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1 Information om Transkulturel Psykiatri, februar 2003 Her er, hvad vi har valgt at viderebringe af informationer indenfor området. Du opfordres til selv at gå til kilden, bl.a. ved hjælp af de links, der er indsat. Vi modtager meget gerne dine kommentarer til "Information om Transkulturel Psykiatri", og hvis du har informationer vedrørende transkulturel psykiatri, som vi tilsyneladende ikke har kendskab til, vil vi blive meget glade for at modtage dem og sende dem ud til en bredere kreds via kommende udsendelser. Der er ingen fast udsendelsesfrekvens. Du er meget velkommen til at videresende denne mail til andre, som du mener kan have glæde af informationerne. Hvis du har modtaget denne mail via en anden, men selv ønsker at abonnere på Information om Transkulturel Psykiatri så send en mail med angivelse af navn og gerne ansættelsessted og stillingsbetegnelse. Hvis du ikke længere ønsker at modtage "Information om Transkulturel Psykiatri" så send os en mail med den besked. Helle Rasmussen, Informationskoordinator Videnscenter for Transkulturel Psykiatri tlf. : Skriv til os Danske nyheder om transkulturel psykiatri generelt om psykiatri Kalender marts april maj juni september oktober november Videnskabelig litteratur Danske nyheder om transkulturel psykiatri Fælles udtalelse fra Lægeforeningen og Integrationsministeriet Dato: 30/01/03 Lægeforeningen og Integrationsministeriet vil på grund af en række artikler i dagspressen i dag præcisere, at det parterne tirsdag blev enige om var, at anvende standardiserede lægeattester vedr. helbredsoplysninger til brug for ministeriets sagsbehandling. Læger har oplevet, at udlændingemyndighederne har efterspurgt lægeattester med meget kort tidsfrist og med spørgsmål, som læger ikke meningsfuldt kan besvare. Omvendt har udlændingemyndighederne set lægeerklæringer med et indhold, de ikke har fæstet lid til. Lægeforeningen gav på mødet tilsagn om at formidle kontakt til speciallæger med særlig viden til brug for ministeriets sagsbehandling. Aftalen har følgende indhold: At Lægeforeningen på baggrund af et udkast fra ministeriet skal udarbejde en særlig blanket, som fremover skal benyttes ved indhentelse af helbredsoplysninger fra læger og psykiatere i sager om humanitær opholdstilladelse. Erklæringernes indhold tilpasses herved ministeriets behov for oplysninger. Det forventes, at anvendelsen af denne blanket vil kunne træde i kraft samtidig med lovændringerne i udlændingeloven den 1. maj Information om Transkulturel Psykiatri, februar

2 At Lægeforeningen fremover vil være ministeriet behjælpelig med anvisning af en kvalificeret læge eller psykiater i tilfælde, hvor ministeriet i en sag om humanitær opholdstilladelse har behov for at indhente en objektiv vurdering af en ansøgers helbredstilstand. Dette kan efter ministeriets opfattelse være relevant i tilfælde, hvor en modtaget erklæring ikke kan lægges til grund for behandlingen af sagen, idet ministeriet ikke finder, at den fremtræder uvildig, men subjektiv, eller hvis der i øvrigt er tvivl om erklæringens saglighed. Behandling af traumatiserede flygtninge Kommunernes Landsforenings hjemmeside 13. februar 2003 Indenrigs- og Sundhedsminister Lars Løkke Rasmussen har i et brev til samtlige kommuner meddelt, at han har besluttet ikke at fremsætte lovforslag vedrørende frit valg til de tre behandlingscentre for traumatiserede flygtninge OASIS, CEPAR og RCT-Jylland. Hermed tilsidesætter ministeren en af anbefalingerne i rapporten fra foråret 2001 fra Sundhedsministeriets arbejdsgruppe vedrørende rehabilitering af traumatiserede flygtninge (http://www.im.dk/publikationer/rehabtrauma/index.htm) og punktet vedrørende behandling af traumatiserede flygtninge i den senere aftale mellem Amtsrådsforeningen og den daværende regering Ministeren begrunder beslutningen med uenighed mellem ministeriet og de kommunale parter omkring finansieringen, idet det ikke har været muligt at opnå enighed om, at der i finansieringen af fritvalgsrammen til de tre centre kan modregnes udgifter, som kommuner har afholdt frivilligt uden særskilt hjemmel eller forpligtelser i lovgivningen. KLs kommentarer til Lars Løkke Rasmusssens beslutning kan læses i sin helhed i dette nyhedsbrev : på integrationsområdet nr. 104.doc Etniske sindssyge ladt i stikken Information 19. februar 2003, af Rasmus Lindboe Landets største afdeling for kriminelle sindssyge beder nu socialminister Henriette Kjær om hjælp til at tackle et stigende antal patienter med indvandrerbaggrund. Psykisk syge indvandrere belaster hospitalernes retpsykiatriske afdelinger i så høj grad, at landets største hospital for psykisk syge nu slår alarm. Indvandrere savner viden om psykiske sygdomme Information 20. februar 2003 / Af Rasmus Lindboe Sindssyge kriminelle med indvandrerbaggrund er et stigende problem på retspsykiatriske afdelinger. Nyt projekt retter søgelyset mod indvandrerkredse Sindssyge indvandrere med grov kriminalitet på samvittigheden udgør en stadig større del af patienterne på landets retspsykiatriske afdelinger. Derfor skal en ny projekt sætte fokus på indvandrer- og flygtninge familier. Det oplyser overlæge Marianne Kastrup, Videnscenter for Transkulturel Psykiatri under Rigshospitalet. Det landsdækkende center er oprettet netop for at løse problemerne med flere psykisk syge indvandrere. NB : Kommentar fra Videnscenter for Transkulturel Psykiatri Der er beklageligvis opstået en misforståelse. Videnscentret påtænker ikke for nærværende at igangsætte et projekt, der retter sig mod indvandrerforeningerne. Raske kriminelle ingen adgang Information 25. februar Af Rasmus Lindboe Chefen på landets største hospitalsafdeling for kriminelle sindssyge er træt af enten at blive anklaget for at lade patienterne flygte eller pumpe dem fulde af medicin Udlændinge med særlige undervisningsbehov Ministeriet for Flygtninge, Indvandrere og Integration En del af de udlændinge, der kommer til Danmark, er traumatiserede eller har et fysisk eller psykisk handicap. Ofte har behovene for denne målgruppe ført til spørgsmål som: Hvilke regler og finansieringsbestemmelser gælder Information om Transkulturel Psykiatri, februar

