Background: Finland faced a large inflow of refugees during 2015-2016. That forced the professionals from different fields to reflect on services they produce. Occupational therapy and research among the mental health care of refugees is limited. In order to improve and strengthen services for refugees, we need to listen to their needs. Aim: This study aimed to investigate how adult refugees experience the Finnish mental health services, and what kind of self-perceived well-being elements do adult refugees find as important towards better quality of life. Method: This qualitative grounded theory study consists of six refugee interviews. The data were analysed by qualitative content analysis and the Participatory Occupational Justice Framework was used as a framework for the presentation of the data. Results: The Finnish mental health interventions are mostly available and based on discussion and medication. Information and supporting environment, occupational and social participation, self- direction, and time use are the base of the experienced well-being. The results show that occupational therapy can offer tools for the mental health work among refugees, bring important information of the person´s occupational history, needs, roles, and habits, and it should be taken alongside traditional therapies.

Background: The high prevalence of mental disorders related to posttraumatic stress among Syrian refugees is often in contrast with their low utilization ofmental health care in the host countries. Mental health self-stigma, i.e., internalized stigma of having a mental disorder, could prevent individuals from seeking mental health care. Therefore, we aimed to provide evidence on different aspects of mental health self-stigmatization among adult Syrian refugees with posttraumatic stress symptoms residing in Germany. Moreover, we investigated associations with sociodemographic and psychopathological variables in order to identify those at higher risk of self-stigmatization. Material and Methods: Overall, 133 participants with mild to moderate posttraumatic stress symptoms were recruited in the metropolitan areas of Leipzig, Dresden and Halle, Germany, using a multimodal approach. Mental health self-stigma was assessed using the Self-Stigma of Mental Illness Scale – Short Form (SSMIS-SF), consisting of four subscales (Stereotype awareness, Stereotype agreement, Application to self, Harm to self-esteem), each scoring from 5 (low) to 45 (high) points. Linear regression analysis was used to test associations of sociodemographic and psychopathological variables with self-stigma subscales. Results: On average, self-stigma ratings ranged from 16.5 (SD = 6.6) points on Application to self to 28.3 (SD = 7.5) points on Stereotype awareness. Results showed higher scores on Application to self for individuals who were younger (t =2.65, p=0.009) and single (F = 5.70, p = 0.004). Regression analyses yielded statistically significant associations between having multiple comorbidities and a higher Application to self stigma ( = 0.18, p = 0.044), controlling for sociodemographic covariates. Discussion: Mental health self-stigma was increased among Syrian refugees in Germany. Correlates of increased self-stigma could inform efforts to improve access to mental health care among Syrian refugees with mental ill-health. Longitudinal studies following an intersectional approach by concurrently examining multiple forms of public and internalized stigma could provide helpful insights for developing tailored stigma reduction efforts in this context.

The deterioration of health status for immigrants and refugees is mostly observed after their arrival in Canada. Additionally, immigrant and refugee minorities are at a higher risk for mental health problems. Yet, refugees and immigrants in Canada, particularly those from non-European countries tend to underutilize community resources and mental health services. This study uses a participatory arts-based method of photovoice to gain deeper knowledge of the realities and lived experiences of immigrants and refugees who have or are dealing with mental health problems in Winnipeg. Additionally, it will shed light on the barriers faced by immigrant and refugee community, and the context in which they are unable to access services. Six immigrant and refugee individuals volunteered to participate in this photovoice project. The participants discussed structural barriers, non-recognition of non-Canadian credentials, underemployment/ unemployment, poverty, discrimination, stigma, language barriers, lack of culturally inclusive services, inequality, lack of social network, and marginalization. The findings have implications for social work and future research is discussed. / February 2017