Improving access to and engagement with mental health services among young people from refugee backgrounds: service user and provider perspectives

Limited research has been conducted worldwide on the experiences that children and young people from refugee backgrounds have with mental health services, despite evidence that they have significant vulnerability to the development of mental health problems and to suicidal behaviour and that those with mental ill-health typically underutilise services. The authors were particularly interested in barriers and facilitators to service access and engagement, and conducted two qualitative research projects to improve understanding of the issues – the first with service providers experienced in the refugee area and the second with young refugee service users. The aim of this project was to compare the perspectives of professionals and service users and to identify similarities and differences. The perspectives of the service users and providers were strikingly similar. The analysis identified 21 implications for policy makers, agencies and practitioners, which ranged from issues concerning cultural sensitivity, background matching and mental health literacy to accessibility, setting boundaries and expectations and implementing a holistic and outreach approach. There is a range of specific, practical measures that policy makers and service providers can introduce to enhance access to and engagement with mental health services for young people from refugee backgrounds

Improving access to and engagement with mental health services among young people from refugee backgrounds: service user and provider perspectives

Limited research has been conducted worldwide on the experiences that children and young people from refugee backgrounds have with mental health services, despite evidence that they have significant vulnerability to the development of mental health problems and to suicidal behaviour and that those with mental ill-health typically underutilise services. The authors were particularly interested in barriers and facilitators to service access and engagement, and conducted two qualitative research projects to improve understanding of the issues – the first with service providers experienced in the refugee area and the second with young refugee service users. The aim of this project was to compare the perspectives of professionals and service users and to identify similarities and differences. The perspectives of the service users and providers were strikingly similar. The analysis identified 21 implications for policy makers, agencies and practitioners, which ranged from issues concerning cultural sensitivity, background matching and mental health literacy to accessibility, setting boundaries and expectations and implementing a holistic and outreach approach. There is a range of specific, practical measures that policy makers and service providers can introduce to enhance access to and engagement with mental health services for young people from refugee backgrounds

Fracture of a carotid stent: An unexpected complication

We present the first reported case of a carotid artery stent fracture where a Nitinol stent was used for the management of carotid artery stenosis. An 83-year-old man underwent right carotid artery stenting in July 2005. On follow-up ultrasound, stenosis of the right internal carotid artery was noted. In January 2006, he underwent left carotid artery stenting and at this procedure, precontrast assessment of the right neck revealed a complete fracture through the waist of the stent in the right internal carotid artery. This fractured segment correlated with the area of stenosis reported at the previous ultrasound. In July 2006, this gentleman underwent successful removal of the carotid stent with uneventful carotid endarterectomy and synthetic patch repair. Carotid artery stenting is a newer and alternative modality to carotid endarterectomy for the treatment of carotid artery stenting. More data are emerging to support its safety and efficacy. An unexpected complication can happen with any procedure and complications help define the follow-up management of subsequent patients undergoing this procedure