title: Determinants of resource needs and utilization among refugees over time.
abstract: OBJECTIVE
  This study examined refugees' resource needs and utilization over time, investigated the relationships between pre-displacement/socio-demographic variables and resource needs and utilization, and explored the role of resource needs and utilization on psychiatric symptom trajectories.
  
  
  METHODS
  Iraqi refugees to the United States (N = 298) were assessed upon arrival and at 1-year intervals for 2 years for socio-demographic variables and pre-displacement trauma experiences, their need for and utilization of 14 different resources, and PTSD and depressive symptoms.
  
  
  RESULTS
  Although refugees reported reduction of some needs over time (e.g., need for cash assistance declined from 99 to 71 %), other needs remained high (e.g., 99 % of refugees reported a need for health care at the 2-year interview). Generally, the lowest needs were reported after 2 years, and the highest utilization occurred during the first year post-arrival. Pre-displacement trauma exposure predicted high health care needs but not high health care utilization. Both high need for and use of health care predicted increasing PTSD and depressive symptoms. Specifically, increased use of psychological care across the three measurement waves predicted more PTSD and depression symptoms at the 2-year interview.
  
  
  CONCLUSIONS
  Differences emerged between need for and actual use of resources, especially for highly trauma-exposed refugees. Resettlement agencies and assistance programs should consider the complex relationships between resource needs, resource utilization, and mental health during the early resettlement period.
authors.affiliation: Department of Psychology, Wayne State University, Detroit, MI, USA. amwright@wayne.edu.|Department of Family Medicine and Public Health Sciences, Wayne State University, Detroit, MI, USA. amwright@wayne.edu.
authors.forename: A Michelle
authors.initials: AM
authors.lastname: Wright
authors.affiliation: Department of Family Medicine and Public Health Sciences, Wayne State University, Detroit, MI, USA.|Department of Psychology, University of Detroit Mercy, Detroit, MI, USA.
authors.forename: Abir
authors.initials: A
authors.lastname: Aldhalimi
authors.affiliation: Department of Psychology, Wayne State University, Detroit, MI, USA.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Lumley
authors.affiliation: Department of Family Medicine and Public Health Sciences, Wayne State University, Detroit, MI, USA.|Institute of Environmental Health Sciences, Wayne State University, Detroit, MI, USA.
authors.forename: Hikmet
authors.initials: H
authors.lastname: Jamil
authors.affiliation: Department of Psychology, Smith College, Northampton, MA, USA.
authors.forename: Nnamdi
authors.initials: N
authors.lastname: Pole
authors.affiliation: Department of Family Medicine and Public Health Sciences, Wayne State University, Detroit, MI, USA.|Institute of Environmental Health Sciences, Wayne State University, Detroit, MI, USA.|Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
authors.forename: Judith E
authors.initials: JE
authors.lastname: Arnetz
authors.affiliation: Department of Family Medicine and Public Health Sciences, Wayne State University, Detroit, MI, USA.|Cardiovascular Research Institute, Wayne State University, Detroit, MI, USA.|Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.|College of Human Medicine, Michigan State University, East Lansing, MI, USA.
authors.forename: Bengt B
authors.initials: BB
authors.lastname: Arnetz
mesh_terms: D000328:Adult; D003863:Depression / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006301:Health Services Needs and Demand; D006801:Humans; D007493:Iraq / Q000208:ethnology; D008297:Male; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D012036:Refugees / Q000523:psychology* / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology*; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: Depression; PTSD; Refugees; Resource need; Resource utilization