Psychological Distress Among Immigrants from the Former Soviet Union to Israel

(Translated by the author) As the end of the 20th century approaches, the problems related to migration of populations are quite severe. The success of the integration of refugees and immigrants in their new country is generally measured by “objective” parameters, such as: work, living conditions and language acquisition. Good material conditions are of course necessary for a successful integration, but are they sufficient for defining the success of the integration? Another important criteri..

Les utilisateurs fréquents des services de médecine générale

Exposé du problème, état de la rechercheL'augmentation des frais de santé primaire menace l'équilibre financier des organismes qui en assurent la prise en charge ou le remboursement. À cet égard, le problème des « utilisateurs fréquents des services de médecine générale », c’est-à-dire des malades qui ont recours de manière répétée aux visites et consultations de généralistes, constitue un problème préoccupant dans le champ des politiques de santé. Ce problème concerne au premier chef la popu..

Les utilisateurs fréquents des services de médecine générale

Exposé du problème, état de la rechercheL'augmentation des frais de santé primaire menace l'équilibre financier des organismes qui en assurent la prise en charge ou le remboursement. À cet égard, le problème des « utilisateurs fréquents des services de médecine générale », c’est-à-dire des malades qui ont recours de manière répétée aux visites et consultations de généralistes, constitue un problème préoccupant dans le champ des politiques de santé. Ce problème concerne au premier chef la popu..

High users of primary care services

(Translated by the author) Presentation of the problem, scientific backgroundIn western countries, the increase in the primary health costs threatens the financial balance of the organizations paying or refunding these expenses. In this respect, the problem of “high users of primary care services”, i.e. patients who frequently consult their general practitioner (GP), is a serious problem for policy makers. This problem is particularly significant for women who are consistently the highest use..

High users of primary care services

(Translated by the author) Presentation of the problem, scientific backgroundIn western countries, the increase in the primary health costs threatens the financial balance of the organizations paying or refunding these expenses. In this respect, the problem of “high users of primary care services”, i.e. patients who frequently consult their general practitioner (GP), is a serious problem for policy makers. This problem is particularly significant for women who are consistently the highest use..

Adapting the SRQ for Ethiopian Populations:A Culturally-Sensitive Psychiatric Screening Instrument

The objective of the study was to develop a culturally sensitive psychiatric screening instrument valid for Ethiopians in Ethiopia and Israel. The study sample was composed of 356 Amharic-speaking Ethiopians from Ethiopia and Israel, aged 18-55, divided into three groups: i) general population; ii) people in non-psychiatric treatment; iii) people in psychiatric treatment. They were interviewed with the Self-Reporting Questionnaire (SRQ), modified to include 10 culturally specific items, and the Brief Psychiatric Research Scale (BPRS) as a criterion of psychopathology. Physicians also completed an encounter form about the presence of mental health symptoms in participants. To make the questions more culture-specific, the translation of 12 items on the SRQ was changed. The content, construct, and criterion validity of each question were also examined, leading to the deletion of five items. The validity of the revised instrument (SRQ-F) was superior to that of the original instrument (SRQ). This study demonstrates the need for psychiatric screening instruments to be adapted to different cultures by incorporating meaningful translations and adding culturally specific items

Effect of implementation of mental health services within primary care on GP detection and treatment of mental disorders in Israel

Abstract Background Psychiatric morbidity is frequent in primary care, but a substantial proportion of these psychiatric problems appear to be neither recognized nor adequately treated by GPs. There exists a number of models of introduction of mental health services (MHS) into primary care, but little data are available on their effect on GPs’ detection or management of mental disorders. The study aimed to measure the effect of referring patients to a psychiatrist within primary care (Shifted OutPatient model—SOP) or consultation of psychiatrists by the GPs (Psychiatric Community Consultation Liaison—PCCL) on the detection and treatment of mental disorders by GPs. Methods In six primary care clinics in Israel (three “SOP clinics” and three “PCCL clinics”), GP detection of mental disorders and treatment of GP-detected cases were evaluated before and after provision of 1-year MHS, according to GP questionnaires on a sample of primary care consecutive attenders whose psychological distress was determined according to the GHQ12 and psychiatric disorders according to the Composite International Diagnostic Interview. Results After model implementation, a significant reduction in detection of mental disorders was found in SOP clinics, while no significant change was found in PCCL clinics. No significant change in detection of distress was found in any clinic. An increase in referrals to MHS for GP-diagnosed depression and anxiety cases, a reduction in GP counselling for GP-detected cases and those with diagnosed anxiety, an increased prescription of antidepressants and a reduced prescription of antipsychotics were found in SOP clinics. In PCCL clinics, no significant changes in GP management were observed except an increase in referral of GP-diagnosed depression cases to MHS. Conclusions MHS models did not improve GP detection of mental disorders or distress, but possibly improved referral case mix. The SOP model might have a deskilling influence on GPs, resulting from less involvement in treatment, with decrease of detection and counselling. This should be taken into consideration when planning to increase referrals to a psychiatrist within primary care settings. Lack of positive effect of the PCCL model might be overcome by more intensive programs incorporating educational components

Varia

J.C. McChrystal, Int. of Residenc