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Aim: To report participants' and facilitators' experiences of mental health promotion, prevention, and early‐intervention training program targeted at school nurses in the United Arab Emirates (UAE). Background: The UAE school healthcare service is staffed by full‐time nurses and part‐time doctors and linked to primary healthcare centers. This service supports children's physical and mental well‐being. However, school nurses' capacity to realize the potential of this service, particularly regarding mental health, has not yet been explored. Methods: We used an exploratory qualitative approach with data triangulation. Data were drawn from school nurses that participated in a targeted mental health promotion, prevention, and early‐intervention training program. Data were gathered through focus group interviews with participating school nurses, written reflections, and notes recorded by the program designers and trainers. All school nurses who participated in the training program (N = 15) were included in this study. This study adhered to the consolidated criteria for reporting qualitative research. Results: Nurses' narratives encompassed three main themes, which indicated the program was an enjoyable professional and personal journey that allowed professional discovery/development and personal growth. Program organizers/facilitators indicated the training program was important, but challenging to implement. Four themes emerged from their reflections that covered the structure of school nursing services, participants' competency and education, the UAE context, and teaching style. Conclusion: A well‐structured professional development program can contribute to improving mental healthcare in schools. Improved service structure and regulations to support this goal are essential. Implications for nursing practice, research, and policy: School nurses benefit professionally and personally from targeted mental health training, which also improves the care students receive. School healthcare service managers should consider increasing such training opportunities for nurses and focus on measuring service outcomes and evaluating effectiveness. It is also necessary to reassess the minimum qualification requirement for school nurses. Specific professional development programs for school nurses will improve their clinical practice and support the recruitment of competent and prepared staff. [ABSTRACT FROM AUTHOR]

Stigma is of central importance to people with mental illness and their families. It impacts how they experience their illness and access available health services. An important principle in mental healthcare is empowering patients to live independently and productively, which requires optimal caring from family members. Stigma can seriously hinder this principle. This qualitative study was based on Straussian grounded theory. Participants were 25 family members of people with mental illness. Data were collected through semi-structured interviews, field notes and memos, and managed using Paillé data analysis. We extracted four interrelated categories: pasung (confinement), demonic/devil possession, alternative treatments and social isolation. Because of misunderstandings about mental illness, participants turned to alternative treatments provided by shamans and religious leaders. Participants reported being expelled from or isolated by their community, suggesting stigma is a reality experienced by families of people with mental illness in Indonesia. Addressing family stigma is important to ensure on-going support for patients and families. It is also important to develop and evaluate anti-stigma interventions in the Indonesian context. The present findings are relevant for mental healthcare professionals, related practice areas where families may be exposed to stigmatization and for international audiences with similar cultural and religious contexts. [ABSTRACT FROM AUTHOR]

Objective: Targeted public health campaigns are important in countries where health resources are limited. This is especially the case for countries such as Iraq since decades of sanctions, war and armed conflict have depleted the health system. The current study investigated the influence of sociodemographic characteristics on attitudes towards the novel coronavirus (COVID-19) relating to knowledge and behaviors held by people living in North Iraq. Method: A cross-sectional survey, conducted from 21st March to 12th April 2020, used an online platform. Multivariate analyses were used to examine the relationship between sociodemographic factors and respondents’ knowledge, attitude and behavioral practices in response to COVID-19. Results: Respondents with better self-reported health were most likely to report sleep impairment (OR=2.32,1.49-3.68) impaired eating (OR=1.84, 1.17-2.95) fear in response to social media news on COVID-19 (OR=1.92, 1.32-2.81) and were more likely to practice COVID-19 prevention measures (OR= 1.08, 1.01-1.14). On the other hand, those with better self-reported health (OR= 0.4; 0.27-0.59) were less likely to report good knowledge on COVID-19 whereas those with higher levels of education (OR= 3.59, 1.29-10.2) claimed to have higher knowledge of COVID-19. Men believed that war was more frightening than COVID-19 (OR=1.91, 1.33-2.75) compared to woman. Conclusion: Self-reported health and type of employment were the sociodemographic factors most frequently noted to influence knowledge, attitude and behaviors toward COVID-19 amongst the northern Iraqi population. In a country where health resources are scare and stretched because of a history of sanctions and prolonged war and community violence, these results provide directions for targeted approaches to support public health campaigns. [ABSTRACT FROM AUTHOR]