3 egentlig på dette område, hvor flere aktører og myndigheder spiller sammen? Hvordan kan der rent praktisk skabes et godt samarbejde mellem de forskellige faglige ekspertiser? Vejledning om undervisning af voksne udlændinge med særlige undervisningsbehov (januar 2003) Formålet med antologien er at beskrive målgruppen og synliggøre og kvalificere et fagligt og institutionelt svagt funderet område i voksenundervisningen. Antologien beskriver erfaringer for god praksis og faglighed, som er udviklet i samarbejde mellem danskundervisning og andre fagområder, især specialundervisningen for voksne. Vejledningen indeholder: En gennemgang af relevante lovregler Visitationen på sprogcentre Specialpædagogisk støtte Samarbejdet mellem sprogcentre og den amtslige specialundervisning Lærer- og vejlederkvalifikationer Vejledningen er udsendt til samtlige amtskommuner, kommuner, centerkommuner, specialundervisningsinstitutioner for voksne samt sprogcentre. Vejledningen er desuden tilgængelig på ministeriets hjemmeside : Studietur om transkulturel psykiatri til Tyrkiet Steffen Høy Pedersen, Kirsten Behnke, Hanne Calberg, Christian Nørregaard & Kirsten Skougaard Ugeskrift for Læger, nr. 6, pp , 2003 Hvordan skal vi forstå de tyrkiske patienter? Det spørgsmål ville en gruppe danske psykiatere gerne have svar på. Derfor tog de på en studietur til Tyrkiet for at finde ud af, hvordan den tyrkiske psykiatri arbejder i en islamisk sammenhæng. At skynde sig langsomt Etnisk opsøgende At man skal skynde sig langsomt og med respekt i kontakten, er nogle af de konklusioner som psykolog Aytekin Coskun nåede frem til efter at have lavet et stort opsøgende arbejde blandt sindslidende med anden etnisk baggrund på Vesterbro i København. Udgangspunktet er ikke egentligt Støtte- og KontaktPersons-arbejde, men mange af problemstillingerne og erfaringerne fra Vesterbro, vil uden tvivl kunne inspirere når man overvejer hvordan SKPindsatsen kan blive et reelt tilbud, også til mennesker med anden etnisk baggrund end dansk Socialpsykiatri 1 : 10-11, 2003 Om flygtningebørn : kan det gøres bedre? / af Ingrid Busck Flygtningebørn og familier er en del af vores samfund, og de skal have samme målrettede hjælp som andre ramte børn og familier. Nu er det tid til at løfte flygtningebørnene højere op på dagsordenen I efteråret 2002 blev der på tankevækkende vis rettet fokus mod psykologers forpligtelser over for en udsat gruppe børn i det danske samfund: traumatiserecte flygtningebørn. Det skete ikke mindst gennem tre temaarrangementer, som i høj grad havde adresse til danske psykologer. Psykolognyt 3: 3-7, 2003 FOKUS udbyder kurser m.h.b.p. traumatiserede flygtninge Dansk Flygtningehjælp På baggrund af bevilling fra Integrationsministeriet til i en 4 årig periode ( ) at have særligt fokus på integrationsarbejdet, særligt i forhold til Traumatiserede flygtningefamilier og børn Traumatiserede flygtninge og deres muligheder for tilknytning til arbejdsmarkedet De etniske minoriteters egne organisationer og deres rolle i forhold til traumatiserede flygtninge udbyder Dansk Flygtningehjælp fra foråret 2003 kurser i hele landet til kommunalt ansatte medarbejdere i form af en kursuspakke bestående af et 1-dags kursus om "Traumatisering og den professionelle hjælperrolle", et 2-dags kursus om "Traumatiserede flygtningefamilier og børn samt det tværsektorielle kommunale samarbejde" og en opfølgningsdag med fokus på det tværsektorielle samarbejde om traumatiserede flygtninge. Målgruppen for kurserne er sagsbehandlere i integrationsafdelinger, i børne- familieafdelinger og i arbejdsmarkedsafdelinger, jobkonsulenter, sundhedsplejersker, pædagoger i daginstitutioner folkeskolelærere og medarbejdere i PPR ordninger, der arbejder med eller kommer i berøring med traumatiserede flygtninge. Underviser på kurserne er socialrådgiver og psykoterapeut Grete Svendsen, som siden 1983 har arbejdet med Information om Transkulturel Psykiatri, februar

4 behandling og rådgivning af flygtninge, dels som leder i behandlingsinstitutionen OASIS og af Dansk Flygtningehjælps Psykosociale Projekt ( ). Siden 2002 ansat som konsulent i Dansk Flygtningehjælps Psykosociale Enhed. Undervisningen er gratis, men der opkræves et mindre beløb til lokaler, forplejning, materiale m.v. Kursusprogram med tilmeldingsblanket vil blive tilsendt de enkelte kommuner. Den første kursusrunde udbydes som følger: Jylland Syd: , og Jylland Midt: , og Jylland Nord: , og Bornholm: , og Sjælland og øer: , og Hovedstaden: , og I 2004 og 2005 følger endnu en kursusrunde. Yderligere information kan fås hos Grete Svendsen eller Vibeke Hallas, Dansk Flygtningehjælp, tlf eller eller mobil eller via generelt om psykiatri Ny psykiatriaftale Amtsrådsforeningens hjemmeside 24. januar Amtsrådsforeningen tiltræder en ny psykiatriaftale for perioden Aftalen afsætter en milliard kroner fordelt over fire år, heraf 600 mio. kr. til sundhedsområdet og 400 mio. kr. til socialområdet. Cirka 300 mio. kr. skal bruges til at videreføre aktiviteter fra den forrige psykiatriaftale. På sundhedsområdet er blandt andet 200 mio. kr. øremærket enestuer og anlægsaktiviteter, 120 mio. kr. til nedbringelse af ventetider i børne- og ungdomspsykiatrien og 200 mio. kr. til særlige formål. Midlerne på socialområdet er fordelt mellem indsatsen for børn og unge, dobbeltdiagnosticerede og centrale initiativer Brugerundersøgelser i psykiatrien på tværs af amter Århus amts hjemmeside Brugerne bliver i større og større udstrækning systematisk inddraget i kvalitetsudviklingen af amternes ydelser. Nordjyllands Amt, Ribe Amt og Århus Amt har taget fælles initiativ til at gennemføre brugerundersøgelser i psykiatrien. I to nye rapporter er det for første gang blevet muligt i en lettilgængelig og overskuelig form at sammenligne brugernes tilfredshed på tværs af amterne. Sammenligninger viser, at der på nogle områder er større eller mindre forskelle i brugernes tilfredshed, men generelt giver syv ud af ti patienter behandlingen i psykiatrien topkarakter. Rapporterne kan ses på de enkelte amters hjemmesider Psykiatrien i Nordjyllands Amt: under linket Psykiatri. Psykiatrien i Århus Amt: Psykiatrien i Ribe Amt: Amterne effektiviserer på psykiatriområdet Amtsrådsforeningens hjemmeside 19. februar Amtsrådsforeningen har fortaget en kortlægning af ændringerne i psykiatrien (sygehus-, distrikts- og socialpsykiatrien) i amterne i forbindelse med budget Hovedkonklusionen er, at amterne samlet set sparer 38,4 mio. kr. fra forventet regnskab 2002 til budget 2003 på psykiatriområdet. Den største del af besparelserne findes ved effektivisering af området. Detaljerne kan læses her : Rapport om skærmning i psykiatrien Amtsrådsforeningens hjemmeside 19. februar Rapporten kan læses her : Kalender Information om Transkulturel Psykiatri, februar

