Nytt arbetssätt för tidig identifiering av psykisk ohälsa bland migranter

Det största antalet flyktingar sedan andra världskriget flyr nu förföljelse, krig och konflikter. Migrationsprocessens olika faser innebär ofta stora påfrestningar och flyktingar har en ökad risk att drabbas av psykisk ohälsa. Alla asylsökande som kommer till Sverige är berättigade en hälsoundersökning. Vi beskriver här ett projekt som syftar till att förbättra möjligheterna för vårdpersonal som möter asylsökande och andra migranter att tidigt identifiera psykisk ohälsa. Genom införandet av ett screening-instrument för psykisk ohälsa, samt systematisering av dokumentation i journalsystem och vidareremittering till rätt instans hoppas vi kunna förbättra hanteringen av psykisk ohälsa samt öka kunskapen om vårdbehoven inom målgruppen.

What value for whom? – provider perspectives on health examinations for asylum seekers in Stockholm, Sweden

Abstract Background In Sweden asylum seekers are offered a voluntary health examination, free-of-charge (HE). The HE coverage is low. The organization and implementation of the HE involves collaboration between different agencies with different roles within the provision of health information and service. This study aimed to assess their perspectives on the barriers and facilitators regarding implementation of the HE, as well as on the purpose, content and value of the HE. Method Thematic analysis of focus groups, individual and group interviews conducted between 2016 and 17 with 41 participants from various authorities and healthcare professionals involved in the delivery of HE in Stockholm. Results Suggestions were taken from interviewees of how to facilitate the uptake and delivery of HE through improved outreach to the target group with better collaboration, coordination and continuity between authorities. Apart from control of specific communicable diseases, the perceived ultimate goal of HE varied and was often vaguely formulated. Respondents desired better monitoring to assess the effects of HE and predict needs among asylum seekers. This included standardized procedures to promote equitable health care access and more explicit inclusion of mental health and other health dimensions in the HE. Conclusion There are several possible avenues for improving HE coverage and uptake. However, ambiguity exists concerning the benefits of such efforts given the uncertainty of the value of HE. Lack of available data on health status, determinants of health and impact of HE among asylum seekers emerged as barriers preventing optimal approaches for the assessment of health needs. Implementation of standardized guidelines, procedures and documentation would aid the understanding. A more holistic approach beyond infectious diseases is necessary. This would only be useful if there is value in screening for such conditions. More research is required to assess the effectiveness and cost-effectiveness of HE and related screening policies in Sweden

Additional file 1: of What value for whom? – provider perspectives on health examinations for asylum seekers in Stockholm, Sweden

Interview guides for health care professionals and authorities. (DOCX 18 kb