Healthy minds – where to start?

As part of our mental health refugee project funded by Stichting Dioraphte a group of experts of civil society organizations such as Dokters van de wereld, IPSY, Mind Spring, Team Ed, and SaNour (Syrische artsen Nederlandse ondermemers uw raadgevers) gathered around the table to discuss the importance of “early recognition, acknowledgment and treatment of psychological problems amongst refugees and newcomers”.

Where and when are symptoms visible and who can recognize them? Often in the Dutch primary care system refugees and newcomers are misunderstood, psychological problems are not recognized and wrong referrals are given. This stagnates the process of good integration in the Dutch society and can cause severe mental problems, which may have been prevented with adequate early detection.

During the meeting it became clear that persons directly related to newcomers in their daily life, like family, friends, language teachers, neighbors and translators are key for early recognition of mental problems. The main reasons for newcomers to deny or hide their mental problems are taboo, stress, fear or too much focus on basic life necessities. It became clear that the support newcomers receive from various government and non-government organizations during the integration process is often scattered and lacks collaboration. Newcomers have no idea where to go and have difficulty to understand the Dutch health care system.

A possible solution to improve cohesion between civil society organizations and primary care is the involvement of cultural mediators or coaches. They can bridge the gap between the so called “zero and 1st line” mental care for newcomers. In addition, the praktijk ondersteuner huisarts (POH) can play a role in early recognition of mental problems and an intake meeting with the general practitioner together with the POH should be obligatory for all newcomers. The importance of training was also mentioned. The round table participants mentioned that if Health[e]Foundation can train as many general practitioners and POHs as possible in cultural sensitivity and special refugees care this may significantly improve the understanding of newcomers and lead to better care of this group. In addition, newcomers themselves should also be given training in “how the Dutch healthcare system works?” during their integration process.

The evening ended with the conclusion that it had been a very interesting and informative “round table meeting” with lots of ideas and solutions. Thanks to all the participants for their contributions and useful insights, to be continued!