5 marts 2003 Faglig sammenslutning for sygeplejersker, der arbejder med tværkulturel sundheds- og sygepleje Landskursus, Odense Vandrerhjem Begrænset deltagerantal - nr2 21. marts 2003, 14 dage Ayurveda : Kursus i Sydindien Dansk Etnomedicinsk Selskab Afrejse søndag den 23. marts 2003 Dag 1. Afrejse fra Danmark via London kl til Bombay og Trivandrum med ankomst den 24. marts. Dag 2 : Ankomst til Sometheeram tidligt om morgenen ca. kl Ayurveda - en introduktion. v/ Dr. C.A. Raman Chief Physician Præsentation af gruppens forventning. Dag Introduktion til yoga Ayurvedaens elementer (doshaer), Vata, Pitta og Kapha gennemgås. v/ Dr. R. Sreelatha Massage er et meget vigtigt element i en forebyggende eller genoprettende behandling. Her gennemgås forskellige massageteknikker Massage Dag Yoga Gennemgang af behandlingsformer v/ Dr. R. Hareendran Nair, Dr. B. Sreedevi og Dr. Anil Kumar Gruppearbejde. Kursusdeltagerne deles i grupper og gennemgår sammen med en lokal læge et af følgende emner: Kostforståelse Immunsystemet Patient eksamination Medicinering Behandlinger Gruppearbejde, praktiske øvelser og patientbehandlinger. Dag Pulsdiagnose Yoga Gruppearbejdet fortsætter Andre behandlinger Præsentation. Grupperne præsenterer de væsentligste konklusioner fra deres gruppearbejde. Dag Yoga Ayurveda og Vesten Besøge det ayurvediske hospital i Thrivandrum. Stuegang. Dag Yoga Kursusafslutning og evaluering. Afrejse fra Sometheeram til Coching. Efter indcheckning på hotellet er resten af dagen til fri disposition. Dag 8 ( ) Coching Sightseeing i Coching En af Sydindiens mest interessant byer, der kaldes The Queen of the Arabian Sea. Byens huse er en blanding af britisk kolonistil, og huse inspireret af kinesisk, arabisk og portugisisk byggeskik. Gennem de senere år er det den moderne indiske byggestil eller mangel på samme, der har sat sit præg på byen. Men Coshing er en multikulturel smeltedigel, og en aftentur gennem byen vil kalde os tilbage til virkeligheden efter vores dage på Someteheeram. Om eftermiddagen besøger vi et lokalt hospital eller finder et noget andet spændende at besøge. Dag 9 Munar Vi kører fra Coching op til Munar, som er en af de smukkeste sydindiske hillstations. Munar var sommerresidens for den engelske administration og bærer stadig præg af det. På vej op til byen kører vi forbi masser af teplantager, hvor de grønne tebuske ligger som et tæppe af grøn vat. I Munar starter vores trek gennem området omkring Anamundi, Sydindiens højeste bjerg med 2695 moh. Dag 10 Trek En rolig trekkingtur gennem den smukke, frodige og stedsegrønne natur, som udgør Kerala s Hill områder. Teplantager, smukke søer og et fantastisk fugleliv venter os. Trekket er ikke vanskeligt. Overnatning i fast teltlejr. Dag 11 Trek Turen fortsætter gennem Keralas smukke natur. Overnatning i fast teltlejr. Dag 12 Kerala Efter endt trek kører vi til Kollam, en typisk sydindisk by. Her skal vi finde vores husbåde, der skal danne hjem for os de næste to nætter. Efter anstrengelserne i bjergene er husbådene ren afslapning. Backwaters er det tætteste man kan komme på Edens Have. I vores store husbåde med kurvemøbler og belevent personale sejler vi gennem det system af floder og søer, der udgør Backwaters. Omkring os er landsby og flodliv, som man oplever intenst og helt tæt på. I udhulede stammer stager fiskerne sig forbi, net bliver kastet, og man gribes af fornemmelsen af at intet har forandret sig Information om Transkulturel Psykiatri, februar

6 de sidste tusinde år. Dag 13 Husbåd Backwaters, - sidste nat i paradis. Dag 14 Soma. Vi kører tilbage til Sometheeram, og måske bliver der tid til en enkelt massagetur inden afskedsmiddagen. Sidst på aftenen kører vi til lufthavnen og vores ventende fly, der skal bringe os tilbage til hverdagen i Danmark. Dag april 2003 Hjemrejse tidligt om morgenen og ankomst til København kl Flere oplysninger ved at maile til : hjemmeside : 4. april 2003, kl Symposium: The new psychiatric diseases Dansk Selskab for Psykiatrisk Epidemiologi (DSPE) i samarbejde med Videnscenter fortranskulturel Psykiatri og Interessegruppen for psykosomatik og Liasonpsykiatri, Dansk Psykiatrisk Selskab København, Rigshospitalet, Psykiatrisk Auditorium Med den stigende grad af multietnicitet i Danmark kan forekomsten af psykiske lidelser tænkes ændret. Dette gælder især de ikke psykotiske lidelser. Er der tale om nye sygdomme, eller er det gammel vin på nye flasker? Dette tema vil blive belyst Ankomst og sandwiches. Velkomst ved Henrik Day Poulsen, formand for DSPE. The occurrence of psychiatric diseases among immigrants (Preliminary title)prof. Dinesh Bhugra, Institute of Psychiatry, London Mental Health Consequences of Severe Traumatization including Torture, overlæge, lic med Marianne Kastrup, Videnscenter for Transkulturel Psykiatri Pause med te og kaffe Cost-effectiveness of Psychotherapy and Paroxetine for Severe Irritable Bowel Syndrome, Professor of Psychological Medicine Francis Creed, University Department of Psychiatry, Rawnsley Building, Manchester Royal Infirmary, Manchester From epidemiology to intervention in functional somatic Syndromes, overlæge, dr.med. Morten Birket-Smith, Liaisonpsykiatrisk H:S Enhed, Bispebjerg Hospital. Diskussion Chairman: Læge, ph.d Henrik Day Poulsen, Rigshospitalet, Formand for DSPE. Rejseudgifter, maks. 500 kr. vil blive refunderet for medlemmer af DSPE fra Fyn og Jylland ved fremsendelse af bilag til læge Pia Jeppesen, Børne- og ungdomspsykiatrisk afdeling F, Bispebjerg Hospital. Arrangementet er muliggjort ved støtte fra Janssen-Cilag, Pfizer og Lundbeck. Tilmelding er ikke nødvendig Medlemskab af DSPE koster 150 kr. årligt. Giroindbetalingskort fås ved henvendelse til sekretær Helen Nielsen, Psykiatrisk afdeling, Rigshospitalet,:: april 2003 Psyko-biologiske aspekter af PTSD Oasis, Behandling og Rådgivning for Flygtninge Todages kursus, som tager udgangspunkt i sammenhængen mellem de neuro-biologiske og psykologiske aspekter af PTSD, især m.h.p. en forståelse af ekstreme og langvarige stresspåvirkninger. Kurset vil bl.a. indeholde følgende temaer Traumers påvirkning af centralnervesystemet og hukommelsesfunktionen Gennemgang og drøftelse af begrebet ekstrem psykotraumatisering (DESNOS) Psykosociale behandlingsmetoder Medikamentel behandling København 15. april Information om Transkulturel Psykiatri, februar

