[Models of Mental Health Care for Vulnerable Refugees in the Community]

Psychother Psychosom Med Psychol. 2017 Apr;67(3-04):134-141. doi: 10.1055/s-0042-116080. Epub 2016 Oct 17.
[Article in German]

Abstract

A non-neglectable portion of people that have fled to Germany have been subjected to expulsion, violence, torture and grave human loss. In some of them, signs of secondary mental problems are obvious. In the light of the efforts at integration, these diseases must not be neglected. Outlined are the federal legal requirements and how the cost coverage, as well as the admission to health care system, is structured. Additionally, 2 exemplary regional models for psychosomatic health care are being introduced: Dresden's "Stepped Care Model for Psychologically Vulnerable Refugees" includes phased offers for prevention and treatment of acute mental crises, as well as somatoform disorders in refugees and their volunteer helpers. The PSZ in Bielefeld unites already existing expertise of social work and trauma therapy to form a shared project and favors, among other things, training courses and the instruction of language mediators. The local circumstances and differences lead to individual, sometimes totally new solutions. Already existing clinical care offers as well as concepts of trauma therapy are focal points for the development of a comprehensive health care provision. Most effective is a combination of medicinal care, psychosocial networking and psychosomatic treatment. For a working health care provision without parallel structures it is indispensible to use expertise in trauma therapy that is already in place. While being very resource-saving psychosomatic centers offer targeted applications in the network of all actors in refugee care especially when combined with well-trained volunteers and language mediators, informed on the issue of trauma.

MeSH terms

  • Community Mental Health Services / organization & administration*
  • Cross-Sectional Studies
  • Culturally Competent Care / organization & administration
  • Germany
  • Health Services Accessibility / organization & administration
  • Health Services Needs and Demand / organization & administration
  • Humans
  • Interdisciplinary Communication
  • Intersectoral Collaboration
  • Mental Disorders / epidemiology
  • Mental Disorders / psychology*
  • Mental Disorders / therapy*
  • Models, Organizational*
  • National Health Programs
  • Psychophysiologic Disorders / epidemiology
  • Psychophysiologic Disorders / psychology*
  • Psychophysiologic Disorders / therapy*
  • Refugees / psychology*
  • Somatoform Disorders / epidemiology
  • Somatoform Disorders / psychology*
  • Somatoform Disorders / therapy*
  • Stress Disorders, Post-Traumatic / epidemiology
  • Stress Disorders, Post-Traumatic / psychology
  • Stress Disorders, Post-Traumatic / therapy
  • Vulnerable Populations / psychology*