Asylum seekers and psychiatric care
observations of cultural competence in patient records
Abstract
Research concerning psychiatric care of refugees or asylum seekers has not been done in Finland. Asylum seekers are in many ways more vulnerable to mental health problems than other immigrants. Exile, immigration and long asylum process in Finland may activate mental problems and the need for admission to psychiatric hospital. This article describes how asylum seekers were treated as psychiatric patients in Finnish psychiatric special health care, what cultural aspects incare were taken into account and how did cultural competence occur. Cultural competence was examined through Giger and Davidhizar's transcultural assessment model. The data were collected from patient records (N = 21) of all adult asylum seekers admitted to psychiatric hospital in 1995-1999. The data consisted of all physicians' and nurses' documentations from those records. Asylum seekers were treated like all other patients in the psychiatric hospital. They were given medication and psychotherapy. The asylum seekers' background in formation was well documented but cultural observation was difficult to find. Language and communication problems were observed and the spoken language and the need for interpretation were best documented in the records. Nationality, family background, exile and asylum process were well documented. Mother tongue was not always asked. The patients' own meanings and values for health and illness were not considered nor the patients' expectations for the care. Most patients were satisfied with the care. Some patients felt that nobody could understand or help them. The quality in documentation varied a lot depending on physician, nurse and ward.