7 Kommunikation og etnicitet Arrangør: MET forskningscenter ved Københavns Universitet og Videnscenter for Socialpsykiatri. Yderligere information og tilmelding: Nummer tre i en række af seks temadage om etnicitet og psykosocial sundhed april 2003 Mennesker der har anden etnisk baggrund Dansk Sygeplejeråd, Nordjyllands Amtskreds Arbejder du med mennesker der har anden etnisk baggrund? Mangler du, i dette arbejde viden og kvalifikationer som sygeplejerske? Dansk Sygeplejeråd Nordjyllands Amtskreds afholder kursus i emnet. Alle interesserede sygeplejersker kan deltage uanset ansættelsessted. Hvilken betydning har religion, kultur og tradition for sygdomsforløb og forestillinger om døden? Hvilken indflydelse har det på dig, som sygeplejerske at arbejde med mennesker der har en anden etnisk baggrund end dansk? Indhold: Med udgangspunkt i kristendom og islam arbejdes der med indføring i trosindhold og dogmer, syn på sygdom, ære og skam, dødsforestillinger, dommedag og frelse. Troens religiøse indhold perspektiveres i forhold til kultur, etnicitet, tradition og racisme. Der arbejdes endvidere med, hvordan professionelle sygeplejersker kan arbejde indenfor dette arbejdsområde, uanset hvor mødet finder sted. Dansk Sygeplejeråd, Sofiendalsvej 3, 9200 Aalborg maj 2003 Træning i kollegial supervision ud fra et interkulturelt perspektiv Oasis, Behandling og Rådgivning for Flygtninge Todages kursus med fokus på, hvordan man i form af kollegial supervision kan støtte hinanden i sit arbejde med de ofte vanskelige flygtningesager og modvirke udbrændthed. Kurset er tilrettelagt som en vekselvirkning mellem teoretiske oplæg og træning i supervisionsgrupper. Følgende temaer vil blive inddraget: Den kollegiale supervisions metode Brug af reflekterende team i gruppesupervision Forskellige niveauer i supervisionsprocessen Det interkulturelle perspektivs indflydelse på arbejdet København 13. maj 2003 Samverkan eller motverkan mellan olika sjukvårdstraditioner? Transkulturellt Centrum, Stockholms Läns Lansting Människor söker ofta vård i olika medicinska traditioner samtidigt (t ex komplementär medicin, folkmedicin). Seminariet syftar till att belysa hur olika vårdtraditioner kan samverka eller motverka varandra i olika kulturer inklusive Sverige. En prisbelönad videofilm av doc Antti Pakaslahti, Helsingfors Universitet, kommer att visas. Stockholm 19. maj 2003 Belastninger i arbejdet med flygtninge Oasis, Behandling og Rådgivning for Flygtninge Endags kursus. At arbejde med flygtninge og dermed blive vidne til deres traumatiske baggrund udsætter behandleren for en alvorlig stressfaktor, som kan føre til sekundær traumatisering, dvs. behandleren belastes med nogle af de samme symptomer som klienterne. Følgende temaer vil være centrale: Behandleres reaktion på traumatiserede flygtninge Færdigheder i at håndtere egne følelsesmæssige reaktioner Strategier der mindsker risikoen for sekundær traumatisering København maj 2003 Information om Transkulturel Psykiatri, februar

8 VIII European Conference on Traumatic Stress European Society for Traumatic Stress Studies Berlin juni 2003 Tibetansk medicin Dansk Etnomedicinsk Selskab Flere oplysninger ved at maile til : hjemmeside : september 2003, Essen Ethnicity & Mental Health in Europe Satellite Conference (following the Annual Meeting of the DTGPP) Organized by the Section on Transcultural Psychiatry of the German Association of Psychiatry & Psychotherapy (DGPPN) Supported by the German Association of Psychiatry & Psychotherapy (DGPPN) and the World Psychiatric Association (WPA) Summary : The change in Europe towards multicultural societies has lead to a growing demand for an adaptation of health care services to the necessities of migrants. Despite increased psychosocial stressors for this population, there is no evidence of an increased rate of mental disorders, but there are several difficulties that arise in the care of persons suffering from these disorders. These problems start with difficulties in the access to care for the migrant population, but also in diagnosing and treating the disorders. The gap on cultural awareness can lead to misdiagnosis as other mental disorders or as somatic disorders, mainly due to differences in syndromal presentation, delaying or impeding the necessary treatment of these disorders. Due to the demands that arise within the European unification process, it is necessary to bring together the different experiences of ethnicity and mental health research from all European countries, in order to develop a network for future research activities in the field. It will also be necessary to incorporate experiences of ethnicity and mental health research from other continents. Wielant Machleidt (Hannover), chairman Christian Haasen (Hamburg), co-chairman Program for Saturday, Sept. 20 th, 2003 (open to DTGPP-Congress participants) Topics : Epidemiology Access to care Treatment: pharmacological issues Treatment: psychotherapeutic issues Treatment: psychosocial issues Psychosis Somatization and depression Addiction Traumatized refugees Ethnicity & mental health research in the Americas Ethnicity & mental health research in the Africa & Middle East Speakers and/or participants Ethnicity & mental health research in Asia Country reports: Ethnicity & mental health research in Europe Program for Sunday, Sept. 21 st, 2003 (closed expert sessions) Round table discussions Research networking in the field of ethnicity & mental health in Europe Initiation of a research journal on ethnicity & mental health Developing guidelines for culture sensitive psychiatric services Norman Sartorius (Switzerland) Luis Alejandro Caballero (Spain) Miguel Casas (Spain) Goffredo Bartocci (Italy) Marianne Kastrup (Denmark) Edvard Hauff (Norway) Sofie Baarnhielm (Sweden) Riyadh Al-Baldawi (Sweden) Kaan Kora (Turkey) Robin Murray (UK) John Cox (UK) Joop de Jong (Netherlands) Jim van Os (Netherlands)Fragiskos Gonidakis (Greece) Ledia Lazeri (Albania) Joan Obiols (Andorra) Wielant Machleidt (Germany) Christian Haasen (Germany) Hans-Joerg Assion (Germany) Thomas Heise (Germany) Wolfgang Krahl (Germany) Pedro Ruiz (USA) Juan Mezzich (USA) Tarek Okasha (Egypt) oktober 2003, Montreal Information om Transkulturel Psykiatri, februar

