Simone Penka

How to express mental health problems: Turkish immigrants in Berlin compared to native Germans in Berlin and Turks in Istanbul.

The paper explores expressions used by Turkish immigrants in Berlin to delineate psychiatric illnesses and psychological problems. These are compared to expressions used by native Germans in Berlin and Turks in Istanbul to assess possible cultural differences in articulating mental disorders. For this purpose, results of a Free Listing carried out with the three above mentioned groups are presented. The data suggest that relevant items which are connected to mental health issues vary between the groups as well as within the groups, thus showing dependency on factors such as education. For the group of Turkish immigrants the data further suggest that this group connects psychic stress to family problems. Concerning help seeking, Turkish immigrants, like members of the other groups, mention professional psychological/psychiatric help as useful for solving mental health problems.

When local poverty is more important than your income: Mental health in minorities in inner cities

Volkswagen Foundation and the German Federal Ministry for Education and Research . Grant Number: BMBF 01 EL0807

Interkulturelle Aspekte der Interaktion und Kommunikation im psychiatrisch/psychotherapeutischen Behandlungssetting

ZusammenfassungInterkulturelle Behandlungssituationen stellen besondere Anforderungen an die Behandelnden und Patienten/Patientinnen. Die Gesundheitsversorgung von Menschen mit Migrationshintergrund kann deshalb unzureichend sein. Im vorliegenden Beitrag stehen „kommunikative Hindernisse“ im Vordergrund, die für den psychiatrisch/psychotherapeutischen Bereich besonders relevant sind. Neben Sprachbarrieren zählen dazu auch komplexere Verständigungsprobleme, die auf unterschiedlichen Erklärungsmustern über die Ursachen, Kennzeichen und Therapieoptionen bei verschiedenen Erkrankungen basieren. Zur allgemein geforderten interkulturellen Öffnung von medizinischen und psychosozialen Einrichtungen gehört der Einsatz von Sprach- und KulturmittlerInnen, die Berücksichtigung unterschiedlicher Erklärungsmodelle, die Vermeidung von Kulturalisierung und Stereotypisierung sowie eine offene, neugierige und selbstreflexive professionelle Haltung. Verschiedene strukturelle Rahmenbedingungen wie die Finanzierung des Dolmetschereinsatzes und die Auseinandersetzung mit institutionellen Zugangsbarrieren müssen umgesetzt werden, um eine adäquate Versorgung aller Menschen mit Migrationshintergrund zu gewährleisten.AbstractMental health care for migrants is often impaired by a lack of policies and provisions in the respective institutions. This article focuses on “communication barriers” in psychosocial and psychotherapeutic settings, where personal communication is of great importance. Barriers that prevent migrants from using health care institutions include translation problems but also more complex misunderstandings based on divergent explanations regarding the causes, course, and adequate treatment of different disorders. The widely recommended intercultural opening of medical and psychosocial institutions involves using interpreters as cultural experts, reflecting on and mediating between divergent explanatory models, and avoiding cultural and ethnic stereotyping as well as encouraging an open, curious, and reflective professional attitude. With respect to institutional settings, rules for the financing of interpreters are as important as tackling barriers that limit migrants’ access to medical and psychosocial institutions.

Der Stand der interkulturellen Öffnung in der psychosozialen Versorgung- Ergebnisse einer Studie in einem innerstädtischen Berliner Bezirk

The need for intercultural opening of supply facilities for improving access and treatment of people with migration background is acknowledged in Germany. The purpose of the survey was to determine the current state of intercultural opening of psychosocial services in one Berlin district. 127 representatives of institutions were interviewed using a semi-structured assessment tool. The response rate was very high. The cross-cultural opening was implemented on a small scale. Staff as well as users with migration background were underrepresented. Varying and missing standardized documentation as well as problems in assessing users with migration background might be responsible for their low utilization rates. The use of professional interpreters was often not implemented. To judge the low level of implementation of cross-cultural opening in the psychosocial supply system in general, a review of responsible causes is required.