Background: Mental health literacy (MHL) is an essential competency for all healthcare professionals. In the United Arab Emirates, previous studies reported a low level of MHL among healthcare professionals working with vulnerable populations such as children and adolescents with chronic illnesses. Further in-depth exploration is necessary to build understanding of beliefs and knowledge about mental illness among pediatric health professionals. Methods: Written narratives exploring mental health knowledge were collected from pediatric nurses and analyzed using content analysis. These written narratives were extracted from responses to open-ended questions embedded in a questionnaire completed as part of previous studies. The Standards for Reporting Qualitative Research were followed in reporting this study. Results: The overarching theme that emerged from the data was that nurses struggled to negotiate the complexities of psychological distress and mental illness. Two overlapping sub-themes were identified: (1) professional knowledge was incomplete, confused, and lacking in clarity and (2) professional knowledge was impacted by cultural beliefs and stigma. A third sub-theme reflected how participants identified with others' suffering and felt powerless to help themselves or others. Participants described stress and mental exhaustion. Conclusions: Participants' narratives were characterized by struggles arising from insufficient knowledge, confusion, and deeply-held cultural and religious beliefs. Therefore, they were unable to resolve the conflict between professional knowledge, attitudes, and beliefs about mental illness and stigma arising from cultural and religious beliefs/attitudes. Culturally-specific education is needed for healthcare professionals that addresses contextual, cultural, and religious factors impacting on stigma while actively supporting the healthcare workforce and enabling access to mental health services. [ABSTRACT FROM AUTHOR]

The current study sought to examine resettled Iraqi refugees' recognition of trauma-related psychopathology and the association between recognition and help-seeking. Participants were 66 men and women aged 18 to 70 years with clinically significant symptoms of posttraumatic stress disorder (PTSD) recruited from a larger, community-based sample in Western Sydney, Australia. Participants were presented with a vignette of a fictional character who had been exposed to trauma prior to leaving Iraq and who was suffering from symptoms of PTSD. Participants were then asked if they believed that they might currently have a problem such as the one described in the vignette. Approximately half (50.8%) of participants believed that they might currently have a problem such as the one described in the vignette and one third (33.3%) of participants had ever sought help for such a problem. Participants who believed that they might currently have a problem like the one described were 13 times more likely to have sought help for such a problem, controlling for demographic characteristics, trauma-related symptomatology, and levels of general psychological distress. Poor self-recognition level of trauma-related psychopathology among resettled Iraqi refugees may be a barrier to help-seeking and may therefore be an important target for health promotion and early intervention initiatives. [ABSTRACT FROM AUTHOR]

Objective: To examine the resettlement experiences of former refugees living in regional Australia, focusing on mental health and mental health and support services, including barriers to access. Design: A phenomenological approach utilising a combination of six qualitative, semi‐structured, face‐to‐face focus groups (n = 24) and seven individual interviews. Data were analysed thematically using NVivo 10 software. Setting: Launceston, Tasmania. Participants: Adult and youth former refugees from Afghanistan, Bhutan, Burma, Sierra Leone, Sudan and Iran, and essential service providers, residing in Launceston. Main outcome measures: Participants were asked about experiences of resettlement and mental health. Results: Participants reported that their mental health had improved since resettlement; however, major stressors impacted mental health and resettlement included employment and housing access and mastering the English language. Past experiences continued to impact current functioning, with trauma commonly experienced intergenerationally through parenting and attachment and ongoing trauma and feelings of guilt and responsibility experienced with families left behind. Participants noted barriers to accessing services: (a) Language difficulties including lack of interpreters; and (b) lack of culturally sensitive and trauma‐informed practices. Discrimination was experienced through the inconsistent provision of interpreters and lack of due consideration of cultural and religious differences. The use of children as interpreters enhanced a number of risk including miscommunication of medical information, exposure to age‐inappropriate information and the resulting increased risk of trauma for the child. Conclusion: Culturally sensitive, trauma‐informed and discrimination‐free practices should be employed across services, where Western‐views surrounding this medical model are not imposed, cultural differences are respected, and timely access to interpreters was provided. [ABSTRACT FROM AUTHOR]

