Psychiatric assessment

This section reviews those key factors unique to the psychiatric evaluation and diagnosis of the refugee patient. Primary care: the proper setting for a refugee clinic

The psychiatric literature has generally stressed the importance of evaluating and treating refugee patients in a primary-health-care setting, whether in a refugee camp or in a country of resettlement. Four factors seem to support this viewpoint:

1. refugee patients seldom self-refer to psychiatry;

2. in many societies considerable stigma is associated with psychiatry but not with primary care medicine;

3. the majority of refugees seek out the care of their local medical doctors and indigenous traditional healers for the relief of their emotional suffering;

4. most refugees have associated medical and psychiatric disorders.

Considerable field experience has shown that establishing a mental health programme within a health facility where refugees already seek medical care can result in the highly successful utilization of psychiatric professionals and treatment.

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