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Asylum seekers: general health status and problems with access to health care
I Sinnerbrink1, D M Silove, V L Manicavasagar
1Psychiatry Research and Teaching Unit, School of Psychiatry, University of New South Wales, Sydney.
Objective:
To investigate the general health status of asylum seekers and their access to health services.
Design:
Prospective questionnaire survey.
Setting:
A community-based asylum seeker centre in Sydney from March to September 1994, before the Limited Health Care Assistance Scheme had taken effect.
Participants:
Forty of 57 eligible asylum seekers from 21 different countries attending English language classes.
Main Outcome Measures:
Results on the traumatic events section of the Harvard Trauma Questionnaire, a postmigratory problem checklist, the COOP Functional Health Assessment charts, the Duke-University of Northern Carolina Health Profile, and a structured interview to assess difficulties in accessing health care in Australia.
Results:
More than 30 of the 40 participants reported exposure to past trauma. Asylum seekers were more impaired in their emotional health than a normative group of patients with minor (P < 0.001) and serious (P < 0.001) medical illnesses, and more impaired in role functioning than those with minor medical illnesses (P < 0.001). Twenty or more reported symptoms of nervousness, headache, and/or depression; 28 reported having pain in the previous four weeks. Twenty-seven reported major difficulties in accessing dental services. The same number reported problems in obtaining general medical care; the most important reason cited was not having a Medicare card.
Conclusions:
Although a selective sample, the asylum seekers in our study appeared to be suffering substantial levels of emotional and somatic symptoms, yet, for most, access to health care was a major problem. The effectiveness of recent sequential changes to the provisions covering welfare and health care for asylum seekers needs to be closely monitored.