"I just need to be with my family": resettlement experiences of asylum seeker and refugee survivors of torture.

A global migration of individuals fleeing persecution, violence and armed conflict reached almost 60 million world-wide in 2015. This world-wide crisis of displacement reflects people seeking safety across borders and oceans; dangerous journeys that compound the trauma endured by these women, men and children. Refugees/asylum seekers face barriers upon entry to the U.

Mental Health and Illness.

Circumstances forcing individuals and families to flee set the stage for disruptions in mental health and forge resilience. Individual characteristics and conditions premigration, perimigration, and postmigration influence health, mental health, care-seeking behavior, and stages of well-being and successful resettlement. Primary care providers have strategies to promote mental well-being, including focusing on resilience and social determinants of health.

Adolescent Substance Use and Misuse: Recognition and Management.

Adolescent use of illicit substances imposes an enormous burden on individuals, families, and communities. The types of illicit substances adolescents are using have changed drastically over the past decade with decreases in alcohol use (including binge alcohol use) offset by increases in electronic cigarette, marijuana, and opioid use. Primary care physicians have the opportunity to identify adolescents who use illicit substances.

Strengthening effective preventive services for refugee populations: toward communities of solution.

Refugee populations have unequal access to primary care and may not receive appropriate health screening or preventive service recommendations. They encounter numerous health care disadvantages as a consequence of low-income status, race and ethnicity, lower educational achievement, varying degrees of health literacy, and limited English proficiency. Refugees may not initially embrace the concept of preventive care, as these services may have been unavailable in their countries of origin, or may not be congruent with their beliefs on health care.

Changing Places: Where Will We Be with Our Patients? A Perspective from the Keystone IV Conference.

Dr. Stephens knew a lot about place-his place within family medicine and the place of family medicine as a catalyst for change in our communities. In "G.

Recognition and Differential Diagnosis of Psychosis in Primary Care.

Psychosis is a symptom complex that may include hallucinations, delusions, disorders of thought, and disorganized speech or behavior. Acute psychosis is primary if it is symptomatic of a psychiatric disorder, or secondary if caused by a specific medical condition. Patients with primary psychiatric disorders are likely to have auditory hallucinations, prominent cognitive disorders, and complicated delusions.

Communities of solution: partnerships for population health.

Communities of solution (COSs) are the key principle for improving population health. The 1967 Folsom Report explains that the COS concept arose from the recognition that complex political and administrative structures often hinder problem solving by creating barriers to communication and compromise. A 2012 reexamination of the Folsom Report resurrects the idea of the COS and presents 13 grand challenges that define the critical links among community, public health, and primary care and call for ongoing demonstrations of COSs grounded in patient-centered care.

Family practice enhancements for patients with severe mental illness.

Individuals with severe mental health disorders experience difficulty maneuvering the complexity encountered in primary care (PC). This study describes the impact of three components of primary care practice enhancements on: changes in missed appointments, changes in health outcomes, number of ER visits and hospitalization days, and perceptions of integrated care. Missed PC appointments: baseline to post practice enhancement changed from 42 to 11, statistically significant (p < .

A randomized trial: are care navigators effective in connecting patients to primary care after psychiatric crisis?

Persons with serious mental illnesses suffer excess medical morbidity compared to the general population. This RCT aimed to determine whether navigators are effective in helping patients connect to primary care after psychiatric crisis. Adults presenting for emergency care were randomly assigned to a navigator versus usual care.

How patients view primary care: differences by minority status after psychiatric emergency.

Background: Patients' race or ethnic background may affect their ability to access health care due to their socioeconomic status, hereditary predispositions to illnesses, or discrimination either perceived or actual by those providing health care. For patients with mental health disorders, additional barriers are created due to poor experiences with the health care system.

Methods: This was a mixed methods randomized control study examining the effectiveness of care managers linking patients to primary care after psychiatric crisis.

How patients view primary care: differences by minority status after psychiatric emergency.

Background: Patients' race or ethnic background may affect their ability to access health care due to their socioeconomic status, hereditary predispositions to illnesses, or discrimination either perceived or actual by those providing health care. For patients with mental health disorders, additional barriers are created due to poor experiences with the health care system.

Methods: This was a mixed methods randomized control study examining the effectiveness of care managers linking patients to primary care after psychiatric crisis.

Adolescent substance use and abuse: recognition and management.

Substance abuse in adolescents is undertreated in the United States. Family physicians are well positioned to recognize substance use in their patients and to take steps to address the issue before use escalates. Comorbid mental disorders among adolescents with substance abuse include depression, anxiety, conduct disorder, and attention-deficit/ hyperactivity disorder.

Primary care after psychiatric crisis: a qualitative analysis.

Purpose: Patients with serious psychiatric problems experience difficulty accessing primary care. The goals of this study were to assess whether care managers improved access and to understand patients' experiences with health care after a psychiatric crisis.

Methods: A total of 175 consecutive patients seeking care in a psychiatric emergency department were randomly assigned to an intervention group with care managers or a control group.

Linkage to primary medical care following inpatient detoxification.

It is important to address the medical problems of individuals admitted for detoxification by arranging for follow-up with primary care physicians after discharge. This was a prospective cohort study of 119 patients admitted for detoxification. Follow-up data were collected over the telephone one week following discharge.

Connections to primary medical care after psychiatric crisis.

Background: Patients presenting with a psychiatric emergency face a unique set of challenges in connecting to primary care.

Objectives: We tested the hypothesis that, in contrast to usual care, case management will result in higher rates of connection to primary care. We examined variables affecting primary care entry, including insurance status, hospital admission, and concurrent linkages to mental health care.

Seriously emotionally disturbed youth: a needs assessment.

A desire to improve outcomes for children and families led Erie County, New York to collaborate with the University at Buffalo Department of Family Medicine on a needs assessment of children with emotional disturbance. Demographic and behavioral characteristics, as well as service needs were identified through case-based interviews conducted with key informants who provided services to children with emotional disturbance. Family interviews were conducted whenever possible.

Refugee health and medical student training.

Background And Objectives: Cultural awareness training is an increasingly important priority within medical curricula. This article describes an academic family practice-community partnership focusing on health care needs of refugees that became the model for a medical school selective on cultural sensitivity training.

Methods: The monthly Refugee Health Night program featured dinner with preceptors and patients, international sessions on special medical needs of refugees, and actual clinical encounters with patients.