Psychische Störungen bei Menschen mit Migrationshintergrund in Deutschland

Currently the majority of data regarding indicators of psychiatric morbidity of migrant and minority groups in Germany is derived from studies on help-seeking behavior, mental health service use, or data from population studies, which were not specifically aimed at including migrants. Such data are only available for certain groups, for example, population-based studies on psychiatric disorders and suicidal behavior among Turkish migrants have been conducted, while, comprehensive data on the psychiatric morbidity among major migrant groups in Germany are still rather limited. Barriers to recruiting migrants for health studies, difficulties in assessing psychiatric morbidity in multi-cultural samples, observed as feasibility problems, are among the factors that interfere with population-based studies.ZusammenfassungAktuell stehen in Deutschland als Indikatoren für die psychiatrische Morbidität von Menschen mit Migrationshintergrund vorwiegend Daten aus Studien zum Hilfesuchverhalten, zur Inanspruchnahme und aus Studien in der deutschen Allgemeinbevölkerung zur Verfügung. Diese waren allerdings nicht auf die Rekrutierung von Menschen mit Migrationshintergrund hin angelegt. In den vergangenen Jahren erfolgten Erhebungen zur Prävalenz von psychiatrischen Störungen sowie zum suizidalen Verhalten von Menschen mit türkischem Migrationshintergrund, Daten auf der Bevölkerungsebene zu anderen Migrantengruppen fehlen jedoch. Barrieren bei der Rekrutierung von Menschen mit Migrationshintergrund für Studien oder Schwierigkeiten bei ihrer psychiatrischen Diagnostik erschweren die Machbarkeit von populationsbasierten Studien bei dieser heterogenen Bevölkerungsgruppe.AbstractCurrently the majority of data regarding indicators of psychiatric morbidity of migrant and minority groups in Germany is derived from studies on help-seeking behavior, mental health service use, or data from population studies, which were not specifically aimed at including migrants. Such data are only available for certain groups, for example, population–based studies on psychiatric disorders and suicidal behavior among Turkish migrants have been conducted, while, comprehensive data on the psychiatric morbidity among major migrant groups in Germany are still rather limited. Barriers to recruiting migrants for health studies, difficulties in assessing psychiatric morbidity in multi–cultural samples, observed as feasibility problems, are among the factors that interfere with population–based studies.

Lifetime prevalence of mental disorders among first and second generation individuals with Turkish migration backgrounds in Germany

BackgroundThis paper focuses on the lifetime prevalence of mental disorders in individuals with Turkish migration backgrounds in Germany, as there is a lack of reliable epidemiological data on this subject.MethodsIn total, 662 adults with Turkish migration backgrounds were interviewed in Hamburg and Berlin by trained, bilingual interviewers using the computerized Composite International Diagnostic Interview (CIDI DIA-X Version 2.8) to assess diagnoses according to the DSM-IVTR.ResultsThe analyses showed a weighted lifetime prevalence of 78.8% for any mental disorder, 21.6% for more than one and 7.3% for five or more disorders. Any mood disorder (41.9%), any anxiety disorder (35.7%) and any somatoform disorder/syndrome (33.7%) had the highest prevalences. Despite the sociodemographic differences between the first and second generations, there were no significant differences in the lifetime prevalence between generations, with the exception of any bipolar disorder. Female gender, older age and no current partnership were significantly associated with the occurrence of any mood disorder.ConclusionsOverall, the results indicate a high lifetime prevalence in individuals with Turkish migration backgrounds in Germany. These initial data are highly relevant to the German clinical and psychosocial healthcare system; however, the methodological limitations and potential biases should be considered when interpreting the results.

Mental disorders of immigrants in Germany

Currently the majority of data regarding indicators of psychiatric morbidity of migrant and minority groups in Germany is derived from studies on help-seeking behavior, mental health service use, or data from population studies, which were not specifically aimed at including migrants. Such data are only available for certain groups, for example, population-based studies on psychiatric disorders and suicidal behavior among Turkish migrants have been conducted, while, comprehensive data on the psychiatric morbidity among major migrant groups in Germany are still rather limited. Barriers to recruiting migrants for health studies, difficulties in assessing psychiatric morbidity in multi-cultural samples, observed as feasibility problems, are among the factors that interfere with population-based studies.ZusammenfassungAktuell stehen in Deutschland als Indikatoren für die psychiatrische Morbidität von Menschen mit Migrationshintergrund vorwiegend Daten aus Studien zum Hilfesuchverhalten, zur Inanspruchnahme und aus Studien in der deutschen Allgemeinbevölkerung zur Verfügung. Diese waren allerdings nicht auf die Rekrutierung von Menschen mit Migrationshintergrund hin angelegt. In den vergangenen Jahren erfolgten Erhebungen zur Prävalenz von psychiatrischen Störungen sowie zum suizidalen Verhalten von Menschen mit türkischem Migrationshintergrund, Daten auf der Bevölkerungsebene zu anderen Migrantengruppen fehlen jedoch. Barrieren bei der Rekrutierung von Menschen mit Migrationshintergrund für Studien oder Schwierigkeiten bei ihrer psychiatrischen Diagnostik erschweren die Machbarkeit von populationsbasierten Studien bei dieser heterogenen Bevölkerungsgruppe.AbstractCurrently the majority of data regarding indicators of psychiatric morbidity of migrant and minority groups in Germany is derived from studies on help-seeking behavior, mental health service use, or data from population studies, which were not specifically aimed at including migrants. Such data are only available for certain groups, for example, population–based studies on psychiatric disorders and suicidal behavior among Turkish migrants have been conducted, while, comprehensive data on the psychiatric morbidity among major migrant groups in Germany are still rather limited. Barriers to recruiting migrants for health studies, difficulties in assessing psychiatric morbidity in multi–cultural samples, observed as feasibility problems, are among the factors that interfere with population–based studies.

