A Qualitative Study to Understanding Barriers to PTSD Treatment for Immigrants and Refugees in Primary Care.

Abstract

We share findings from a needs assessment to understand barriers to posttraumatic stress disorder (PTSD) treatment for immigrants and refugees (IR) in primary care settings. Providing culturally responsive and accessible PTSD treatment to IR patients is critical. The study conducted qualitative interviews with 15 interprofessional staff and providers (e.g., primary care physicians, behavioral health clinicians, case manager, and a nurse practitioner) as well as two focus groups with physician residents serving IR patients. Results from qualitative analysis revealed several key barriers to integrating PTSD treatment for IR in primary care settings, including training gaps, mental health literacy and stigma, poor social determinants of health (i.e., food insecurity, housing stability, economic security, transportation), and lack of PTSD screening. Our findings suggest that reducing barriers to PTSD treatment for IRs may be addressed through multilevel changes and interventions for providers (e.g., training in culturally responsive trauma-informed intervention) and patients (e.g., addressing the intersection of stigma, trauma, and social determinants of health).