Assessment of some mental health problems and mental health service needs of Syrian refugees and opinions of health care providers and health decision makers

This mixed-methods study aimed to determine the prevalence and predictors of posttraumatic stress disorder (PTSD) and depression among Syrian refugees, assess need for and utilization of mental health services from the perspectives of refugees, health care providers, and health policy makers, and determine refugees' general healthcare service utilization and associated factors in Turkey. The quantitative data were collected via a household survey in two neighborhoods with the highest refugee population in Ankara, and qualitative data were collected via in-depth interviews with 10 health care providers and 10 health policy makers. Probable PTSD and depression rates were 36.5% and 47.7%, respectively. Female gender, physical illness, self-rated poor mental health and higher number of potentially traumatic events predicted both PTSD and depression. PTSD was additionally predicted by having children, past psychiatric illness and perceived need for mental health care in Turkey, while depression was predicted by lower economic status and self-rated poor general health. Only 1.4% of the participants reported having utilized mental health services in Turkey. Both qualitative and quantitative findings showed that there was an unmet need for mental healthcare. Nearly half of the refugees reported having used healthcare services within the last year, and around one-fifth stated that they were unable to access healthcare services in Turkey. A regression analysis revealed that refugees with a second language, those who received financial support, and those who were satisfied with their housing conditions were associated with better access to healthcare. On the other hand, being married, self-rated poor general health and better access to healthcare were associated with higher utilization of health services.