Opioidsubstitution bei heroinabhängigen Patienten mit Migrationshintergrund

ZusammenfassungHintergrundBisher liegen im deutschsprachigen Raum keine regionsumfassenden Untersuchungen zu opioidabhängigen Patienten mit Migrationshintergrund in Substitutionsbehandlung vor.Ziel der ArbeitDie vorliegende Arbeit untersucht, inwieweit sich opioidabhängige Patienten mit und ohne Migrationshintergrund in Substitutionsbehandlung hinsichtlich sozioökonomischer Parameter, Charakteristika der Abhängigkeitserkrankung sowie der Bewertung der Substitutionstherapie unterscheiden.Material und MethodenVon Mai bis Oktober 2011 wurden substituierte Personen in allen 20 psychiatrischen Kliniken sowie den 110 Praxen mit Lizenz zur Opioidsubstitution in Berlin befragt.ErgebnisseVon 986 teilnehmenden Personen machten 956 Angaben zur Herkunft. Davon gaben 204 Personen (21,3 %) einen Migrationshintergrund an. Diese waren, verglichen mit Patienten ohne Migrationshintergrund, signifikant kürzer substituiert, wünschten häufiger eine Möglichkeit zur Beendigung ihrer Substitutionstherapie und sprachen sich häufiger für deren grundsätzliche zeitliche Begrenzung aus.DiskussionDie Unterschiede hinsichtlich der Substitutionsdauer und des Beendigungswunsches können für einen stärkeren Abstinenzwunsch und für eine andere Bewertung der Substitutionstherapie von Personen mit Migrationshintergrund stehen.SummaryBackgroundNo regional analyses regarding opioid-dependent patients in maintenance treatment with a migration background have so far been performed in German-speaking countries.ObjectivesThis study examined patients with and without a migration background regarding socioeconomic parameters, characteristics of dependency and attitude towards opiate maintenance treatment (OMT).Material and methodsFrom May to October 2011 patients in OMT from all of the 20 psychiatry clinics and 110 physician practices in Berlin with a licence to provide OMT were included in this analysis.ResultsOut of the 986 participating patients, 956 gave information on migration background and of these, 204 (21.3 %) originated from a country other than Germany. Compared to patients without a migration background, their participation in a maintenance program was significantly shorter and they more often expressed a desire to end OMT and wanted a limited duration of OMT.ConclusionThe differences regarding duration of OMT and the wish to end OMT can reflect a stronger desire for abstinence and a different attitude towards maintenance treatment of patients with a migration background.BACKGROUND No regional analyses regarding opioid-dependent patients in maintenance treatment with a migration background have so far been performed in German-speaking countries. OBJECTIVES This study examined patients with and without a migration background regarding socioeconomic parameters, characteristics of dependency and attitude towards opiate maintenance treatment (OMT). MATERIAL AND METHODS From May to October 2011 patients in OMT from all of the 20 psychiatry clinics and 110 physician practices in Berlin with a licence to provide OMT were included in this analysis. RESULTS Out of the 986 participating patients, 956 gave information on migration background and of these, 204 (21.3 %) originated from a country other than Germany. Compared to patients without a migration background, their participation in a maintenance program was significantly shorter and they more often expressed a desire to end OMT and wanted a limited duration of OMT. CONCLUSION The differences regarding duration of OMT and the wish to end OMT can reflect a stronger desire for abstinence and a different attitude towards maintenance treatment of patients with a migration background.

Psychische Störungen bei Menschen mit Migrationshintergrund in Deutschland@@@Mental disorders of immigrants in Germany

