Mental illness among refugee arrivals: Examining rates of DSM-V diagnoses, predictors, and patterns of engagement in U.S. Resettlement Programs

Abstract

Abstract Purpose This article examines the prevalence of clinically significant mental disorders among 446 newly arrived refugees receiving clinical services through a U.S. Refugee Resettlement organization’s mental health program. Of the analytic sample, a subsample of 197 refugees received onsite psychiatric services in the same resettlement program. The paper answers two questions: First, what predicts enrollment in psychiatric care among refugee arrivals identified in resettlement programs? Second, how do refugees receiving psychiatric care navigate other clinical and non-clinical resettlement services? Methods Using logistic regression modeling, the study examined the prevalence of schizophrenia, major depressive disorder, post-traumatic stress disorder (PTSD), generalized anxiety disorder, adjustment disorder, and other covariates that predict psychiatric care enrollment and levels of refugee engagement in clinical and resettlement services broadly. Results Presenting problems of PTSD (b = 1.094, t(371) = 2.94, OR = 2.985, p = .003) and schizophrenia (b = 2.932, t(371) = − 2.73, OR = 18.760, p = .006) were each associated with an increased likelihood of enrollment in psychiatric services. Refugees from African nations (b = − 1.076, t(371) = − 2.85, OR = 0.341, p = .005) were about 66% less likely to be enrolled in psychiatric care than were refugees from the Middle East. Receiving the general adjustment presenting problem flag (b = − 2.569, t(371) = − 7.09, OR = 0.077, p < .001) was also associated with a decreased likelihood of psychiatric care enrollment. Conclusion The findings provide directions for addressing mental illness within resettlement context and considerations for providing psychiatric care to culturally-diverse refugee arrivals.