Background: To support promotion, prevention and early intervention for mental illness school nurses need to be mental health literate. Methods: Three hundred and thirty-nine school nurses employed in government and private schools from three Emirates in the UAE were surveyed. A culturally adapted Mental Health Literacy questionnaire comprising three vignettes of fictional characters meeting diagnostic criteria for the target conditions along with the Kessler Psychological Distress Scale (K10) was administered to ascertain school nurses' ability to correctly identify the conditions and to elicit beliefs about helpfulness of treatment interventions and of health care providers for these conditions. Results: Less than 50% of the respondents correctly identified the disorders presented, while accurate identification of evidence-based interventions was also limited. Correlations between level of psychological distress and level of inaccurate survey responses was also revealed, respondents who correctly identified the correct diagnosis of the vignette and the most appropriate interventions were those who had a significantly lower K10 score. Conclusions: Low levels of mental health literacy amongst respondents in combination with potential religious and cultural factors as reported in the literature, highlight the need for curriculum enhancements for future health professionals and a targeted program of culturally appropriate professional development focused on mental health promotion for those in clinical practice. The level of psychological distress noted in this cohort also signals a need to ensure that appropriate supports are available for clinical staff employed in schools. [ABSTRACT FROM AUTHOR]

Background: Australia is a multicultural nation with a humanitarian program that welcomes a large number of Iraqi refugees. Despite the high prevalence of trauma related disorders, professional help-seeking in this group is very low. This study sought to evaluate a face-to-face mental health literacy (MHL) Course that teaches community-based workers how to provide initial help to Iraqi refugees with depression and post-traumatic stress disorder (PTSD) related problems. Methods: An uncontrolled pre, post and follow-up design was used to measure improvement in MHL in community- based workers assisting Iraqi refugees. Results: Eighty-six participants completed the pre- and post-training questionnaires. Forty-five (52%) completed all 3-time point questionnaires. Fifty-six percent (48/86) of participants were able to correctly recognise 'PTSD' as the problem depicted in a vignette before the training. This increased to 77% (66/86) after training and was maintained at follow-up with 82% (37/45) correctly recognising the problem (p = 0.032). Recognition of depression also increased from 69% (59/86) at pre-training to 83% (71/86) after training and to 82% (37/45) at follow-up. There was a significant increase in perceived helpfulness of professional treatments for depression after training (p < 0.001 at post-training, p = 0.010 at follow-up). Significant changes were reported in confidence of participants when helping an Iraqi refugee with PSTD (p < 0.001 at post-training, p < 0.001 at follow-up) and depression (p < 0.001 at post-training, p = 0.003 at follow-up). A decrease were also found on social distance mean scores associated with PTSD (p = 0.006 at post-training, p < 0.001 at follow-up) and depression (p = 0.007 at follow-up). Changes were not significant following training for offering help and helping behaviours in both PSTD and depression vignettes and, the 'dangerous/unpredictable' subscale in the depression vignette. Conclusion: This training is a recommendable way to improve and better equip staff on how to respond to mental health crises and offer Mental Health First Aid in a culturally sensitive manner to Iraqi refugees. [ABSTRACT FROM AUTHOR]

Background: In the United Arab Emirates (UAE) 35% of the population are aged 0-24 years. A significant proportion of these young people are living with chronic conditions (e.g., asthma, type 1 diabetes, cardiac conditions, and geneticallytransmitted conditions such as thalassemia and cystic fibrosis). This group has increased vulnerability to developmental delays and mental health problems, and is increasingly coming to the attention of service providers in mainstream schools, primary healthcare centers, and pediatric hospitals. Despite the government directing attention to improving the mental health of the UAE population, there is concern that mental health services are not growing at the rate needed to meet the mental health needs of children and young people with chronic conditions. Method: A cross sectional survey design was used to determine the mental health literacy of nurses and other healthcare professionals working with children with chronic illnesses. Participants completed a culturally-adapted mental health literacy questionnaire comprising three vignettes of fictional characters meeting diagnostic criteria for posttraumatic stress disorder, psychosis, and depression with suicidal thoughts. Participants also completed the Kessler Psychological Distress Scale (K10). Results: Participants were 317 healthcare professionals from across the UAE. The majority were nurses. Correct identification of the diagnosis for each vignette was limited, with the highest level of accuracy achieved for the psychosis vignette (n = 113, 54.3%). Accurate identification of appropriate evidence-based interventions was also limited. K10 scores indicated 40% of participants had moderate to high levels of psychological distress. Conclusions: These findings are concerning and provide important data to inform the development of undergraduate and continuing education programs for nurses. The K10 scores suggest healthcare professionals are under considerable stress, highlighting the need to support healthcare professionals who experience multiple psychosocial stressors. [ABSTRACT FROM AUTHOR]

