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      “Let’s manage the stressor today” exploring the mental health response to forced migrants in Johannesburg, South Africa

      research-article
      Rebecca Walker , Jo Vearey
      International Journal of Migration, Health and Social Care
      Emerald Publishing
      Migration, Well-being, South Africa, Refugees, Trauma, Mental Health, Health-care, Health systems

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          Abstract

          Purpose

          In South Africa, the majority of the population struggles to access care and support for mental health challenges. Drawing on challenges faced by asylum seekers and refugees in the urban margins of Johannesburg, this paper aims to explore the relationship between migration and mental health through a lens of heightened vulnerability, precarious urban spaces and unmet basic needs.

          Design/methodology/approach

          Remote interviews were conducted with respondents working in the mental health-care sector (public and private) and with migrant communities in Johannesburg. Respondents were identified via purposive sampling and interviews were conducted in English. Key findings were identified using thematic analysis.

          Findings

          Effective responses to asylum seekers and refugees facing mental health challenges are based on an understanding of context, of crisis and of the need to meet basic needs such as paying rent, finding employment and providing for families. These “daily stressors” not only compound “extreme traumatisation” but are a form of trauma in and of itself.

          Originality/value

          This paper shows how alternative responses determined by an understanding of context, of crisis and of the need to meet basic needs provide critical and potentially far-reaching interventions. Locating trauma in the unmet needs, precarious urban spaces and marginalisation opens up space to further question the ways that migration and mental health shape and reshape one another.

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          Most cited references48

          • Record: found
          • Abstract: found
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          Impact of the COVID-19 Pandemic on Mental Health and Quality of Life among Local Residents in Liaoning Province, China: A Cross-Sectional Study

          Our study aimed to investigate the immediate impact of the COVID-19 pandemic on mental health and quality of life among local Chinese residents aged ≥18 years in Liaoning Province, mainland China. An online survey was distributed through a social media platform between January and February 2020. Participants completed a modified validated questionnaire that assessed the Impact of Event Scale (IES), indicators of negative mental health impacts, social and family support, and mental health-related lifestyle changes. A total of 263 participants (106 males and 157 females) completed the study. The mean age of the participants was 37.7 ± 14.0 years, and 74.9% had a high level of education. The mean IES score in the participants was 13.6 ± 7.7, reflecting a mild stressful impact. Only 7.6% of participants had an IES score ≥26. The majority of participants (53.3%) did not feel helpless due to the pandemic. On the other hand, 52.1% of participants felt horrified and apprehensive due to the pandemic. Additionally, the majority of participants (57.8–77.9%) received increased support from friends and family members, increased shared feeling and caring with family members and others. In conclusion, the COVID-19 pandemic was associated with mild stressful impact in our sample, even though the COVID-19 pandemic is still ongoing. These findings would need to be verified in larger population studies.
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            • Record: found
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            No health without mental health.

            About 14% of the global burden of disease has been attributed to neuropsychiatric disorders, mostly due to the chronically disabling nature of depression and other common mental disorders, alcohol-use and substance-use disorders, and psychoses. Such estimates have drawn attention to the importance of mental disorders for public health. However, because they stress the separate contributions of mental and physical disorders to disability and mortality, they might have entrenched the alienation of mental health from mainstream efforts to improve health and reduce poverty. The burden of mental disorders is likely to have been underestimated because of inadequate appreciation of the connectedness between mental illness and other health conditions. Because these interactions are protean, there can be no health without mental health. Mental disorders increase risk for communicable and non-communicable diseases, and contribute to unintentional and intentional injury. Conversely, many health conditions increase the risk for mental disorder, and comorbidity complicates help-seeking, diagnosis, and treatment, and influences prognosis. Health services are not provided equitably to people with mental disorders, and the quality of care for both mental and physical health conditions for these people could be improved. We need to develop and evaluate psychosocial interventions that can be integrated into management of communicable and non-communicable diseases. Health-care systems should be strengthened to improve delivery of mental health care, by focusing on existing programmes and activities, such as those which address the prevention and treatment of HIV, tuberculosis, and malaria; gender-based violence; antenatal care; integrated management of childhood illnesses and child nutrition; and innovative management of chronic disease. An explicit mental health budget might need to be allocated for such activities. Mental health affects progress towards the achievement of several Millennium Development Goals, such as promotion of gender equality and empowerment of women, reduction of child mortality, improvement of maternal health, and reversal of the spread of HIV/AIDS. Mental health awareness needs to be integrated into all aspects of health and social policy, health-system planning, and delivery of primary and secondary general health care.
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              • Record: found
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              • Article: not found

              Barriers to mental health treatment: results from the WHO World Mental Health surveys.

              To examine barriers to initiation and continuation of mental health treatment among individuals with common mental disorders.
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                Author and article information

                Contributors
                Journal
                IJMHSC
                10.1108/IJMHSC
                International Journal of Migration, Health and Social Care
                IJMHSC
                Emerald Publishing
                1747-9894
                1747-9894
                31 August 2022
                16 March 2023
                : 19
                : 1
                : 1-15
                Affiliations
                [1]The African Centre for Migration and Society (ACMS), The University of Witwatersrand , Johannesburg, South Africa
                Author notes
                Rebecca Walker can be contacted at: bexjwalker@gmail.com
                Article
                690647 IJMHSC-11-2021-0103.pdf IJMHSC-11-2021-0103
                10.1108/IJMHSC-11-2021-0103
                01191697-87fd-4012-872c-10cdfb44b40c
                © Rebecca Walker and Jo Vearey

                Published by Emerald Publishing Limited. This article is published under the Creative Commons Attribution (CC BY 4.0) licence. Anyone may reproduce, distribute, translate and create derivative works of this article (for both commercial and non-commercial purposes), subject to full attribution to the original publication and authors. The full terms of this licence may be seen at http://creativecommons.org/licences/by/4.0/legalcode

                History
                : 11 November 2021
                : 05 March 2022
                : 05 March 2022
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 35, Pages: 15, Words: 9022
                Categories
                research-article, Research paper
                cat-HSC, Health & social care
                cat-VG, Vulnerable groups
                cat-IDMG, Inequalities & diverse/minority groups
                cat-SOCY, Sociology
                cat-RES, Race & ethnic studies
                cat-MIN, Minorities
                cat-SOCY, Sociology
                cat-RES, Race & ethnic studies
                cat-MLT, Multiculturalism
                cat-SOCY, Sociology
                cat-RES, Race & ethnic studies
                cat-RIL, Racial identity
                cat-SOCY, Sociology
                , Work
                , economy & organizations
                cat-LMOV, Labour movements
                Custom metadata
                Z
                Web-ready article package
                Yes
                Yes
                JOURNAL
                excluded

                Health systems,Migration,Well-being,South Africa,Refugees,Trauma,Mental Health,Health-care

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