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Health in Sweden

Health in Sweden. Improving mental health of asylum seekers and new arrivals in Sweden*. Helsinki, Feburary 7 th 2017. ”Hälsa i Sverige för asylsökande och nyanlända” [SWE]. Uppdrag Psykisk Hälsa, SALAR. The Swedish Associations of Local Authorities and Regions (SALAR).

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Health in Sweden

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  1. Health in Sweden Improving mental health of asylum seekers and new arrivals in Sweden* Helsinki, Feburary 7th2017 ”Hälsa i Sverige för asylsökande och nyanlända” [SWE]. Uppdrag Psykisk Hälsa, SALAR

  2. The Swedish Associations of LocalAuthorities and Regions (SALAR) SALAR representsSweden’s: • 290 municipalities • 20 countycouncils/regions • Weact as an employer’s organisation, and defendand promote the interests of ourmembers.

  3. Schedule • Background • The process • Health in Sweden - National implemenation • Outcome

  4. Largestnumberofpeopleofdisplacedpeoplesince WWII Asylum applicants in the EU 2005-2015 (Thousands) Photo source: http://www.dailymail.co.uk/news/article-2304980/Images-war-A-child-wanders-amid-rubble-dust-town-called-home-looks-like-film-set-apocalyptic-future.html (17-01-16 11:31) Source: http://www.migrationsinfo.se/migration/eu/asylsokande-i-eu/

  5. http://www.unhcr.org/576408cd7.pdf

  6. http://www.unhcr.org/576408cd7.pdf

  7. Asylumseekers inSweden 163 000

  8. Motivation to act on mental health? Humanitarian causes Multiplestressesof migration Poor mental health1 Economically (Samhällsekonomisktlönsamt) • Illhealthinterferes with integration • Strain on public systems • Potential to benefit Sweden 1) Socialstyrelsen. Psykisk ohälsa hos asylsökande och nyanlända migranter - Ett kunskapsunderlag för primärvården. Socialstyrelsen, Artikelnummer 2015-1-19

  9. Schedule • Background • The process • SALAR applied to the Ministry of Health and Social Affairs to do a preporatorystudy • Health in Sweden - National implementation • Outcome

  10. PreporatorystudyOctober 2015 – March 2016 Purpose Improving the immigration process (in terms ofhealthcare). To increase mental health and to reducesufferingamongasulymseekers and newlyarrived

  11. PreporatorystudyOctober 2015 – March 2016 How? management/personnel asylumseekers/newlyarrived

  12. Steps From good examples to nation wide dissemination PreporatorystudyOctober 2015 – March 2016 1. Identification of good practice (tools and methods) 2. Tool enhancement together with national experts 3. Live test in a ”pilot County” 4. Products ‘tried and tested’ for nation wide dissemination

  13. Preporatory studyOctober 2015 – March 2016 End ”Products” Digital tool for planning/follow-up Basic education of specialists Telephone-/video support Online sharingof best practice Severe mental illness Health Group Group Session Guide Online self-careadvice (in progress) Mild to moderate mental illness Health information Adapted for language/culture Basic education Migration & mental health Health Screening Health promotion & prevention

  14. Preporatory studyOctober 2015 – March 2016 ExampleMaterials for personell thatperformHealth Screenings Questionnaire (template) Model for improvedprocess Picture based information/ invitation

  15. Example • Aids for personell to manage support groups PreporatorystudyOctober 2015 – March 2016 3. Session guide (preparations, topics, movies) 1. Screening questions 2. Template to introduce offer 4. Diplomatemplate (for participants)

  16. PreporatorystudyOctober 2015 – March 2016 Example Information films for asylumseekers • Topics • Health effectsof migration • Trauma and stress • The Swedish healthcare system • Sleep, excercise & nutrition • Alcohol and narcotics • Languages • Swedish • English • Arabic • Somali • Tigrinja • Dari

  17. Preporatory studyOctober 2015 – March 2016 Online tool for sharinggoodexamples- 89 so far • 6 Severe • 15 Mild to moderate • 74 Health promotion & Prevention

  18. Schedule • Background • The process • Health in Sweden - National implementation • Outcome

  19. 2016 – Health in Sweden For asylum seekers and newly arrived Goal Implementation i all regions 2016 (30 million SEK in June) Method Traintrainers to reach all personelwithtools and knowledge

  20. Program plan (Timeline)

  21. 20 of21 countiesanalyzed the need for betterways to aidasylumseekers and new arrivals In cooperationwith SALAR • 17 countiesgathered in total 310 webbforms from different services. • 3 countiesdidindepententanalyses. • 1 county is planning to a needsassesment. Independently Planning to Countiesthatundertood a needsassesment.

  22. Assementrevealsbigneeds over all Averagepercentageofreportedneed* Severe mental illness • Offer services • Educatepersonel • Guidance to personel (tutoring) 47% 66% 60% Mild to moderate mental illness • Offer services • Educatepersonel • Guidance to personel (tutoring) 62% 66% 60% Health promotion/prevention • Materials and metods to givehealth information • Materials and methods to conducthealthexams • Offer promotive and preventivecare • Educatepersonel on migration and effects om mental health 75% 31% 63% 78% Källa: Behovsanalyser i 17 landsting/regioner genomförda via webbformulär under aug-okt 2016 * Genomsnittlig andel som uttryckte ett behov i de 17 landstingen/regionerna

  23. Courses and materials Daycourses for trainers + materials Severe mental illness • Basic knowledgeabout Trauma • Lifespan Integration (Treatmentmethod)* • Migration and mental health – for psychiatrists Mild to moderate mental illness • To givehealth information + health support in group • Basic knowledgeabout Trauma • Lifespan Integration (Treatmentmethod)* • Migration and mental health – for Primary Care • Migration and mental health – for School Health Services • Managinggroup support and transformation Health promotion & Prevention • What the entire organization should know! • To give health information + health support in group • Orientationskills for unaccompanied minors • New arrivals as a resource • Improved metods for healthexams • Migration and mental health – basicknowledge *Not in train the trainerconcept

  24. ”Products”, tools - For trainers - For professionals - For asylumseekers

  25. For trainers Outlayofcourses • Theory • Tools • Discussion on implementation Ex. materials for trainingothers • Manual • Presentation (slides, movies)

  26. Schedule • Background • The process • Health in Sweden - National implementation • Outcome

  27. Fall/winterdaycourseshavebeen given 23 timeswith 1000 participants in total 1000 participants • 14 different daycourses (8 on multipleoccations) • 1000 participants 2016, 500 spring 2017 • Ca 88% ofparticipants from counties, others from municipalities or governmentalagencies (ex employmentoffice). • 55% ofparticipantsareexplicitlycommited to trainingothers. • Averageappreciationofcources: 4,17 outof 5

  28. If everyotherparticipanttrains 5 collegues the program willhavereached 3750 persons! ~1000 • attended national daycources ~500 • morehavesignedup for spring courses… =~1500 • trained personnel

  29. Affiliated counties 9 countiesaffiliated with national tool for monitoring and planning healthcare services for asylumseekers Affiliated Connecting in feb-17 Interested Turned down offer

  30. Report (+eng version) 28 feb 2017 Many challenges remain…

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