Background
As a way of looking at and working in the field of psychiatry and psychotherapy, social psychiatry focuses in particular on the social factors and causes of mental disorders, with the aim of developing approaches and concepts for the development of decentralized, participatory care structures and putting these into practice. It emphasizes a holistic understanding of crisis and illness and attempts to avoid social exclusion and stigmatization of the affected people and their relatives and to include resources as well as impairments. In addition, mental crises and illnesses are seen as subjectively meaningful and understandable experiences for which it is particularly important to develop individual solutions. In this context, the consideration of intersectionality, i.e. the influences of race, gender, culture, etc., also plays a key role in this specialist area.
One area of research and work in social psychiatry is ensuring and improving care for migrants with mental illnesses. More than one in four people living in Germany today have a migrant background, whereby these people represent a very heterogeneous group due to their different countries of origin and embedding in different cultural, social and socio-economic contexts. Mentally ill people with a migrant background need psychiatric and psychotherapeutic care that is tailored to their needs and takes their particular life situation into account with appropriate professional intercultural competence.
Possible language and cultural comprehension difficulties as well as structural barriers can make access to the (psychiatric-psychotherapeutic) healthcare system more difficult for those affected and their relatives. On the one hand, this circumstance can contribute to an increased risk of incorrect medical histories and the resulting diagnoses and treatments and, on the other hand, can also lead to underdiagnosis and non-treatment. The inclusion of individual explanatory models for understanding health and illness and the consideration of linguistic, cultural, social and structural factors could make a decisive contribution to improving care. Despite numerous advances in the psychiatric-psychotherapeutic care of mentally ill persons with a migration context, the healthcare system has so far only been able to guarantee adequate access to and implementation of treatment for this patient group to a limited extent.
Overarching goals
The aim of this research group is firstly to investigate social factors and associated causes of mental disorders, especially in particularly vulnerable or highly stressed groups. On the other hand, to incorporate specific approaches and measures into the psychiatric-psychotherapeutic care system. Thematic / research focuses are:
- Symptom, treatment and care experience at the level of patients and practitioners depending on specific individual characteristics and factors such as sex and gender, social context and social conditions, participation, linguistic, cultural and socio-economic circumstances, etc.
- Factors and measures that contribute to stabilization in cases of chronic mental illness or severe mental illness (SMI) and provide implications for the redesign of care structures in cases of SMI
- Effect of intercultural opening, stepped-care approaches and cross-interface care on reducing the treatment gap for migrants and refugees
In Germany, there are still deficits in outpatient psychiatric-psychotherapeutic crisis intervention and follow-up multidisciplinary complex treatment for severely and chronically mentally ill people. GPCs are outpatient psychiatric-psychotherapeutic treatment and support services that are specifically aimed at severely ill patients who have not received any, insufficient or incorrect care due to many obstacles in the care system. A multi-professional outpatient team made up of staff from a psychiatric institute outpatient clinic of the sector care clinic and the social psychiatric service forms the basis of this treatment offer, which is based on Steinhart's functional basic model. In addition, a low-threshold, integrative day clinic service and many other collaborations with local complementary service providers are provided for individual and needs-based support, treatment and guidance. The aim of this study is to quantitatively evaluate the quality of outcomes as part of the implementation of the first GPC as part of standard care in Lower Saxony at four measurement points in comparison to regular outpatient treatment by existing psychiatric outpatient clinics. In addition to the influence of the service on the reduction of healthcare costs, the aim is to determine the extent to which an improvement in participation and involvement within the community as well as life satisfaction can be achieved in comparison to the control group and/or over time. Possible stabilizing influences on clinical symptoms will also be examined in more detail and specific influences of individual treatment elements will be investigated further.
Contact: Fabienne Führmann, Fabienne.fuehrmann@stud.mh-hannover.de
Migration is a drastic experience in the lives of the people concerned. Stressors associated with the migration process can cause increased vulnerability to mental illness. In some areas, a so-called treatment gap is becoming apparent: despite increased psychiatric morbidity, the corresponding care services are underused by migrants, for which structural and cultural as well as migration-specific barriers are held responsible. The intercultural opening of the healthcare system is considered a mandatory prerequisite for breaking down access barriers and promoting the regular participation of people with a migration background in standard psychiatric-psychotherapeutic care.
Up-to-date, reliable figures on the actual care situation and the utilization behavior of people with a history of migration are a necessary prerequisite for quantifying the current status quo of intercultural openness, uncovering ongoing needs and deriving targeted measures on this basis. Accordingly, the aim of the research project is a systematic and comprehensive survey of the intercultural opening of the hospital-related psychiatric-psychotherapeutic care system in Germany. In sub-studies, figures on the use of corresponding care services by people with a history of migration will be recorded and both the provider perspective and the perspective of those being cared for will be integrated using qualitative and quantitative approaches.
