Defining effective care coordination for mental health referrals of refugee populations in the united states

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Abstract

Objectives: Refugee populations arriving to the United States report high rates of exposure to trauma and associated psychiatric distress that may necessitate referrals to mental health services. Although refugee arrivals receive a voluntary health screening, mental health screening is not routine. Public health providers report that one barrier to mental health screening concerns uncertainty about how to connect refugee patients to mental health services. This article reports essential components of successful and unsuccessful care coordination related to mental health referrals of refugees. Design: A community based participatory research study explored the characteristics of successful and unsuccessful mental health referrals of refugee patients through an online survey of refugee providers. Ten coders sorted provider stories of mental health referrals into critical incidents that were analyzed using principle components analysis (PCA). Care coordination emerged as an important characteristic of referral success. This category of care coordination was analyzed further into components of successful and unsuccessful care coordination using a higher order PCA. A similar process was followed examining providers’ perceptions of why care coordination was successful or unsuccessful. Results: Components describing successful care coordination include ongoing communication between providers, scheduling initial appointments directly, access to emergency mental health services, and case management provided by health plan staff. Components related to unsuccessful care coordination describe the failure to communicate about care or establish appointments in a timely manner and the failure to resolve access barriers. Trust in relationships among providers and between refugee patients and providers was an important reason why care coordination was successful. Conclusion: Ongoing communication between providers is essential to successful mental health referrals of patients with refugee backgrounds. Multidisciplinary systems of care may benefit from education about the importance of building relationships among providers and the essential components of successful care coordination.

Citation

Relevant Evidence Summaries

The evidence was reviewed and included in the following summaries: 

What are the impacts of case management on refugees?

While rigorous evidence is limited, the literature suggests that case management is associated with numerous positive outcomes. The body of evidence is largely suggestive in rigor and yields generally positive outcomes, although some studies show mixed results. The one available impact study yields positive results. The available studies have examined diverse outcomes such as self-sufficiency, […]

About this study

AGE: Multiple Age Groups

DIRECTION OF EVIDENCE: Positive impact

FULL TEXT AVAILABILITY: Free

GENDER: All

HOST COUNTRY: United States

HOST COUNTRY INCOME: High

INTERVENTION DURATION: Various

INTERVENTION: Referral to treatment

OUTCOME AREA: Mental Health

POPULATION: Refugees

REGION OF ORIGIN OF PARTICIPANT(S): Multiple Regions

STRENGTH OF EVIDENCE: Suggestive

TYPE OF STUDY: Suggestive evidence

YEAR PUBLISHED: 2021

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