[Models of Mental Health Care for Vulnerable Refugees in the Community]. / Modelle zur regionalen Versorgung psychisch vulnerabler Flüchtlinge.

A non-neglectable portion of people that have fled to Germany have been subjected to expulsion, violence, torture and grave human loss. In some of them, signs of secondary mental problems are obvious. In the light of the efforts at integration, these diseases must not be neglected. Outlined are the federal legal requirements and how the cost coverage, as well as the admission to health care system, is structured. Additionally, 2 exemplary regional models for psychosomatic health care are being introduced: Dresden's "Stepped Care Model for Psychologically Vulnerable Refugees" includes phased offers for prevention and treatment of acute mental crises, as well as somatoform disorders in refugees and their volunteer helpers. The PSZ in Bielefeld unites already existing expertise of social work and trauma therapy to form a shared project and favors, among other things, training courses and the instruction of language mediators. The local circumstances and differences lead to individual, sometimes totally new solutions. Already existing clinical care offers as well as concepts of trauma therapy are focal points for the development of a comprehensive health care provision. Most effective is a combination of medicinal care, psychosocial networking and psychosomatic treatment. For a working health care provision without parallel structures it is indispensible to use expertise in trauma therapy that is already in place. While being very resource-saving psychosomatic centers offer targeted applications in the network of all actors in refugee care especially when combined with well-trained volunteers and language mediators, informed on the issue of trauma.

[Aspects of psychosomatics and psychotraumatology in refugees : Challenges for internal medicine]. / Aspekte der Psychosomatik und Psychotraumatologie bei Geflüchteten : Herausforderungen für die Innere Medizin.

Many people seek protection from war and violence in Germany. Flight and displacement often have an impact on mental health. The situation in the country of arrival, separation, grief and loss, and worries about the future can be additional burdens. The barriers to adequate healthcare are high, a visit to the doctor for somatoform complaints is sometimes less alien than talking about fears and hopelessness. The medical internistic encounter thus plays an important key role in recognizing and adequately assessing psychological symptoms without pathologizing. A brief overview of innovations in the International Classification of Diseases and Related Health Problems 11th edition (ICD-11) on stress-related disorders aims to facilitate the assignment. Information on screening, trauma-informed interviewing and interpreter-assisted communication complement the recommendations of the current guidelines.

[Domestic Violence and Intimate Partner Violence - a Challenge within the Health Care Sector - Result of a Survey Among Physicians]. / Häusliche Gewalt und Partnerschaftsgewalt ­ eine Herausforderung im Gesundheitssektor.

Domestic violence evidently endangers health. Since physicians are seen as primary contact persons by victims of violence it is necessary to understand their perception of their role. 1346 of all physicians and dentists registered in 2015 with the Saxony Board of Physicians filled in a questionnaire on contact with victims, knowledge on support structures and willingness to take part on specific medical education. Frequency of contact was estimated to be low, while readiness to approach patients in case of suspicion was high. There was uncertainty about where to refer, as well as a limited level of awareness of existing support structures. Most indicated a high request in further education. In conclusion, motivation and readiness contrast with uncertainty and lack of awareness. Education focusing on key players and major network interfaces should endorse physicians in their significant role within the care and prevention system of violence.

[Domestic violence in patients - underestimated by medical staff: self-report data from medical staff of the outpatient clinical settings in Dresden and Chemnitz and of the inpatient departments of the Medical University of Dresden in Saxony, Germany]. / Häusliche Gewalt bei Patienten - durch medizinische Fachkräfte vermutlich unterschätzt Eine Vollerhebung bei Dresdner und Chemnitzer niedergelassenen medizinischen Fachkräften und solchen des Dresdner Universitätsklinikums.

Medical staffs have a key role in the adequate treatment of victims of domestic violence. The present study collects self-report data about subjective perception, general knowledge and motivation for further training about domestic violence from medical staff of inpatient and outpatient clinical settings. A questionnaire was developed and sent to doctors, nursing staff, midwives, and psychotherapists working in outpatient clinical settings in Dresden and Chemnitz and in the inpatient departments of the Medical University of Dresden in Saxony, Germany. 1,107 (23%) of 4,886 distributed questionnaires were returned and analysed. The participants reported that they were seldom confronted with the consequences of domestic violence in their clinical practice. The unawareness among staff in specialised care facilities and advisory centres was highly noticeable. More than 90% of the participants did not know the main advisory centre for victims of domestic violence. Even if some facilities were known there was virtually no contact. The majority was not satisfied with the level of support they were able to offer. Further difficulties pointed out by participants included lack of time and the assumption that victims were unwilling to answer questions about domestic violence. The participants also expressed a high demand for further training.