Contact: Vera Mohwinkel, Vera.Mohwinkel@ZfP-Zentrum.de
This population-based study examines the group of Jewish migrants from the former Soviet Union (SU) in three host countries, namely Germany, Austria and Israel, and the group of non-migrant Jewish people in one country of origin, Russia. The main aim of the study is the comparative analysis of (1) the mental health of this migrant group (measured as depression, anxiety, somatization and quality of life) in the respective host country with the respective control group without a migration background and (2) the mental health of this migrant group in the different host countries and in the country of origin. Furthermore, the effects of the following factors on the mental health of migrants will be investigated: the acculturation attitude of migrants and the host society, religiosity, experiences of discrimination and anti-Semitism of migrants as well as xenophobia and anti-Semitism in the country of origin and host country.
Contact: Beata Trilesnik, btrilesnik@gmail.com
Publications:
- Trilesnik, B., Stompe, T., Walsh, S. D., Fydrich, T., & Graef-Calliess, I. T. (2023). Impact of new country, discrimination, and acculturation-related factors on depression and anxiety among ex-soviet jewish migrants: Data from a population-based cross-national comparison study. International Review of Psychiatry, 35(3-4), 289- 301. DOI: https://doi.org/10.1080/09540261.2022.2164180
- Trilesnik B, Graef-Calliess IT, Stompe T, Fydrich T. (2022). Religiosity, perceived anti-Semitism, xenophobia and mental health: Experiences of Jewish immigrants from the former Soviet Union in Austria and Germany. Transcultural Psychiatry, 0(0). DOI: 10.1177/13634615221107204
- Trilesnik, B., Stompe, T. & Graef-Calliess, I.T. (2021). "The good, the bad and the ugly: Influence of the host country on mental health and acculturation factors in Jewish migrants from the former Soviet Union in Germany, Austria and Israel". Presentation at the DGPPN Congress, Berlin.
- Trilesnik, B. & Graef-Calliess, I.T. (2020). "Influence of post-migratory factors on the mental health of people of different cultural affiliations". Presentation at meeting of German-speaking social psychiatrists, Mallorca, Spain.
- Trilesnik, B., Koch, S. C. & Stompe, T. (2018). Mental health, acculturation and religiosity in Jewish migrants from the former Soviet Union in Austria. Neuropsychiatry, 32(2), 84-92.
According to various estimates, Germany has taken in more than 1.1 million war refugees from Ukraine since March 2022. The high level of network coverage and easy access to the internet enable refugees to quickly find out about what is happening in their home country and even in their city. They can also stay in constant contact with their relatives who have remained in their country of origin and are exposed to danger there on a daily basis.
Depending on how this group of people use the internet, this can have a wide range of consequences - both negative effects (on mental health, well-being and integration success) and positive effects that strengthen well-being (e.g. support in maintaining a sense of belonging, autonomy, etc.). In order to explore exactly how refugees use online media and how it affects them, qualitative research based on grounded theory is planned. The study is based on a clinical sample, excluding people in acute psychotic or suicidal states. The main aim of the study is to investigate how refugees use online media and how they are influenced by it. In addition, recommendations for the psychosocial support of refugees will be developed, taking into account this post-migration factor.
Contact: Gala Kachur, galakornienko@gmail.com
Treatment needs, requirements and options for women with female genital mutilation (FGM) in Germany
An estimated 230 million girls and women worldwide are currently affected by female genital mutilation/female circumcision. Of these, around 600,000 live in Europe and around 100,000 in Germany, with an upward trend.
The possible physical consequences of FGM have already been described in detail. The act of "circumcision" is often accompanied by severe pain and high blood loss. In some cases, it is directly fatal. Secondary consequences often include infections, fistula formation and pain during urination, menstruation and sexual intercourse. FGM also significantly increases the risk of complications during childbirth.
However, there are only vague descriptions of the psychological consequences. Anxiety disorders, depression, pain disorders and post-traumatic stress disorders are possible. The aim of the study is therefore to find out what kind of treatment and in what form the women affected themselves would like in Germany in order to then compare these wishes, ideas and expectations with the possibilities of professional practitioners in Germany and develop treatment recommendations.
