title: Psychological trauma and help seeking behaviour amongst resettled Iraqi refugees in attending English tuition classes in Australia.
abstract: BACKGROUND
  To examine levels of psychological distress and help seeking behaviour in resettled refugees attending English tuition classes in Australia, and their associations with participants' demographic characteristics.
  
  
  METHODS
  Data was collected by bilingual interviewers between March and November 2013. A volunteer sample of attendees of Adult Migrant English Programs (AMEP) in Western Sydney were recruited. Participants were two hundred and twenty five Iraqi refugees resettled in Western Sydney, who had left Iraq no earlier than 1991, were fluent in Arabic and/or English, and were between the ages of 18 and 70. The chief outcome measures used were the Kessler Psychological Distress Scale (K-10) as well as The Harvard Trauma Questionnaire (HTQ).
  
  
  RESULTS
  On the K-10, 39.8% of participants had severe psychological distress, 19.4% moderate distress, and 40.7% had low to mild distress. Ninety-five percent of participants reported having experienced one or more potentially traumatic event (PTE) as defined by the HTQ prior to leaving Iraq, with a mean of 14.28 events (SD = 8.69). Thirty-one percent of participants met the threshold (≥2.5) for clinically significant PTSD symptomatology, with a significantly higher occurrence among participants with lower education attainment (χ (2) (3) = 8.26, p = .04). Of those participants with clinically significant PTSD symptomatology according to the HTQ, only 32.9% reported ever having ever sought help for a mental health problem.
  
  
  CONCLUSIONS
  The high level of distress found in this sample, combined with low uptake of mental health care, highlights the need for programs targeted to promote help-seeking among Iraqi refugees who have resettled in Australia. Further, the higher level of PTSD symptomatology found amongst those with lower education attainment has mental health promotion and treatment implications. Specifically, in designing service and treatment programs, consideration should be given to the possible impact excessive levels of psychological distress may have on learning in refugees, to ensure that those who have been unable to develop proficiency in the English language receive effective care.
authors.affiliation: Mental Health, School of Medicine, The University of Western Sydney, Locked Bag 1797 Penrith South DC, NSW Australia.
authors.forename: Shameran
authors.initials: S
authors.lastname: Slewa-Younan
authors.affiliation: Department of Psychology, Macquarie University, Sydney, Australia.
authors.forename: Jonathan M
authors.initials: JM
authors.lastname: Mond
authors.affiliation: Mental Health, School of Medicine, The University of Western Sydney, Sydney, Australia.
authors.forename: Elise
authors.initials: E
authors.lastname: Bussion
authors.affiliation: Mental Health, School of Medicine, The University of Western Sydney, Sydney, Australia.
authors.forename: Maral
authors.initials: M
authors.lastname: Melkonian
authors.affiliation: Mental Health, School of Medicine, The University of Western Sydney, Sydney, Australia.
authors.forename: Yaser
authors.initials: Y
authors.lastname: Mohammad
authors.affiliation: Mental Health, School of Medicine, The University of Western Sydney, Sydney, Australia.
authors.forename: Hanan
authors.initials: H
authors.lastname: Dover
authors.affiliation: New South Wales Refugee Health Service, Liverpool, UK.
authors.forename: Mitchell
authors.initials: M
authors.lastname: Smith
authors.affiliation: South Western Sydney Local Health District Eastern Campus, Liverpool Hospital, Sydney, Australia.
authors.forename: Diana
authors.initials: D
authors.lastname: Milosevic
authors.affiliation: Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.
authors.forename: Anthony Francis
authors.initials: AF
authors.lastname: Jorm
keywords: Mental health; Posttraumatic stress disorder; Psychological distress; Refugees; Resettlement; Trauma