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A video vignette study on the bias in refugees getting admission to residential psychiatric health care in Flanders

Timo Van Canegem (UGent) , Piet Bracke (UGent) , Veerle Buffel (UGent) and Melissa Ceuterick (UGent)
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Abstract
Asylum seekers and refugees are characterized by a high prevalence of mental problems–especially PTSD– due to an amalgam of stressors before, during and after the migration movement. In addition, this vulnerable group faces difficulties in accessing mental health care and is underrepresented in residential psychiatric care in Europe. Stereotypical attitudes of health care providers are partly responsible for this paradoxical situation. Audit studies also show that denial of access to services by gatekeepers is a common form of discrimination. This project, an initiative of the Ghent University’s Research Group on Health and Demographic Research (HEDERA), is researching the bias in the referral and decision making process and treatment management of refugee and asylum seekers in the Flemish mental health care sector, and more specifically in the granting of access by psychiatrists to residential psychiatric health care. The objective is to understand which barriers to an adequate and culturally sensitive care are present in the current system. A quantitative quasi-experimental design is developed with randomly allocated video-recorded vignettes depicting a fictive intake conversation. A steering committee of experts helped rating and finetuning the video vignettes to enhance their validity. The vignettes are identical apart from the patient’s different migration background, thereby removing any confounding factors from the social context of the consultation or other aspects of patients’ symptomatology or behavior. Whether the patient is an asylum seeker/refugee or not is therefore the main manipulated independent variable. The use of video vignettes is a relatively new methodological tool to determine biases in the mental health care sector on the basis of migration background. Psychiatrists perform a gatekeeper role in referral to the residential psychiatry and are therefore selected as the theoretical sample. After watching the video vignettes, the psychiatrists are asked to answer a series of questions about their diagnostic decision, the decision making process and potential referral and treatment management of the hypothetical patient. At the end of the research, the professional decisions and actions of the respondents will be analyzed statistically and assessed regarding their potential influence of patient’s status as refugee or asylum seeker.
Keywords
asylum seekers, health care

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Citation

Please use this url to cite or link to this publication:

Chicago
Van Canegem, Timo, Piet Bracke, Veerle Buffel, and Melissa Ceuterick. 2018. “A Video Vignette Study on the Bias in Refugees Getting Admission to Residential Psychiatric Health Care in Flanders.” In ESHMS 2018 : Abstracts.
APA
Van Canegem, T., Bracke, P., Buffel, V., & Ceuterick, M. (2018). A video vignette study on the bias in refugees getting admission to residential psychiatric health care in Flanders. ESHMS 2018 : abstracts. Presented at the 17th Biennial ESHMS Conference 2018 : Old Tensions, Emerging Paradoxes in Health: rights, knowledge, and trust.
Vancouver
1.
Van Canegem T, Bracke P, Buffel V, Ceuterick M. A video vignette study on the bias in refugees getting admission to residential psychiatric health care in Flanders. ESHMS 2018 : abstracts. 2018.
MLA
Van Canegem, Timo et al. “A Video Vignette Study on the Bias in Refugees Getting Admission to Residential Psychiatric Health Care in Flanders.” ESHMS 2018 : Abstracts. 2018. Print.
@inproceedings{8581929,
  abstract     = {Asylum seekers and refugees are characterized by a high prevalence of mental problems–especially PTSD– due to an amalgam of stressors before, during and after the migration movement. In addition, this vulnerable group faces difficulties in accessing mental health care and is underrepresented in residential psychiatric care in Europe. Stereotypical attitudes of health care providers are partly responsible for this paradoxical situation. Audit studies also show that denial of access to services by gatekeepers is a common form of discrimination.
This project, an initiative of the Ghent University’s Research Group on Health and Demographic Research (HEDERA), is researching the bias in the referral and decision making process and treatment management of refugee and asylum seekers in the Flemish mental health care sector, and more specifically in the granting of access by psychiatrists to residential psychiatric health care. The objective is to understand which barriers to an adequate and culturally sensitive care are present in the current system.
A quantitative quasi-experimental design is developed with randomly allocated video-recorded vignettes depicting a fictive intake conversation. A steering committee of experts helped rating and finetuning the video vignettes to enhance their validity. The vignettes are identical apart from the patient’s different migration background, thereby removing any confounding  factors from the social context of the consultation or other aspects of patients’ symptomatology or behavior. Whether the patient is an asylum seeker/refugee or not is therefore the main manipulated independent variable. The use of video vignettes is a relatively new methodological tool to determine biases in the mental health care sector on the basis of migration background.
Psychiatrists perform a gatekeeper role in referral to the residential psychiatry and are therefore selected as the theoretical sample. After watching the video vignettes, the psychiatrists are asked to answer a series of questions about their diagnostic decision, the decision making process and potential referral and treatment management of the hypothetical patient. At the end of the research, the professional decisions and actions of the respondents will be analyzed statistically and assessed regarding their potential influence of patient’s status as refugee or asylum seeker.
},
  author       = {Van Canegem, Timo and Bracke, Piet and Buffel, Veerle and Ceuterick, Melissa},
  booktitle    = {ESHMS 2018 : abstracts},
  keywords     = {asylum seekers,health care},
  language     = {eng},
  location     = {Lisbon, Portugal},
  pages        = {1},
  title        = {A video vignette study on the bias in refugees getting admission to residential psychiatric health care in Flanders},
  year         = {2018},
}