title: The mental health status of refugees and asylum seekers attending a refugee health clinic including comparisons with a matched sample of Australian-born residents.
abstract: The aim of this study was to survey refugees and asylum-seekers attending a Refugee Health Service in Melbourne, Australia to estimate the prevalence of psychiatric disorders based on screening measures and with post-traumatic stress disorder (PTSD) specifically highlighted. A secondary aim was to compare the prevalence findings with Australian-born matched comparators from the 2007 National Survey of Mental Health and Well-Being.
  
  
  
  We conducted a cross-sectional survey of 135 refugees and asylum-seeker participants using instruments including Kessler-10 (K10) and PTSD-8 to obtain estimates of the prevalence of mental disorders. We also performed a comparative analysis using matched sets of one participant and four Australian-born residents, comparing prevalence results with conditional Poisson regression estimated risk ratios (RR).
  
  
  
  The prevalence of mental illness as measured by K10 was 50.4%, while 22.9% and 31.3% of participants screened positive for PTSD symptoms in the previous month and lifetime, respectively. The matched analysis yielded a risk ratio of 3.16 [95% confidence interval (CI): 2.30, 4.34] for abnormal K10, 2.25 (95% CI: 1.53, 3.29) for PTSD-lifetime and 4.44 (95% CI: 2.64, 7.48) for PTSD-month.
  
  
  
  This information on high absolute and relative risk of mental illness substantiate the increased need for mental health screening and care in this and potentially other refugee clinics and should be considered in relation to service planning. While the results cannot be generalised outside this setting, the method may be more broadly applicable, enabling the rapid collection of key information to support service planning for new waves of refugees and asylum-seekers. Matching data with existing national surveys is a useful way to estimate differences between groups at no additional cost, especially when the target group is comparatively small within a population.
authors.affiliation: Southern Synergy, Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, 3800, Australia. frances.shawyer@monash.edu.
authors.forename: Frances
authors.identifier: 0000-0002-2496-7094
authors.initials: F
authors.lastname: Shawyer
authors.affiliation: Southern Synergy, Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, 3800, Australia.|Royal District Nursing Service Institute, 31 Alma Rd, St Kilda, VIC, Australia.
authors.forename: Joanne C
authors.initials: JC
authors.lastname: Enticott
authors.affiliation: Special Medicine and Refugee Health & Wellbeing, Monash Health, Dandenong, VIC, 3175, Australia.|Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, 3800, Australia.
authors.forename: Andrew A
authors.initials: AA
authors.lastname: Block
authors.affiliation: Southern Academic Primary Care Research Unit, Department of General Practice, Monash University, Notting Hill, VIC, 3168, Australia.
authors.forename: I-Hao
authors.initials: IH
authors.lastname: Cheng
authors.affiliation: Southern Synergy, Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, 3800, Australia.|Mental Health Program, Monash Health, Dandenong, VIC, 3075, Australia.|Melbourne School of Population and Global Health, University of Melbourne, Parkville, VIC, 3010, Australia.
authors.forename: Graham N
authors.initials: GN
authors.lastname: Meadows
mesh_terms: D000328:Adult; D001315:Australia / Q000453:epidemiology; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D008875:Middle Aged; D015995:Prevalence; D012036:Refugees / Q000523:psychology*; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology*
keywords: Asylum seeker; Epidemiology; Mental disorders; Posttraumatic stress disorder; Refugee; Screening