9 The Society for the Study of Psychiatry and Culture : annual meeting Hjemmeside : Videnscenter for Transkulturel Psykiatri oktober november Antropologisk metode Dansk Etnomedicinsk Selskab 3 kursusaftner i København Flere oplysninger ved at maile til : hjemmeside : november 2003 Vestlig og traditionel medicin i Indien og Nepal Dansk Etnomedicinsk Selskab Flere oplysninger ved at maile til : hjemmeside : november 20023, Malta For better mental health through deeper understanding and more adaptive dissemination The Transcultural Psychiatry Section of the World Psychiatric Association, Caretranslate International Network anduniversity of Malta Invite interested persons to participate in Psychiatric Care Across Cultures Venue: Golden Tulip Vivaldi Hotel St Julians, Malta. Participants are also encouraged to write papers on any of the three themes covered by its program, as outlined below: Program and Themes It is the time-honoured practice of WPA TPSection to hold its symposia at venues that promise to provide the best platform at the time for the launch of its message. Malta has been chosen for the WPA TP Section Symposium 2003 so that a meeting of professional minds can take place at the centre of cross-currents of extreme cultural importance. The initiative comes equally from the University of Malta and Caretranslate International Network. We are also working in collaboration with the World Islamic Association for Mental Health and the Istituto Italiano Igiene Mentale Transculturale. 8 November evening: registration for TP Section Symposium; informal discussion and social activity for participants November: CONFERENCE 1: WPA TP Section Symposium 2003 Conference 1 will be dedicated to two themes: Theme 1A : Psychiatry Across Cultures As is the custom, members of WP ATP Section will update participants about the progress of their work in cross-cultural psychiatry. Non-members will join the members of the Transcultural Psychiatry Section in discussing papers about this vigorously growing subject. One session will be dedicated to papers written by non-members. One must keep in mind that this was the branch of psychiatry that attracted the largest number of participants in the XII WORLD CONGRESS OF PSYCHIATRY IN YOKOHAMA, Here an opportunity is offered to reopen and extend this lively debate, as a stepping stone to XII WORLD CONGRESS OF PSYCHIATRY, to be held in Cairo in Theme 1B (same as 2C): Migration and Acculturative Stress (covered in both Conference 1 and Conference 2) Migrants face challenges to their mental health throughout the various stages of their experience, from well before they depart to long after they have arrived at their destination. Many issues call for discussion and dialogue: issues of theoretical understanding, service adaptation and treatment response; personal, family and community issues of acceptance and engagement in treatment and care; problems of adjustment to culture that are faced by of both sides. This important international topic has been widely requested November: CONFERENCE 2: First Pan Mediterranean Conference on Psychiatry and Cultures, incorporating Caretranslate Conference 2 will be dedicated to three themes: Theme 2A (mainly first day): Mental Health in the light of Islam and Related Cultures This theme addresses the religious and other core components of culture that impinge on mental health and on illness and its care within the vast parts of the world and among the scattered minorities that follow the call of Islam. It is hoped that better mutual understanding will promote not only better mutual learning and cooperation, but also better self understanding and more appropriate care within whichever culture and service system one operates. Theme 2B (mainly second day): Adapting Service to Culture, Capability and Need The dissemination of good policy, service design and practice calls for adaptations to the realities of the receiving country or ethnic group. Papers are sought that communicate experiences and improve the collected know how of such adaptation so as to make the service congruent with the culture, the resource and organisational capability, as well as the need, that characterise the receiving context. (See Note About Theme 2B, below). Theme 2C (same as 1B): Migration and Acculturative Stress (covered in both Conference 1 and Conference 2 description above) 13 November: To be mainly dedicated to cultural events. The morning may be used for further paper presentations if required. Information om Transkulturel Psykiatri, februar

10 Further Notes Notes about the Conference, Accommodation and Social Activities Conference Organisers Papers collected in the form of a CD-ROM and hard copies of the abstracts will be distributed to participants at the conference, and covered by registration fees. Note: A paper will not be published in the CD ROM or in the s unless at least one author registers for the conference. Please take note of the following important dates: 15 June 2003: Deadline for submission of abstracts ( words). 1 August 2003: last date for hotel booking 31 August 2003: Deadline for papers, in camera ready state to be submitted by (or fax, number +(356) , where is unavailable). See note below re submission and format requirements. Early submission of abstracts ( words) is encouraged. English will be the language of the proceedings of the conference. A social program will be organised for participants and accompanying persons both during and outside conference hours. The conference secretariat is november november 2003 Videnscenter for Socialpsykiatri VISP og Københavns Universitet MET Etnicitet og psykosocial sundhed - en seminarrække for virksomme indenfor det socialpsykiatriske område Kulturhuset Bryggen, København Videnskabelig litteratur Long-term consequences of unrecognised PTSD in general outpatient psychiatry / Suad Al- Saffar (1)(2), Per Borgå (3), Tore Hällström (2) (1) Unit of Mental Health, Stockholm Center of Public Health, Box 17533, Stockholm, Sweden. (2) Section for Psychiatry, Neurotec Department, Karolinska Institutet, Stockholm, Sweden (3) Karolinska Institutet Danderyd Hospital, R&D section, Psychiatric Clinic, Danderyd, Sweden Background: Although a number of studies have shown a high prevalence of PTSD in the population, the diagnosis has hardly been recognised in general psychiatric practice. This raises two important questions. How widespread is extreme trauma and PTSD in the general psychiatry population? How does the long-term outcome among patients with PTSD differ from that of other psychiatric patients? The present study examines a psychiatry outpatient population in which none of the