Mental Health Screening

There has been a longstanding discussion amongst scholars about the role and use of early mental health screening to detect common mental disorders in refugees. While the Office of Refugee Resettlement requires a health screening of refugees resettled in the United States, guidelines for mental health are less clear. The complex interaction of refugee trauma, the impact of acculturative stress, and refugee cultural frameworks has made screening and diagnosis difficult. This chapter presents a set of considerations for screening refugees and an overview of the most useful and effective tools for screening. Considerations explored in the chapter include managing communication issues, language and cultural barriers and descriptions of symptoms that do not fit easily into a Western medical context. The chapter also gives practical information and suggestions that will aid providers in the screening process including how to engage and more effectively screen refugee patients. Although there is limited empirical research of screening tools for refugees, the chapter reviews the use of the Vietnamese Depression Scale (VDS), the Harvard Trauma Questionnaire (HTQ), the 15-item Health Leaflet (HL), the Posttraumatic Symptom Scale-Self Report (PSS-SR), and the Hopkins Symptom Checklist-25 (HSCL-25). The chapter concludes with a more extensive review of the development and use of the Refugee Health Screener-15 (RHS-15).