Project Details
Projekt
Mental health treatment for refugees in Germany: need and barriers (TREAT)
Applicant
Professor Dr. Frank Neuner
Subject Area
Personality Psychology, Clinical and Medical Psychology, Methodology
Term
from 2019 to 2024
Project identifier
Deutsche Forschungsgemeinschaft (DFG) - Project number 409654512
The high number of refugees who have arrived in Germany since 2015 has posed a challenge to the German Mental Health care system. While, in general, refugees do not present with higher rates of diseases than the host population, rates of specific psychological disorders, in particular posttraumatic stress disorder (PTSD), are substantially increased. According to current guidelines, the first-line treatment for PTSD is trauma-focused psychotherapy. However, since access to psychotherapy for ethnic minorities has ever been difficult in Germany, it is likely that only a small minority of the refugees have received adequate evidence-based treatment. The aim of the TREAT project is to identify barriers to mental health care for refugees, with a specific focus on psychotherapy. Based on the current literature on health care utilization among refugees, we expect that access to mental health care is limited by both, subjective as well as objective factors. In close collaboration with the PH-LENS NEXUS project, TREAT will carry out in-depth interviews with sub-sample of N = 200 participants of the second wave of the NEXUS survey who screen positive for a psychological disorder. Using validated instruments, we aim to determine a tentative diagnosis of PTSD or depression. Within a process model of mental health care access, we will determine rates and predictors of mental health care utilization on different steps, ranging from the perceived need for treatment to help seeking and, finally, the utilization of adequate evidence-based treatment. As factors that may be associated with utilization we will assess mental health beliefs, knowledge about the health care system, the expected efficacy of various types of treatment as well as attitudes to help seeking including perceived stigmatization. In regression and mediator analyses the process of mental health care utilization will be explored, using both, subjective as well as objective parameters as predictors of utilization. In a preceding preparatory phase of this survey we will adapt and evaluate the study instruments, in particular a questionnaire to assess scientific and traditional mental health beliefs among refugees, in close collaboration with the ENSURE project. Furthermore, we will inform the LARGE project about the key parameters of this study in their panel study to allow the assessment of mental health care utilization in a representative sample of refugees in Germany. TREAT will not only allow to specify the barriers to mental health care access for refugees, but, using the situation of refugees as a magnifying lens of processes in the general population, reveal limitations of the existing mental health care system. In the context of the PH-LENS research unit, TREAT will contribute to the understanding of health system resilience, by determining how subjective individual-level factors interact with health system factors in affecting access to care.
DFG Programme
Research Units