Currently the majority of data regarding indicators of psychiatric morbidity of migrant and minority groups in Germany is derived from studies on help-seeking behavior, mental health service use, or data from population studies, which were not specifically aimed at including migrants. Such data are only available for certain groups, for example, population-based studies on psychiatric disorders and suicidal behavior among Turkish migrants have been conducted, while, comprehensive data on the psychiatric morbidity among major migrant groups in Germany are still rather limited. Barriers to recruiting migrants for health studies, difficulties in assessing psychiatric morbidity in multi-cultural samples, observed as feasibility problems, are among the factors that interfere with population-based studies.ZusammenfassungAktuell stehen in Deutschland als Indikatoren für die psychiatrische Morbidität von Menschen mit Migrationshintergrund vorwiegend Daten aus Studien zum Hilfesuchverhalten, zur Inanspruchnahme und aus Studien in der deutschen Allgemeinbevölkerung zur Verfügung. Diese waren allerdings nicht auf die Rekrutierung von Menschen mit Migrationshintergrund hin angelegt. In den vergangenen Jahren erfolgten Erhebungen zur Prävalenz von psychiatrischen Störungen sowie zum suizidalen Verhalten von Menschen mit türkischem Migrationshintergrund, Daten auf der Bevölkerungsebene zu anderen Migrantengruppen fehlen jedoch. Barrieren bei der Rekrutierung von Menschen mit Migrationshintergrund für Studien oder Schwierigkeiten bei ihrer psychiatrischen Diagnostik erschweren die Machbarkeit von populationsbasierten Studien bei dieser heterogenen Bevölkerungsgruppe.AbstractCurrently the majority of data regarding indicators of psychiatric morbidity of migrant and minority groups in Germany is derived from studies on help-seeking behavior, mental health service use, or data from population studies, which were not specifically aimed at including migrants. Such data are only available for certain groups, for example, population–based studies on psychiatric disorders and suicidal behavior among Turkish migrants have been conducted, while, comprehensive data on the psychiatric morbidity among major migrant groups in Germany are still rather limited. Barriers to recruiting migrants for health studies, difficulties in assessing psychiatric morbidity in multi–cultural samples, observed as feasibility problems, are among the factors that interfere with population–based studies.

[Maintenance treatment in opioid-dependent patients with migration background].

ZusammenfassungHintergrundBisher liegen im deutschsprachigen Raum keine regionsumfassenden Untersuchungen zu opioidabhängigen Patienten mit Migrationshintergrund in Substitutionsbehandlung vor.Ziel der ArbeitDie vorliegende Arbeit untersucht, inwieweit sich opioidabhängige Patienten mit und ohne Migrationshintergrund in Substitutionsbehandlung hinsichtlich sozioökonomischer Parameter, Charakteristika der Abhängigkeitserkrankung sowie der Bewertung der Substitutionstherapie unterscheiden.Material und MethodenVon Mai bis Oktober 2011 wurden substituierte Personen in allen 20 psychiatrischen Kliniken sowie den 110 Praxen mit Lizenz zur Opioidsubstitution in Berlin befragt.ErgebnisseVon 986 teilnehmenden Personen machten 956 Angaben zur Herkunft. Davon gaben 204 Personen (21,3 %) einen Migrationshintergrund an. Diese waren, verglichen mit Patienten ohne Migrationshintergrund, signifikant kürzer substituiert, wünschten häufiger eine Möglichkeit zur Beendigung ihrer Substitutionstherapie und sprachen sich häufiger für deren grundsätzliche zeitliche Begrenzung aus.DiskussionDie Unterschiede hinsichtlich der Substitutionsdauer und des Beendigungswunsches können für einen stärkeren Abstinenzwunsch und für eine andere Bewertung der Substitutionstherapie von Personen mit Migrationshintergrund stehen.SummaryBackgroundNo regional analyses regarding opioid-dependent patients in maintenance treatment with a migration background have so far been performed in German-speaking countries.ObjectivesThis study examined patients with and without a migration background regarding socioeconomic parameters, characteristics of dependency and attitude towards opiate maintenance treatment (OMT).Material and methodsFrom May to October 2011 patients in OMT from all of the 20 psychiatry clinics and 110 physician practices in Berlin with a licence to provide OMT were included in this analysis.ResultsOut of the 986 participating patients, 956 gave information on migration background and of these, 204 (21.3 %) originated from a country other than Germany. Compared to patients without a migration background, their participation in a maintenance program was significantly shorter and they more often expressed a desire to end OMT and wanted a limited duration of OMT.ConclusionThe differences regarding duration of OMT and the wish to end OMT can reflect a stronger desire for abstinence and a different attitude towards maintenance treatment of patients with a migration background.BACKGROUND No regional analyses regarding opioid-dependent patients in maintenance treatment with a migration background have so far been performed in German-speaking countries. OBJECTIVES This study examined patients with and without a migration background regarding socioeconomic parameters, characteristics of dependency and attitude towards opiate maintenance treatment (OMT). MATERIAL AND METHODS From May to October 2011 patients in OMT from all of the 20 psychiatry clinics and 110 physician practices in Berlin with a licence to provide OMT were included in this analysis. RESULTS Out of the 986 participating patients, 956 gave information on migration background and of these, 204 (21.3 %) originated from a country other than Germany. Compared to patients without a migration background, their participation in a maintenance program was significantly shorter and they more often expressed a desire to end OMT and wanted a limited duration of OMT. CONCLUSION The differences regarding duration of OMT and the wish to end OMT can reflect a stronger desire for abstinence and a different attitude towards maintenance treatment of patients with a migration background.