patients have received the primary diagnosis of PTSD. Method: The 233 patients from four ethnic groups who, during a period of 1 year, visited a psychiatric outpatient clinic were asked, 3-4 years later, to complete a questionnaire that included the Self-rating Inventory for Posttraumatic Stress Disorder. Patients were divided into probable PTSD and non-ptsd. Subjects with probable PTSD were compared with non-ptsd, regarding outcome at follow-up. Results: The response rate was 56%. Fifty-three patients fulfilled the instrument's diagnostic criteria for PTSD, whereas 62 did not. In the foreign-born groups PTSD patients constituted a majority (53-69 %) compared to 29% of Swedish-born patients. Although the clinic's original diagnoses and assessment of immediate treatment outcome did not differ between the two groups, PTSD patients did not report improvement to the same extent and had poorer self-rated health at follow-up (p < 0.001) as well as lower participation in working life. Conclusions: A high proportion of PTSD and poorer outcome for PTSD patients compared to other psychiatric patients warrants a primary focus upon PTSD in outpatient psychiatry. Key words PTSD - outpatient psychiatry - outcome - ethnicity - work - self-rated health Social Psychiatry and Psychiatric Epidemiology, 37(12) : , 2002 Anger in adolescents: sex, ethnicity, age differences, and psychometric properties. / Reyes LR, Meininger JC, Liehr P, Chan W, Mueller WH. BACKGROUND The State-Trait Anger Expression Inventory (STAXI), a self-report questionnaire, is designed to measure the experience and expression of anger. Reliability and validity of the STAXI have been well established among African and European Americans aged 13 years and older. However, little is known of the use of this instrument among adolescents younger than 13 years and Hispanic American adolescents.objectives Objectives were (a) to test ethnic, sex, and age group differences in STAXI scores in a sample of 11-to-16-year-old African, Hispanic, and European American adolescents; and (b) to assess the psychometric properties of the STAXI among these same Information om Transkulturel Psykiatri, februar

11 adolescents with special emphasis on Hispanic youths, for whom no data are available.methods A cross-sectional design was used with stratified quota sampling techniques. Participants ( = 394) were African, Hispanic, and European Americans aged years and were drawn from one public middle school and two public high schools in Houston, Texas.RESULTS Internal consistency reliability for the anger scales (STAXI) ranged from 0.61 (anger-in) to 0.91 (stateanger) for the younger group (aged years), and 0.68 (anger-in) to 0.88 (state-anger) for the older Hispanic Americans (aged 14-16). No notable differences were seen among the three ethnic groups in regards to internal consistency. Results of factor analyses of the five anger scales were similar to those reported originally by the scale author. Ethnicity and age had statistically significant main effects on the anger scales, and there was only one interaction.discussion The use of the STAXI among a tri-ethnic adolescent population is warranted. The anger-in scale may be less reliable, especially among younger adolescents. Nursing research 52(1):2-11, 2003 (Jan-Feb) Schizophrenia: illness impact on family members in a traditional society - rural Ethiopia / T. Shibre (2), D. Kebede (2), A. Alem (3), A. Negash (2), N. Deyassa (2), A. Fekadu (3), D. Fekadu (3), L. Jacobsson (1), G. Kullgren (1) (1) Psychiatry, Dept Clinical Sciences, Umeå University, Umeå, Sweden. (2) Dept. of Community Health, Addis Ababa University, Addis Ababa, Ethiopia (3) Dept. of Psychiatry, Addis Ababa University, Addis Ababa, Ethiopia Background: Studies have consistently shown that both the subjective and objective dimensions of burden among family members of schizophrenia patients and other psychiatric disorders are prevalent. However, as most of these reports were from western societies, we lack information on the subject in developing countries. Method: The study was conducted within the framework of the ongoing epidemiological study of course and outcome of schizophrenia and bipolar disorders in a rural population of years of age. Three hundred and one cases of schizophrenia and their close relatives participated in the study. Results: Family burden is a common problem of relatives of cases with schizophrenia. Financial difficulty is the most frequently endorsed problem among the family burden domains (74.4 %). Relatives of female cases suffered significantly higher social burden (Z = 2.103; p = 0.036). Work (Z = 2.180; p = 0.029) and financial (Z = 2.088; p = 0.037) burdens affected female relatives more often than males. Disorganised symptoms were the most important factors affecting the family members in all family burden domains. Prayer was found to be the most frequently used coping strategy in work burden (adj. OR = 1.99; 95 % CI = ; p = 0.026). Conclusion: Negative impact of schizophrenia on family members is substantial even in traditional societies such as those in Ethiopia where family network is strong and important. The scarce existing services in the developing countries should include family interventions and support at least in the form of educating the family members about the nature of schizophrenia illness and dealing with its stigma and family burden. Key words schizophrenia - family - burden - impact - coping - Ethiopia Social Psychiatry and Psychiatric Epidemiology 38(1) : 27-34, 2003 Traumatic events, migration characteristics and psychiatric symptoms among Somali refugees : Preliminary communication / Kamaldeep Bhui (1)(2), Abdisalama Abdi (2), Mahad Abdi (3), Stephen Pereira (4), Mohammed Dualeh (5), David Robertson (6), Ganesh Sathyamoorthy (6), Hellena Ismail (7) (1) Barts & The London Medical School, Institute of Community, Health Sciences, Queen Mary, London E1 4NS, UK. (2) Barts & The London Medical School, Institute of Community, Health Sciences, London, UK (3) Greenwich Networks, 37 Charlton Church Lane, Greenwich, UK (4) GKT Medical School, Guy's Hospital London, UK (5) Refugee Council, London, UK (6) Sainsbury Centre for Mental Health, London, UK (7) Horn of Africa Community Group, Hammersmith, UK. Background: Each refugee group experiences specific migration and resettlement experiences. There are no epidemiological data on risk factors for psychiatric