Improving the provision of services to young people from refugee backgrounds with comorbid mental health and substance use problems: addressing the barriers

BMC Public Health

Research Article

Miriam Posselt¹  Cherrie Galletly²  Karalyn McDonald³  Nicholas Procter⁴  Charlotte de Crespigny⁵ 

[1] Discipline of Psychiatry, School of Medicine, University of Adelaide, Level 4, Eleanor Harrald Building, Frome Rd, Adelaide, South Australia, Australia;Discipline of Psychiatry, School of Medicine, University of Adelaide, Level 4, Eleanor Harrald Building, Frome Rd, Adelaide, South Australia, Australia;Ramsay Health Care, Adelaide, Australia;Northern Adelaide Local Health Network, Adelaide, Australia;Jean Hailes Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia;School of Nursing and Midwifery, University of South Australia, Adelaide, South Australia, Australia;School of Nursing, University of Adelaide, Adelaide, South Australia, Australia;

关键词: Refugee;    Youth;    Comorbidity;    Service provision;    Mental health;    Substance use;   

DOI  :  10.1186/s12889-017-4186-y

 received in 2016-01-29, accepted in 2017-03-14,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundSouth Australia (SA) has resettled 151,134 refugees in the last ten years (Department of Immigration and Border Protection, Settlement reporting facility, 2014). Northern metropolitan Adelaide, an area which experiences significant social disadvantage, has received a significant number of (predominantly young) refugees. Research indicates that refugee youth are at elevated risk of mental health (MH) and alcohol and other drug (AOD) problems. These factors, along with the low socio-economic status of northern Adelaide, the number of refugee youth residing there, and the added complexity of treating comorbid MH and AOD problems (comorbidity) prompted this research. We investigated the barriers and facilitators to culturally responsive comorbidity care for these youth and whether the MH and AOD services were equipped to provide such support.MethodsThis mixed-methods study employed semi-structured interviews with refugee youth and service providers and an online survey with managers of services. Thirty participants (15 refugee youth, 15 service providers) took part in the semi-structured interviews and 56 (40 complete, 16 partially-complete) in the survey.ResultsThematic analysis of the interview data revealed the most commonly reported barriers related to four broad areas: (1) organisational and structural, (2) access and engagement, (3) treatment and service delivery, and (4) training and resources. Survey data supported the barriers identified in the qualitative findings.ConclusionsThis research highlights significant gaps in the response of MH and AOD services to refugee youth with comorbidity. Based on the findings, ways of overcoming the barriers are discussed, and are of particular relevance to policy makers, organisations and clinicians.

【 授权许可】

CC BY   
© The Author(s). 2017