Author(s) : Manon Bourguignon, Muriel Katz-Gilbert
Source : https://doi.org/10.3917/cpc.054.0131
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« Refugees and people with refugee backgrounds are a significant and socially distinct group in Switzerland. They are burdened by their past, e.g. they may be suffering ongoing trauma due to personal experiences of violence and torture, or having continuing social and psychological problems. Little research has been done into the psycho-social situations of refugees in Switzerland in recent decades, even if health is considered an important resource for refugees, e.g. for language learning and labour market participation. Currently available data and literature on the health of refugees in Switzerland indicate that refugees are an at-risk group, regardless of their country of origin. At the same time, individual health and wellbeing are considered important resources for newly-arriving refugees. While current public and political debates focus mainly on the challenges of labour market participation, they leave out discussion of the health of refugees and what measures should be introduced to improve it. Therefore, the health situation of refugees in Switzerland is somewhat ambiguous: On the one hand, general health treatment is covered by the obligatory health insurance scheme, but on the other hand, access to special treatment is limited because of a lack of treatment capacities, e.g. for trauma. Because health is so important, there is an urgent need to ensure that refugees have access to sufficient medical and psychological treatment, close to their arrival in Switzerland. »
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Unaccompanied asylum-seeking adolescents (UASA) are regarded as the most exposed and vulnerable victims of migration. The number of UASA applying for asylum in European countries has grown rapidly over the last three years (2014–2016). Around 3 % of all asylum applications in Europe were processed in Switzerland and in this country for 2015, a 10-fold increase was observed as compared to the 2000s. About 5 % of all UASA received in Switzerland were resettled in the canton of Geneva. These adolescents were all referred to the university adolescent outpatient clinic for a systematic post-arrival health screening and a follow-up. This study aimed to investigate the health status and health care needs of this population.
Refugees have been shown to present high prevalence rates of trauma-related mental disorders. Despite their psychological impairment, they are expected to meet high functional requirements in terms of social integration into, and financial independence from, the host society.
This cross-sectional study examined the relationship of mental health problems, post-migration living difficulties (PMLD), and social integration in a sample of 104 refugees seeking treatment for severe posttraumatic stress and comorbid symptoms in two outpatient clinics in Switzerland.
Despite an average time of residence in Switzerland of over 10 years, participants showed poor integration and a high number of PMLD. Integration difficulties were closely associated with psychological symptoms, but not with socio-demographic parameters such as education or visa status.
Psychological impairment in treatment-seeking traumatized refugees is associated with poor integration. To foster social integration, it is crucial to better understand and address the specific needs of this highly vulnerable population.
Keywords: Integration, mental health, migration, posttraumatic stress, post-migration living difficulties, PTSD, refugees
Migration, particularly among refugees and asylum seekers, poses many challenges to the health system of host countries. This study examined the impact of migration history on illness experience, its meaning and help-seeking strategies of migrant patients from Bosnia and Turkey with a range of common health problems in general practice in Basel, Switzerland. The Explanatory Model Interview Catalogue, a data collection instrument for cross-cultural research which combines epidemiological and ethnographic research approaches, was used in semi-structured one-to-one patient interviews. Bosnian patients who had more traumatic migration experiences than Turkish/Kurdish or Swiss internal migrants reported a larger number of health problems than the other groups. Psychological distress was reported most frequently by all three groups in response to focussed queries, but spontaneously reported symptoms indicated the prominence of somatic, rather than psychological or psychosocial, problems. Among Bosnians, 78% identified traumatic migration experiences as a cause of their illness, in addition to a range of psychological and biomedical causes. Help-seeking strategies for the current illness included a wide range of treatments, such as basic medical care at private surgeries, outpatients department in hospitals as well as alternative medical treatments among all groups. Findings provide a useful guide to clinicians who work with migrants and should inform policy in medical care, information and health promotion for migrants in Switzerland as well as further education of health professionals on issues concerning migrants health.