Characteristics and needs of asylum seekers and refugees in contact with London community mental health teams: a descriptive investigation.
BACKGROUND
Asylum seekers and refugees may have substantial needs for mental health care, to which both pre-migration and post-migration traumas are likely to contribute. However, there is a paucity of data available to guide appropriate service development.


OBJECTIVE
To ascertain numbers and describe the characteristics and needs of asylum seekers and refugees in contact with London Community Mental Health Teams (CMHTs).


METHODS
Data were obtained from staff and clinical records regarding socio-demographic and clinical characteristics and service use. Camberwell Assessment of Need Short Appraisal Schedule (CANSAS) and Health of the Nation Outcome Scales (HoNOS) were completed.


RESULTS
A total of 104 (11%) of the CMHT population were asylum seekers or refugees. Co-morbidity was frequent, and psychiatrists reported significant diagnostic uncertainty for 30%. The most common diagnoses were depression (50%) and post-traumatic stress disorder (PTSD) (41%), and just over half had a psychotic diagnosis (53%). Social isolation was common, levels of unmet need were high (mean of 6.8 unmet needs each using CANSAS) and the group used few services other than CMHTs.


CONCLUSIONS
The combination of high levels of need and limited service use suggests a need to develop more effective services. High rates of diagnostic uncertainty suggest a need for a clearer understanding of the complex clinical syndromes afflicting this group.
McColl
Helen
H
Early Intervention in Psychosis Team, Paterson Centre, 20 South Wharf Road, London W2 1PD, UK. helenmccoll@nhs.net
Johnson
Sonia
S
D000328:Adult; D000368:Aged; D004641:Emigration and Immigration; D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D008131:London; D008297:Male; D008605:Mental Health Services; D008875:Middle Aged; D012036:Refugees; D011795:Surveys and Questionnaires