Collaborative Care for Refugees and Torture Survivors: Key Findings from the Literature

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Abstract

Refugees and torture survivors often present with complex physical, mental, and social conditions. Collaborative care is a promising service delivery approach that addresses the needs of patients with complex conditions. This article reviews the broader field of collaborative care with a focus on content areas relevant to refugees and torture survivors. Doing so, it identifies the potential benefits and limitations of integrated care for these populations, and it highlights future research directions for collaborative care with torture survivors and refugees. Meta-analyses based on research in diverse populations suggest that collaborative care is effective in reducing symptoms of depression and anxiety and in increasing treatment satisfaction and medication adherence. Randomized controlled trials suggest positive results for collaborative care on posttraumatic stress disorder, severe and persistent mental illness, and key chronic health conditions. Research, however, shows inconsistent results for collaborative care on substance abuse, quality of life, and cost-effectiveness, as well as in older adult populations. Although the research on collaborative care is mostly promising in areas directly relevant to refugees and torture survivors, there is limited research on collaborative care with these populations and what does exist provides inconsistent results. Considering the complex needs of and barriers to care faced by refugees and torture survivors, as well as the evidence for the efficacy of collaborative care in relation to key difficulties experienced by these populations, we argue that there is a clear need and an evidence-based justification for additional research on collaborative care with refugees and torture survivors.

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