symptoms among adult Somalis in the UK. Methods: We interviewed a community sample of 180 Somalis. We assessed the relationship between symptoms of psychosis (BPRS), anxiety and depression (SCL-90) and suicidal thinking (BDI) and migration-related experiences such as traumatic events, immigration difficulties, employment and income. Results: Anxiety and depression was incrementally more common with each pre-migration traumatic event (OR per trauma event = 1.31, , p = 0.01). Shortages of food, being lost in a war situation, and being close to death and suffering serious injury were each related to specific psychiatric symptoms. Suicidal thinking was more common among Somalis who were unemployed before migration and those using qat in the UK. Conclusions: War-related experiences, occupational status before migration and current Qat use are risk factors for psychiatric symptoms among Somali refugees. Key words Somali - refugees - epidemiology - psychiatric - symptoms - migration Social Psychiatry and Psychiatric Epidemiology 38(1) : 35-43, 2003 Too tired to care? The psychological effects of working with trauma / S. COLLINS RMN BSc(Hons) DMS DipHE(CBT) PGDip MSc MCGI & A. LONG This quantitative and qualitative longitudinal study was designed to examine the effects on caregivers working Information om Transkulturel Psykiatri, februar

12 therapeutically with seriously traumatized people. The participants were 13 healthcare workers seconded into a trauma and recovery team (TRT) set up to help those traumatized by the Omagh bombing on 15 August Quantitative data were collected using the Compassion Satisfaction/Fatigue Test and the Life Status Review Questionnaire. Qualitative data regarding positive and negative aspects of working with traumatized individuals, as well as caregiver's experience leaving the TRT, were gathered using open-ended questions contained in the final data set. These questionnaires were completed at four points in time: August 1998, December 1998, August 1999 and February Ethical approval for the study was gained from the Sperrin Lakeland Trust research committee. Analysis of the quantitative data indicated that levels of compassion fatigue and burnout increased, respectively, from to and to over the first year. Levels of compassion satisfaction decreased from to 80.15, while levels of satisfaction with life (53.85 to 40.38) and life status (11.23 to 5.62) also decreased. Findings also demonstrated that compassion satisfaction is possibly a protective factor against compassion fatigue and burnout, in that caregivers with high compassion satisfaction scores were less likely to have corresponding high compassion fatigue and burnout scores. Findings from the qualitative data generated, revealed that team spirit and camaraderie, along with the satisfaction of seeing clients recover, were the most positive aspects of working in the team. Media interest, coping with and containing anger shown by bereaved relatives and dealing with the content of client's stories were the most negative. Themes to emerge from leaving the team included lack of understanding and support from non-trauma managers and an underestimation of the impact on caregivers of finishing in the team. Strategies that were found to be beneficial in helping to alleviate the negative effects of working with trauma were also elicited. This research has implications for practice, management and education. Journal of Psychiatric & Mental Health Nursing 10(1) : 17-27, 2003 Should there be separate psychiatric services for ethnic minority groups? Bhui K, Sashidharan P.Barts & London Medical School, Department of Psychiatry, Queen Mary & Westfield College, University of London, 327 Mile End Road, London E1 4NS, UK. Centre for Community Mental Health, University of Central England, Birmingham B15 3TN, UK. Introduction For decades there have been calls for psychiatric services to be more culturally competent. Frustration with a perceived slow pace of change has led to the development of separate services. For instance, in the USA, San Francisco General Hospital has psychiatric wards with different ethnic focuses East Asian Americans, African Americans and Hispanic Americans are admitted to different wards. In the UK, the National Health Service has developed culturally specific services as well as funding voluntary sector services that target specific cultural or ethnic minority groups. Are such developments the correct way forward? Do they produce lasting change or just let general services off the hook? Can they work in major cities like London, Paris or New York where over a hundred languages are spoken? We asked Dr Bhui, author of a Maudsley discussion paper on separate services, and Professor Sashidharan, who is currently working on a national plan for ethnic minority psychiatry in the UK, to debate the question: Should there be separate psychiatric services for ethnic minority groups? The authors borrow heavily from the UK experience but the arguments for and against will have resonance internationally and inform other debates, such as whether there should be specific facilities for women. British journal of psychiatry 182 : 10-12, 2003 Ethnic variations in pathways to and use of specialist mental health services in the UK : Systematic review / Kamaldeep Bhui, Mrcpsych And Stephen Stansfeld, Frcpsych, Department Of Psychiatry, Barts And The London, Queen Mary's School Of Medicine And Dentistry, London, Uk Sally Hull, Md, Department Of General Practice And Primary Care, Barts And The London, Queen Mary's School Of Medicine And Dentistry, London, Uk Stefan Priebe, Md And Funke Mole, Msc, Department Of Psychiatry, Barts And The London, Queen Mary's School Of Medicine And Dentistry, London, Uk Gene Feder, Md, Department Of General Practice And Primary Care, Barts And The London, Queen Mary's School Of Medicine And Dentistry, London, Uk Funding from London National Health Service Research and Development Mental health services are unattractive to people in some ethnic groups, who complain of more-coercive treatments and adverse experiences. Bhui et al, in a systematic review, identify ethnic variations in pathways to specialist mental health services, continuity of contact, and compulsory psychiatric in-patient admission. Strong evidence of variation between ethnic groups exists. Black people are over-represented among in-patients, and Asian patients use in-patient