Background: Psychological trauma, in particular, posttraumatic stress disorder (PTSD) and depression, are highly prevalent among resettled refugees. However, little is known regarding the mental health status and associated helpseeking behaviour of resettled Afghan refugees in Australia. Methods: A sample of 150 resettled Afghan refugees (74 males; mean age 32.8 years, SD = 12.2) living in Adelaide, South Australia were recruited. Self-reported measures of PTSD, depression, exposure to traumatic events, functional impairment, self-recognition of PTSD symptomatology and help-seeking behaviours were completed. Multivariate analysis of variables associated with help-seeking was conducted. Results: Forty-four percent of participants met criteria for clinically significant PTSD symptoms and all but one participant reported being exposed to 1 or more traumatic and/or conflict related events, such as 'losing your property and wealth'. Moreover, 14.7% of participants had symptoms suggestive of clinically significant depression. General practitioners were the most common source of help in relation to mental health problems, with very few participants (4.6%) seeking help from specialist trauma and torture mental health services. Self-recognition of having a PTSD related mental health problem and functional impairment levels were both found to be independent predictors of help-seeking (p = .05). Conclusions: The findings provide further evidence for high rates of PTSD symptomatology and low uptake of mental care among resettled refugees. Poor self-recognition of the presence and/or adverse impact of PTSD symptoms may need to be targeted in mental health promotion programs designed to improve "mental health literacy" and thereby promote early and appropriate help-seeking where this is needed. [ABSTRACT FROM AUTHOR]

Background: Resettled refugees are a vulnerable group for mental health problems and in particular, trauma-related disorders. Evidence suggests that poor 'mental health literacy' (MHL) is a major factor in low or inappropriate treatment- seeking among individuals with mental health problems. This study sought to determine the beliefs regarding the causes of and risk factors for post-traumatic stress disorder (PTSD) amongst two resettled refugee groups in Australia. Methods: Utilising a culturally adapted MHL survey method, 225 Iraqis and 150 Afghans of refugee background were surveyed. Results: Approximately 52% of the Iraqi participants selected 'experiencing a traumatic event' as the 'most likely' cause for the clinical vignette, whereas 31.3% of the Afghan sample selected 'coming from a war torn country' as their top cause. While both groups identified being 'born in war torn country' as the most likely risk, at 34.4 and 48% of the Iraqis and Afghans respectively, differences regarding other risk factors selected were noted. Conclusions: The results of this study indicate the need for culturally sensitive health promotion and early intervention programs seeking to improve MHL relating to PTSD in resettled refugee populations. There is also a need for mental health services to recognise that variation in MHL may be a function of both the cultural origin of a refugee population and their resettlement experiences. Such recognition is needed in order to bridge the gap between Western, biomedical models for mental health care and the knowledge and beliefs of resettled refugee populations. [ABSTRACT FROM AUTHOR]

Background: Refugees are one of the most vulnerable groups in Australian society, presenting high levels of exposure to traumatic events and consequently high levels of severe psychological distress. While there is a need for professional help, only a small percentage will receive appropriate care for their mental health concerns. This study aimed to determine cultural considerations required when providing mental health first aid to Iraqi refugees experiencing mental health problems or crises. Method: Using a Delphi method, 16 experts were presented with statements about possible culturally-appropriate first aid actions via questionnaires and were encouraged to suggest additional actions not covered by the questionnaire content. Statements were accepted for inclusion in a guideline if they were endorsed by ≥90 % of panellists as 'Essential' or 'Important'. Results: From a total of 65 statements, 38 were endorsed (17 for cultural awareness, 12 for cross-cultural communication, 7 for stigma associated with mental health problems, and 2 for barriers to seeking professional help). Conclusion: Experts were able to reach consensus about how to provide culturally-appropriate first aid for mental health problems to Iraqi refugees, demonstrating the suitability of this methodology in developing cultural considerations guidelines. This specific refugee study provided potentially valuable cultural knowledge required to better equip members of the Australian public on how to respond to and assist Iraqi refugees experiencing mental health problems or crises. [ABSTRACT FROM AUTHOR]

