Does Integrated Care Affect Healthcare Utilization in Multi-problem Refugees?

Join the Conversation

Tuesday, July 7th to Wednesday, September 30th

Please join us in an online, open forum on telehealth. NCB is providing an opportunity for clinicians to ask each other questions, share observations and adapted telehealth protocols for the SoT population via an online forum and technical exchange. This conversation will be a forum for peer-led informational exchange. NCB staff will assist in facilitating and monitoring the conversation.

Directions: Please watch Eugene Augusterfer’s presentation and interview Telemedicine in Mental Health first. Then feel free to join us in this open forum. All are welcome to join this forum, whether you have an account on Healtorture.org or not. For more information on using the forum, please read the directions on the first post. Please keep your comments respectful, relevant, factual, and do not share identifying information about clients per client privacy and HIPAA regulations. This forum will be open from July 6, 2020 through September 30, 2020.

Carol C. White, Craig A. Solid, James S. Hodges, Deborah H. Boehm. Journal of Immigrant and Minority Health, August 2014.

A history of trauma is common in refugee populations and appropriate treatment is frequently avoided. Using a convenience sample of 64 patients in a Somali primary care clinic, a culture and trauma specific intervention was developed to address retention into appropriate treatment. One goal of the intervention was to improve the rate of engagement in psychotherapy after a mental health referral and to test the effect of psychotherapy on health care utilization using a staged primary care clinical tool. Forty-eight percent of patients given a mental health referral engaged in psychotherapy. Patients engaging in psychotherapy had higher baseline utilization and over 12 months trended towards less emergency room use and more primary care. Our findings suggest that the intervention improved referral and retention in mental health therapy for East African refugee women.

This primary care intervention study may be useful in promoting assessment and trauma-informed treatment in mainstream settings of refugees with likely trauma experiences. The intervention model was  developed by adult nurse practitioner Deborah Boehm for her work with East African women. It details a four visit staged protocol for addressing common groups of symptoms presented by a new refugee patient. The results of the study demonstrate the efficacy of integrated care in fostering patient willingness to engage in psychotherapy after an initial referral. Table 2 is very useful for training in the staged approach for primary care providers.  

Full article is available to subscribers through the SpringerLink site.

Rating: 

No votes yet

Add new comment