Emotional Distress, Medical Utilization, and Disability Claims in Adult Refugees

J Immigr Minor Health. 2018 Apr;20(2):339-344. doi: 10.1007/s10903-017-0621-5.

Abstract

The refugee health screener-15 (RHS-15) is utilized as a diagnostic proxy for common mental disorders in refugees. Studies are needed to determine its clinical and social utility. A retrospective chart analysis of adult refugees compared RHS-15 scores to utilization of medical services and presence of disability claims. Refugees with negative, positive, and highly positive RHS-15 scores attended 3.1, 4.4, and 5.7 mean primary care visits and 1.6, 2.8, and 4.4 mean non-primary care visits, respectively (p < .000). The 11% (43/392) claiming disability were 5.1 times more likely to have a positive RHS-15 (OR 4.3, 95% CI 2.1-8.8). A positive RHS-15 was not predictive of a disability claim (19% PPV), and those with a negative RHS-15 were unlikely to claim disability (96% NPV). The RHS-15 score correlates with visit utilization. A positive score is not predictive of a subsequent disability claim.

Keywords: Disabled person; Mental disorder; Refugee; Utilization.

MeSH terms

  • Adolescent
  • Adult
  • Disability Evaluation*
  • Eligibility Determination
  • Female
  • Humans
  • Male
  • Mentally Ill Persons / psychology
  • Mentally Ill Persons / statistics & numerical data*
  • Middle Aged
  • Patient Acceptance of Health Care / ethnology*
  • Refugees / psychology
  • Refugees / statistics & numerical data*
  • Retrospective Studies
  • Stress, Psychological / ethnology*
  • United States / epidemiology
  • Young Adult