Mental health and psychosocial support for South Sudanese refugees in northern Uganda: a needs and resource assessment
Mental health and psychosocial support for South Sudanese refugees in northern Uganda: a needs and resource assessment
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DOI：
10.1186/s13031-016-0085-6
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发表时间：
2016-09-07
影响因子：
3.6
通讯作者：
Tol, Wietse A.
中科院分区：
文献类型：
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作者：
Adaku, Alex;Okello, James;Tol, Wietse A.
工作背景：自2013年12月以来，南苏丹的武装冲突已导致220多万人流离失所，其中27万多人目前居住在乌干达各地的难民定居点。现有文献表明，难民面临着更大的风险，面临着一系列精神健康和心理社会问题。有需求和资源评估的重要性，以告知潜在的心理健康和心理社会支持（MHPSS）interventions.Methods：我们进行了MHPSS需求和资源评估犀牛营难民安置在乌干达北方，2014年6月至8月之间。我们遵循世界卫生组织（WHO）和联合国难民事务高级专员（UNHCR）的人道主义环境中MHPSS需求评估指南。评估使用了一系列方法，包括：（文献）审查，以了解精神卫生服务提供的背景; 2）从现有的健康信息系统（HIS）的数据分析; 3）使用谁做什么，在哪里，直到何时（4 Ws）的缩短版本的服务提供的当前基础设施的评估;（4）半结构化的个人访谈和小组访谈（共n = 86）与关键线人（n = 13）和一般社区成员（个人访谈n = 28，四个焦点小组n = 45）。HIS的数据显示，2013年至2014年难民涌入后，因精神病、严重情绪障碍和其他心理疾病而前往难民定居点卫生中心的人数有所增加，但与流行病学研究的估计相比，从卫生中心寻求帮助的总人数很少。在半结构化访谈中，排名最高的三个心理健康和心理社会问题包括“过度思考”，种族冲突和虐待儿童。其他问题包括家庭分离、吸毒、贫穷和无人陪伴的未成年人。4 Ws评估显示，有非常有限的MHPSS服务提供在犀牛Camp.Conclusions：在南苏丹难民在乌干达北方的MHPSS问题的类型是多种多样的，负担似乎是相当大的，但目前很少有可用的服务。评估表明，需要一系列服务来解决社会问题以及各种精神状况。“过度思考”这一成语可能会成为干预发展和心理健康交流的一个有用的起点。
Background: Since December 2013, an armed conflict in South Sudan has resulted in the displacement of over 2.2 million people, more than 270,000 of whom are presently in refugee settlements located throughout Uganda. Existing literature suggests that refugees are at increased risk for a range of mental health and psychosocial problems. There is international consensus on the importance of needs and resource assessments to inform potential mental health and psychosocial support (MHPSS) interventions.Methods: We conducted a MHPSS needs and resource assessment in Rhino Camp refugee settlement in northern Uganda, between June and August 2014. We followed World Health Organization (WHO) and United Nations High Commissioner for Refugees (UNHCR) guidelines for MHPSS needs assessments in humanitarian settings. The assessment used a range of methodologies including: 1) a desk (literature) review to understand the context for mental health service provision; 2) an analysis of data from existing health information systems (HIS); 3) an assessment of the current infrastructure for service provision using a shortened version of a Who does What Where until When (4Ws); and 4) semi-structured individual and group interviews (total n = 86) with key informants (n = 13) and general community members (individual interviews n = 28, four focus groups with n = 45).Results: Data from the HIS indicated that visits to health centers in refugee settlements attributable to psychotic disorders, severe emotional disorders, and other psychological complaints increased following the refugee influx between 2013 and 2014, but overall help-seeking from health centers was low compared to estimates from epidemiological studies. In semi-structured interviews the three highest ranked mental health and psychosocial problems included "overthinking", ethnic conflict, and child abuse. Other concerns included family separation, drug abuse, poverty, and unaccompanied minors. The 4Ws assessment revealed that there were very limited MHPSS services available in Rhino Camp.Conclusions: The types of MHPSS problems among South Sudanese refugees in northern Uganda are diverse and the burden appears to be considerable, yet there are currently few available services. The assessment indicates the need for a range of services addressing social concerns as well as varied types of mental conditions. The idiom of "overthinking" may form a useful starting point for intervention development and mental health communication.