https://emergency.unhcr.org/entry/55772/refugee-definition
  10. ↑ 10.0 10.1 Fitzpatrick J. Revitalizing the 1951 refugee convention. Harv. Hum. Rts. J.. 1996;9:229.
  11. ↑ Zimmermann A, Dörschner J, Machts F, editors. The 1951 Convention relating to the status of refugees and its 1967 protocol: A commentary. Oxford University Press; 2011 Jan 27.
  12. ↑ 12.0 12.1 Müller M, Khamis D, Srivastava D, Exadaktylos AK, Pfortmueller CA. Understanding refugees' health. InSeminars in neurology 2018 Apr (Vol. 38, No. 02, pp. 152-162). Thieme Medical Publishers.
  13. ↑ 13.0 13.1 Ellis BH, Winer JP, Murray K, Barrett C. Understanding the mental health of refugees: Trauma, stress, and the cultural context. InThe Massachusetts General Hospital textbook on diversity and cultural sensitivity in mental health 2019 (pp. 253-273). Humana, Cham.
  14. ↑ 14.0 14.1 Fotaki M. A crisis of humanitarianism: refugees at the gates of Europe. International journal of health policy and management. 2019 Jun;8(6):321.
  15. ↑ Blitz BK, d’Angelo A, Kofman E, Montagna N. Health challenges in refugee reception: dateline Europe 2016. International journal of environmental research and public health. 2017 Dec;14(12):1484.
  16. ↑ Kotsiou OS, Kotsios P, Srivastava DS, Kotsios V, Gourgoulianis KI, Exadaktylos AK. Impact of the refugee crisis on the Greek healthcare system: A long road to Ithaca. International journal of environmental research and public health. 2018 Aug;15(8):1790.
  17. ↑ Wilker S, Catani C, Wittmann J, Preusse M, Schmidt T, May T, Ertl V, Doering B, Rosner R, Zindler A, Neuner F. The efficacy of Narrative Exposure Therapy for Children (KIDNET) as a treatment for traumatized young refugees versus treatment as usual: study protocol for a multi-center randomized controlled trial (YOURTREAT). Trials. 2020 Dec;21(1):1-6.
  18. ↑ Wångdahl J, Lytsy P, Mårtensson L, Westerling R. Health literacy among refugees in Sweden–a cross-sectional study. BMC public health. 2014 Dec 1;14(1):1030.
  19. ↑ Uba L. Cultural barriers to health care for southeast Asian refugees. Public health reports. 1992 Sep;107(5):544.
  20. ↑ Dadzie GM. Healthcare Accessibility for Syrian Refugees: Understanding Trends, Host Countries’ Responses and Impacts on Refugees’ Health.
  21. ↑ 21.0 21.1 21.2 Pitman RK, Rasmusson AM, Koenen KC, Shin LM, Orr SP, Gilbertson MW, Milad MR, Liberzon I. Biological studies of post-traumatic stress disorder. nature Reviews neuroscience. 2012 Nov;13(11):769-87.
  22. ↑ Davidson JR, Hughes D, Blazer DG, George LK. Post-traumatic stress disorder in the community: an epidemiological study. Psychological medicine. 1991 Aug;21(3):713-21.
  23. ↑ Bisson J, Andrew M. Psychological treatment of post‐traumatic stress disorder (PTSD). Cochrane database of systematic reviews. 2007(3).
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