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An online tiered screening procedure to identify mental health problems among refugees

BACKGROUND: Many refugees suffer from mental health problems due to stressful and traumatic events before, during, and after migration. However, refugees are facing a wide variety of barriers, limiting their access to mental health care. Internet-based tools, available in several languages, could be...

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Autores principales: Meurling, Jennifer, Rondung, Elisabet, Leiler, Anna, Wasteson, Elisabet, Andersson, Gerhard, Richards, Derek, Shahnavaz, Shervin, Bjärtå, Anna
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9811744/
https://www.ncbi.nlm.nih.gov/pubmed/36597066
http://dx.doi.org/10.1186/s12888-022-04481-2
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author Meurling, Jennifer
Rondung, Elisabet
Leiler, Anna
Wasteson, Elisabet
Andersson, Gerhard
Richards, Derek
Shahnavaz, Shervin
Bjärtå, Anna
author_facet Meurling, Jennifer
Rondung, Elisabet
Leiler, Anna
Wasteson, Elisabet
Andersson, Gerhard
Richards, Derek
Shahnavaz, Shervin
Bjärtå, Anna
author_sort Meurling, Jennifer
collection PubMed
description BACKGROUND: Many refugees suffer from mental health problems due to stressful and traumatic events before, during, and after migration. However, refugees are facing a wide variety of barriers, limiting their access to mental health care. Internet-based tools, available in several languages, could be one way to increase the availability of mental health services for refugees. The present study aimed to develop and test a screening tool to screen for clinically relevant symptoms of psychiatric disorders common among refugees (i.e. Depression, Anxiety, Post-traumatic stress disorder, and Insomnia). We, designed, translated, and adapted an internet-based tiered screening procedure suitable for use with the largest refugee populations residing in Sweden. The tool aims to accurately identify symptoms of mental distress (Tier 1), differentiate between symptoms of specific psychiatric disorders (Tier 2), and assess symptom severity (Tier 3). We tested the overall efficiency of using a tiered screening procedure. METHODS: Seven hundred fifty-seven refugees residing in Sweden, speaking any of the languages Arabic, Dari, Farsi, English, or Swedish, completed an online questionnaire following a three-tiered procedure with screening instruments for each tier. In this study, the Tier 3 scales were used as reference standards for clinically relevant symptoms, to evaluate screening efficiency in terms of accuracy and reduction of item burden in previous tiers. RESULTS: The results show that the tiered procedure could reduce the item burden while maintaining high accuracy, with up to 86% correctly assessed symptoms and few false negatives with moderate symptoms and above (at most 9%), and very few with severe symptoms (at most 1.3%). DISCUSSION: This study generated an accurate screening tool that efficiently identifies clinically relevant symptoms of common psychiatric disorders among refugees. Using an adapted online tiered procedure to screen for multiple mental health issues among refugees has the potential to facilitate screening and increase access to mental health services for refugees. We discuss the utility of the screening tool and the necessity of further evaluation.
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spelling pubmed-98117442023-01-05 An online tiered screening procedure to identify mental health problems among refugees Meurling, Jennifer Rondung, Elisabet Leiler, Anna Wasteson, Elisabet Andersson, Gerhard Richards, Derek Shahnavaz, Shervin Bjärtå, Anna BMC Psychiatry Research BACKGROUND: Many refugees suffer from mental health problems due to stressful and traumatic events before, during, and after migration. However, refugees are facing a wide variety of barriers, limiting their access to mental health care. Internet-based tools, available in several languages, could be one way to increase the availability of mental health services for refugees. The present study aimed to develop and test a screening tool to screen for clinically relevant symptoms of psychiatric disorders common among refugees (i.e. Depression, Anxiety, Post-traumatic stress disorder, and Insomnia). We, designed, translated, and adapted an internet-based tiered screening procedure suitable for use with the largest refugee populations residing in Sweden. The tool aims to accurately identify symptoms of mental distress (Tier 1), differentiate between symptoms of specific psychiatric disorders (Tier 2), and assess symptom severity (Tier 3). We tested the overall efficiency of using a tiered screening procedure. METHODS: Seven hundred fifty-seven refugees residing in Sweden, speaking any of the languages Arabic, Dari, Farsi, English, or Swedish, completed an online questionnaire following a three-tiered procedure with screening instruments for each tier. In this study, the Tier 3 scales were used as reference standards for clinically relevant symptoms, to evaluate screening efficiency in terms of accuracy and reduction of item burden in previous tiers. RESULTS: The results show that the tiered procedure could reduce the item burden while maintaining high accuracy, with up to 86% correctly assessed symptoms and few false negatives with moderate symptoms and above (at most 9%), and very few with severe symptoms (at most 1.3%). DISCUSSION: This study generated an accurate screening tool that efficiently identifies clinically relevant symptoms of common psychiatric disorders among refugees. Using an adapted online tiered procedure to screen for multiple mental health issues among refugees has the potential to facilitate screening and increase access to mental health services for refugees. We discuss the utility of the screening tool and the necessity of further evaluation. BioMed Central 2023-01-03 /pmc/articles/PMC9811744/ /pubmed/36597066 http://dx.doi.org/10.1186/s12888-022-04481-2 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Meurling, Jennifer
Rondung, Elisabet
Leiler, Anna
Wasteson, Elisabet
Andersson, Gerhard
Richards, Derek
Shahnavaz, Shervin
Bjärtå, Anna
An online tiered screening procedure to identify mental health problems among refugees
title An online tiered screening procedure to identify mental health problems among refugees
title_full An online tiered screening procedure to identify mental health problems among refugees
title_fullStr An online tiered screening procedure to identify mental health problems among refugees
title_full_unstemmed An online tiered screening procedure to identify mental health problems among refugees
title_short An online tiered screening procedure to identify mental health problems among refugees
title_sort online tiered screening procedure to identify mental health problems among refugees
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9811744/
https://www.ncbi.nlm.nih.gov/pubmed/36597066
http://dx.doi.org/10.1186/s12888-022-04481-2
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