facilities less often than White patients do. Black people traverse more complex pathways to care, and in in-patient units are up to four times more likely to experience a compulsory admission compared with White people. Black people do not appear to fall out of contact more often than others do. Background Inequalities of service use across ethnic groups are important to policy makers, service providers and service users. Aims To identify ethnic variations in pathways to specialist mental health care, continuity of contact, voluntary and compulsory psychiatric in-patient admissions; to assess the methodological strength of the findings. Method A systematic review of all quantitative studies comparing use of mental health services by more than one ethnic group in the UK. Narrative analysis supplemented by meta-analysis, where appropriate. Results Most studies compared Black and White patients, finding higher rates of in-patient admission among Black patients. The pooled odds ratio for compulsory admission, Black patients compared with White patients, was 4.31 (95% CI ). Black patients had more complex pathways to specialist care, with some evidence of ethnic variations in Information om Transkulturel Psykiatri, februar

13 primary care assessments. Conclusions There is strong evidence of variation between ethnic groups for voluntary and compulsory admissions, and some evidence of variation in pathways to specialist care. British journal of psychiatry 182 : , 2003 Migration as a risk factor for schizophrenia: a Danish population-based cohort study / Cantor- Graae E, Pedersen CB, McNeil TF, Mortensen PB. Lund University, Malmo, Sweden. Aarhus University, Denmark. Lund University, Lund, Sweden. Aarhus University, Denmark. Background A growing body of evidence suggests that migration is a risk factor for the development of schizophrenia, although the putative mechanism remains obscure. Aims To examine immigrant background and history of foreign residence as risk factors for schizophrenia. Method Using data from the Danish Civil Registration System, we established a population-based cohort of 2.14 million persons resident in Denmark by their fifteenth birthday. Schizophrenia in cohort members and parental psychiatric disorder were identified by cross-linkage with the Danish Psychiatric Case Register. Results The relative risk of developing schizophrenia was 2.45 (95% Cl ) and 1.92 (95% Cl ) among first- and second-generation immigrants respectively, and 1.60 (95% Cl ) among Danes with a history of foreign residence. Conclusions Migration confers an increased risk for schizophrenia that is not solely attributable to selection factors and may also be independent of foreign birth British journal of psychiatry 182 : , 2003 Coping with Concerns: An Exploratory Comparison of Australian, Colombian, German, and Palestinian Adolescents / Erica Frydenberg Associate Professor, Faculty of Education, University of Australia; Ramon Lewis Associate Professor, Institute for Education, La Trobe University, Melbourne, Victoria, Australia Gregor Kennedy Educational Researcher, The Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne Ruben Ardila Professor of Psychology, National University of Colombia, Bogota, Colombia Wolfgang Frindte Professor and Head of the Communication Psychology Unit, Department of Psychology, University of Jena, Germany Rasmiyah Hannoun Professor, Clinical Psychology. He has spent a year as visiting professor in Birmingham, Alabama Consistent with an emphasis on positive psychology, and on ability rather than deficit, this study of adolescents in 4 communities sought to examine how young people cope with their concerns. Samples of Australian, Colombian, German, and Palestinian students completed the general form of the Adolescent Coping Scale, an 80-item instrument used to measure coping. A comparison of young people's usage of 3 coping styles and 18 coping strategies within these communities indicated that Palestinian youth report greater usage of all but three strategies (namely, physical recreation, relaxation, and tension reduction), and German youth report the least usage of 2/3 of the strategies assessed. Both Palestinian and Colombian youth were noted to utilize more seek to belong, focus on the positive, social action, solving the problem, seeking spiritual support, and worry than were German or Australian adolescents. When the relative usage of coping strategies within national settings was considered, some noticeable differences were apparent. For example it was found that regardless of the national setting young people reported most frequent use of working hard and use of problem solving strategies. When it comes to more culturally determined activities such as physical recreation, the Australian and German students ranked this strategy more highly in their coping repertoires than do the Colombians, and more noticeably, the Palestinian students. For example, although physical recreation is ranked as the second most commonly used strategy for the German sample, it is ranked 16th by the Palestinians. The study demonstrates the importance of identifying coping strategies that are reflective of each community under investigation. Similarity in coping cannot be assumed across different student populations. Consequently caution needs to be exercised when importing coping programs from one community to another. Keywords coping, cross-cultural, adolescents Journal of Youth and Adolescence 32 (1): 59-66, February 2003 Toward a Culture-informed Epidemiology : Combining Qualitative and Quantitative Research in Transcultural Contexts / Joop T. V. M. de Jong and Mark Van Ommeren Vrije Universiteit Amsterdam This article presents a model for research that aims to address challenges in transcultural psychiatric epidemiology. The model involves eclectic application of quantitative and qualitative techniques, namely: focus groups, in-depth interviews, snowball sampling and population surveys. The qualitative methods help provide information on the context of symptoms, illness experience and disease. These methods provide the background information needed to shape research questions, to modify instruments for local situations, and to interpret collected epidemiological data. Examples are provided. Transcultural Psychiatry 39(4) :422pp., 2002 Information om Transkulturel Psykiatri, februar

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