MENTAL HEALTH SCREENING TOOL FOR ASYLUM SEEKERS AND REFUGEES: THE STAR-MH

This post forms part of our series in showcasing abstracts of presentations featured at our annual postgraduate interdisciplinary conference on refugee and forced migration research, hosted in October 2017 at The University of Melbourne.

Debbie Hocking, Suresh Sundram & Serafino Mancuso

There is no extant brief and sensitive mental health screening tool for asylum seekers and new refugees (ASR) designed to be administered by non-mental-health trained workers in receiving host nations.

The STAR-MH was iteratively developed and piloted with adult ASR without a known current psychiatric diagnosis. 192 participants from 37 countries were administered the STAR-MH by non-mental health workers, and subsequently underwent a validation interview (structured psychiatric assessment, MINI 6.0) to determine psychiatric morbidity. Statistical analyses were conducted using item response theory methods. Sensitivity/specificity analyses determined the most accurate cut-off score to detect PTSD &/or Major Depressive Disorder (MDD).

The majority was male, had arrived by boat, and required an English language interpreter. Median screening time was 6 minutes (IQR=5–7). 33% met criteria for ≥ 1 clinical diagnosis (MDD, 30%; PTSD, 20%) and 99% of other psychiatric disorders were co-morbid with MDD or PTSD. A cut-off score of ≥ 2 produced 0.93 (SN) and 0.74 (SP) for PTSD &/or MDD with a ROC of 0.91 p<.001.

The STAR-MH is a sensitive and efficient screening tool to facilitate mental health assessment and referral for adult ASR at their agency of first presentation.

Dr Debbie Hocking is a clinical psychologist and mental health researcher. She has worked as a post doc fellow at Florey Institute of Neuroscience & Mental Health and Cabrini Institute, developing mental health screening tools for adult and adolescent forced migrants. She also works pro-bono in a clinical capacity with asylum seekers at the Cabrini Asylum Seeker and Refugee Health Hub in Brunswick.