Background: Resources and training for aged care workers who are working with older people from refugee backgrounds are limited. Thus, a resource titled 'Enhancing the Lives of Older Refugees: A self-Improvement Resource for Community Service Providers' was developed in 2011, and later accompanied by a training program developed in 2012. The aim of the resource and accompanying training was to assist community aged care service providers, based in South Western Sydney and surrounding areas, to recognise an older refugee, increase their knowledge and skills in working with older refugees, have a greater understanding of older refugees' life experiences, and provide additional information that would allow them to offer appropriate services to those in their care. This paper reports on the evaluation of the training package provided to community aged care personnel. Methods: Eleven training sessions were conducted with all participants invited to take part in the research. One hundred and twenty-eight consenting participants completed a pre and post training evaluation questionnaire. Results: Analysis of the data indicated a positive change in participant's ability to define an older refugee, understanding older refugee's life experiences, loss and grief, the impact of the refugees' experience in old age and the capacity to locate and access information to support the care of older refugees. Conclusions: The findings lend support that this mode of training can provide information and resources to increase the capacity of aged care workers to better meet the needs of older people from a refugee background. [ABSTRACT FROM AUTHOR]

Background: Resettled refugees are at high risk of trauma-related mental health problems, yet there is low uptake of mental health care in this population. Evidence suggests poor 'mental health literacy' (MHL) may be a major factor influencing help-seeking behaviour among individuals with mental health problems. This study sought to examine the MHL of resettled Afghan refugees in Adelaide, South Australia. Methods: Interviews were completed with 150 (74 males; mean age 32.8 years, SD = 12.2) resettled Afghan refugees living in Adelaide, South Australia. A convenience sampling method was employed and participants were comprised of volunteers from the Afghan community residing in the northern suburbs of Adelaide. Following informed consent participants were presented a culturally appropriate vignette describing a fictional person suffering from posttraumatic stress disorder (PTSD). This was followed by a series of questions addressing participants' knowledge and understanding of the nature and treatment of the problem described. Self-report measures of PTSD symptoms and co-morbid psychopathology were also administered. Results: Thirty-one per cent of the respondents identified the problem depicted in the vignette as being PTSD, while 26 per cent believed that the main problem was 'fear'. Eighteen per cent of participants believed that 'getting out and about more/finding some new hobbies' would be the most helpful form of treatment for the problem described, followed by 'improving their diet' and 'getting more exercise' (16%). Conclusion: The results of this study demonstrate aspects of MHL that appear to be specific to Afghan refugees who have resettled in Australia. They indicate the need for health promotion and early intervention programs, and mental health services, to recognise that variation in MHL may be a function of both the cultural origin of a refugee population and their resettlement country. Such recognition is needed in order to bridge the gap between Western, biomedical models for mental health care and the knowledge and beliefs of resettled refugee populations. [ABSTRACT FROM AUTHOR]

Background: Psychological distress has been well identified in recently resettled refugee groups; however, evidence on psychological distress over time is not conclusive. Australia has welcomed a large refugee population in recent decades, including Iraqis who currently form one of the largest groups being resettled in Australia. Methods: This study aimed to explore psychological distress in two samples of Iraqi refugees, those who recently arrived (n = 225, average length of stay = 0.55 months) and those with a longer period of resettlement (n = 225, average length of stay = 58.5 months). To assess general symptoms of anxiety and depression, the Kessler Psychological Distress Scale was employed. Associations between participants' demographic characteristics and psychological distress levels were examined. Results: A significant difference between groups, t (441) = -2.149, p = 0.0324, was found, indicating that study participants with longer periods of resettlement were experiencing higher levels of psychological distress than recent arrivals. Conclusion: Our findings have implications for both for government and non-government funded organisations who should consider the provision of assistance programs beyond the initial arrival period. [ABSTRACT FROM AUTHOR]

