abstract: 'Background Jordan has received more than three million refugees from

  bordering countries during times of conflict, including over 600 000

  Syrian refugees between 2011 and 2021. Amidst this humanitarian crisis,

  a new mental health system for Syrian refugees has developed in Jordan,

  with most clinical services administered through non-governmental

  organizations. Prior studies have identified increased risk of

  psychiatric disorders in refugee populations and significant barriers

  for Syrian refugees seeking mental health treatment, but few have

  reviewed the organization or ability of local systems to meet the needs

  of this refugee population.

  Methods Qualitative interviews of mental health professionals working

  with refugees in Jordan were conducted and thematically analyzed to

  assess efficacy and organizational dynamics.

  Results Interviewees described barriers to care inherent in many refugee

  settings, including financial limitations, shortages of mental health

  professionals, disparate geographic accessibility, stigma, and limited

  or absent screening protocols. Additional barriers not previously

  described in Jordan were identified, including clinician burnout,

  organizational metrics restricting services, insufficient visibility of

  services, and security restrictions. Advantages of the Jordanian system

  were also identified, including a receptive sociopolitical response

  fostering coordination and collaboration, open-door policies for

  accessing care, the presence of community and grassroots approaches, and

  improvements to health care infrastructure benefiting the local

  populace.

  Conclusions These findings highlight opportunities and pitfalls for

  program development in Jordan and other middle- and low-income

  countries. Leveraging clinician input can promote health system efficacy

  and improve mental health outcomes for refugee patients.'
affiliation: 'Rafla-Yuan, E (Corresponding Author), Univ Calif San Diego, Dept Psychiat,
  San Diego, CA 92103 USA.

  Al-Soleiti, Majd, Univ Jordan, Sch Med, Amman, Jordan.

  Abu Adi, Mahmoud, CIVIC Social Enterprise, Amman, Jordan.

  Nashwan, Ayat, Yarmouk Univ, Dept Sociol \& Social Work, Irbid, Jordan.

  Rafla-Yuan, Eric, Univ Calif San Diego, Dept Psychiat, San Diego, CA 92103 USA.'
article-number: e38
author: Al-Soleiti, Majd and Abu Adi, Mahmoud and Nashwan, Ayat and Rafla-Yuan, Eric
author-email: eraflayuan@ucsd.edu
author_list:
- family: Al-Soleiti
  given: Majd
- family: Abu Adi
  given: Mahmoud
- family: Nashwan
  given: Ayat
- family: Rafla-Yuan
  given: Eric
da: '2023-09-28'
doi: 10.1017/gmh.2021.36
files: []
issn: 2054-4251
journal: GLOBAL MENTAL HEALTH
keywords: 'Refugee mental health; refugee camps; conflict; displacement; health

  policy; barriers to care'
keywords-plus: SYRIAN REFUGEES; CARE; ACCESS; NEEDS
language: English
month: SEP 28
number-of-cited-references: '25'
orcid-numbers: 'Rafla-Yuan, Eric/0000-0002-7505-0550

  Al-Soleiti, Majd/0000-0002-0680-0549'
papis_id: 30277940e14a616434d36ae2852a2db5
ref: Alsoleiti2021barriersopportunitie
researcherid-numbers: 'Rafla-Yuan, Eric/HSA-6399-2023

  '
times-cited: '6'
title: 'Barriers and opportunities for refugee mental health services: clinician recommendations
  from Jordan'
type: article
unique-id: WOS:000701061400001
usage-count-last-180-days: '0'
usage-count-since-2013: '5'
volume: '8'
web-of-science-categories: Psychiatry
year: '2021'