Mental Health Screening

Abstract

Understanding a refugee's expression of distress requires careful consideration of a variety of factors including language, culture, the individual traumatic history, and the client's medical worldview. Outlined in this chapter is research conducted over a period of years leading to the development of screening instruments by a number of authors considering these complex issues. The human biological system response to stress includes a series of common physiological changes which might predict core symptoms, yet the language used to express these varies based on social and cultural factors. For the purpose of screening, identifying the central symptoms that arise from the neurological process and less on the complex communication of them avoids being distracted by cultural and medical frameworks. Assessment after screening contributes to understanding the complex symptoms, comorbidities, and explanatory models that help define treatment needs. While most refugees anticipate an end to the long-term suffering and uncertainty when they arrive to the city of resettlement, the initial weeks and months is a period of emotional adjustment that can fluctuate between relief and distress, even, in some cases reactivating symptoms of trauma. For others, emotional distress can appear years after arrival. Therefore, mental health screening, at any time, can play a vital role in identifying refugee mental health needs. The role of a screener requires understanding of the unique challenges related to refugee mental health and refugee trauma. This chapter begins by presenting several issues to be considered when screening refugee clients and continues with an overview of research related to screening instruments. Screening is best thought of as a distinct process from diagnosis or assessment with the intent to efficiently detect common mental disorders and distress with reasonably high sensitivity and specificity. It is important to note that refugees are a diverse group and represent a broad variety of ethnic, language, and people groups, and this chapter can only present generalizations of the issues affecting them. (PsycINFO Database Record (c) 2018 APA, all rights reserved) (Source: chapter)