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 (?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. [ABSTRACT FROM AUTHOR]

Objective: Studies that have investigated quality of life (QoL) in eating disorders (EDs) have been focussed on the impact of the ED on QoL and little is known regarding the possible reciprocal impact of QoL on EDs. The aim of this study was to provide a first-time investigation of possible bidirectional relationships between EDs and both health-related QoL (HRQoL) and psychological distress (PD). Method: Structural equation modeling was applied to longitudinal data collected from a community sample of Australian women (N = 828) surveyed at baseline, five annual follow-ups, and again after nine years. Participants reported height and weight (from which body mass index, BMI, was calculated) and completed measures of ED symptoms (Eating Disorder Examination Questionnaire), HRQoL (12-item Medical Outcomes Study Short Form), and PD (Kessler Psychological Distress Scale). Results: Overall, evidence was found for a bidirectional relationship, whereby ED symptoms predicted reduced HRQoL and greater PD over time, while lower levels of HRQoL and greater PD in turn predicted increased levels of ED symptoms. These relationships were stable, observable within 12 months, and remained observable over a time period of at least four years. However, also observed were some inconsistent findings where ED symptoms predicted a short term (one year) improvement in mental HRQoL. This short term boost was not sustained at longer follow-ups. Conclusions: Not only do ED symptoms impact on HRQoL and PD, but perceived poor HRQoL and PD also contribute to ED symptom development or exacerbation. This supports a movement away from symptom-centric approaches whereby HRQoL is conceptualized as a passive outcome expected to be rectified by addressing ED symptoms. Improvement in QoL and PD might rather be viewed as targets to be pursued in their own right under broader approaches in the treatment of EDs. [ABSTRACT FROM AUTHOR]

Background: Resettled refugees are a particularly vulnerable group. They have very high levels of mental health problems, in particular, trauma-related disorders, but very low uptake of mental health care. Evidence suggests that poor “mental health literacy”, namely, poor knowledge and understanding of the nature and treatment of mental health problems is a major factor in low or inappropriate treatment-seeking among individuals with mental health problems. This study used a culturally adapted Mental Health Literacy Survey method to determine knowledge of, and beliefs about, helpfulness of treatment interventions and providers for posttraumatic stress disorder (PTSD) amongst resettled Iraqi refugees. Methods: 225 resettled Iraqi refugees in Western Sydney attending the Adult Migrant English Program (AMEP), federally funded English language tuition, were surveyed. A vignette of a fictional character meeting diagnostic criteria for PTSD was presented followed by the Mental Health Literacy Survey. PTSD symptomology was measured using the Harvard Trauma Questionnaire part IV (HTQ part IV), with Kessler Psychological Distress Scale (K10) used to measure levels of general psychological distress. Results: Only 14.2% of participants labelled the problem as PTSD, with “a problem with fear” being the modal response (41.8%). A total of 84.9% respondents indicated that seeing a psychiatrist would be helpful, followed by reading the Koran or Bible selected by 79.2% of those surveyed. There was some variation in problem recognition and helpfulness of treatment, most notably influenced by the length of resettlement in Australia of the respondents. Conclusions: These findings have important implications for the design and implementation of mental health promotion and treatment programs for resettled refugees and those who work with them. [ABSTRACT FROM AUTHOR]

Psychological distress experienced by resettling refugees has been well documented, with posttraumatic stress disorder (PTSD) and depression being prevalent outcomes. This study examined psychological and physiological measures of trauma exposure in 2 groups of Iraqi refugees resettled in Australia, those seeking psychological treatment (n= 25) versus those not seeking treatment (n= 22). Data from a group of healthy sex- and age-matched controls (n= 32) were collected to facilitate norm comparisons for physiological arousal. Continuous recording of electrocardiogram data examined resting heart rate (HR). Refugees seeking treatment had significantly higher levels of PTSD symptomology and depression levels compared to non-treatment-seeking refugees; however, there was no difference in the number of trauma events endorsed. Finally, resting HR was significantly higher in both refugee groups compared with healthy controls; however, there was no difference between the refugee groups. Clinical consideration of this excessive trauma exposure and elevated autonomic arousal is warranted. [ABSTRACT FROM AUTHOR]

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