Contact: Frauke Baller, FGM-Studie-Baller@posteo.de
Qualification papers
It is possible to carry out qualification theses (Bachelor's, Master's and doctoral theses) and research-related internships in our research group. If you are interested, please contact:
- Prof. Dr. Iris Tatjana Graef-Calliess, IrisTatjana.Graef-Calliess@ZfP-Zentrum.de Calliess.Iris@mh-hannover.de
- Fabienne Führmann, Fabienne.fuehrmann@stud.mh-hannover.de
- Vera Mohwinkel, Vera.Mohwinkel@ZfP-Zentrum.de
- Dr. Julia Krieger, julia.krieger@wahrendorff.de
- Dr. Vanessa Rößner-Ruff, vanessa.roessner-ruff@wahrendorff.de
Research group members
Head of research group
Prof. Dr. Iris Tatjana Graef-Calliess
Medical Director, Head of Central Research and Teaching
ZfP Südwürttemberg, Clinical Department for Psychiatry and Psychotherapy I of the University of Ulm (Weissenau)
Weingartshofer Str. 2, D-88214 Ravensburg
Telephone: 0751/7601-2256
Fax: 0751/7601-2790
IrisTatjana.Graef-Calliess@ZfP-Zentrum.de
Psychiatry and Psychotherapy I | Ulm University Hospital
Excellence at a glance:
- Member of the expert group for the development of the S3 guidelines "Psychosocial therapies for severe mental illness" for the field of transcultural psychiatry & psychotherapy and migration
- Member of the "Migration & Public Health" working group at the Federal Government Commissioner for Migration, Refugees and Integration (sub-working group "Hospital") - new edition of "The culturally sensitive hospital"
- Co-Chair of the Section on Intercultural Psychiatry and Psychotherapy, Migration of the DGPPN
- Chair of the Section on Cultural Psychiatry of the European Psychiatric Association (EPA)
Prof. Dr. med. Stefan Bleich
Medical Director, AMSP Chairman
Clinical Department of Psychiatry, Social- and Psychological Therapy, MHH
Phone: +49 511 532-6748
PD Dr. Dr. Felix Wedegärtner
Senior physician & specialist in psychiatry and psychotherapy
Clinical Department of Psychiatry, Social- and Psychological Therapy, MHH
Phone: +49 511 532-5525
Fax: +49511 532 5526
Other research group members
Title of doctoral thesis: "Clinical characteristics of generalized anxiety disorder: older vs. young adults"
Main areas of research: Transcultural psychiatry, psychiatric care research Neurodevelopmental disorders and mental illness in young adults, PTSD and dissociative disorders, anxiety disorders, cognitive disorders
FGM-Studie-Baller@posteo.de; Frauke.Baller@posteo.de
Topic of the doctoral thesis: Treatment needs, requirements and options for women with female genital mutilation (FGM) in Germany
Clemens.Firnenburg@krh.de
Main areas of research: social psychiatric planning and evaluation of help for mentally ill people in a community psychiatric center, analytical psychosis psychotherapy, prevention and treatment of suicidal tendencies, scientific theory of psychiatry
katrin.f riedrich@wahrendorff.de
Research focus:
- Influence of sport and exercise on mental illness, Digital aftercare for mental illness, Research and development - Wahrendorff
Fabienne.fuehrmann@stud.mh-hannover.de
Topic of doctoral thesis: Evaluation of the implementation of a community psychiatric center (GPZ), Community Psychiatric Center (GPZ) Neustadt a. Rbge. | Counseling Centers | Health | Life in the Hannover Region
Further research focus: Peer support in the context of flight, third-party funded project Refukey, https://refukey.org/
Research focus: Evaluation of the implementation of a community psychiatric center, dynamics in forms of consensual non-monogamy, sexuality in couple relationships
Topic of the doctoral thesis: Intercultural opening of psychiatric Facilities or Institutions in Germany - an integrative view of the provider and patient perspective
Further research interests: Refukey, https://refukey.org/
Topic of the doctoral thesis: The influence of social media usage behavior on the well-being and mental health of refugees using the example of refugees from Ukraine
julia.kr ieger@wahrendorff.de
Title of doctoral thesis: "I'm packing my suitcase and taking ... What enables people with chronic mental illness from inpatient reintegration support to lead an independent and happy life in their own home again?"
Further research focuses: Stabilization in chronic mental illness (SMI), changing service structures in special forms of housing with a focus on social participation, digital aftercare for mental illness, research and development - Wahrendorff
Main areas of research: Influence of nutrition on mental illness, Digital aftercare for mental illness, Research and development - Wahrendorff
vanessa.roessner-ruff@wahrendorff.de
Title of the doctoral thesis: Is "male depression" really gender-specific? Multicenter study on possible gender-specific depressive symptom expression based on the concept of "male depression" in the context of an investigation of individual-level factors in patients with unipolar depression.
Further research interests: Gender and mental illness, depression and gender, depression and personality, effect of neurostimulation procedures in mental illness, research and development - Wahrendorff
cordula.schweiger@wahrendorff.de
Topic of the doctoral thesis: Attitude and habitus in the psychiatric-psychotherapeutic care context. Latent and manifest aspects of the shadow side of helping.
Topic of the doctoral thesis: "The good, the bad and the ugly: Cross-national comparison of mental health in Jewish migrants from the former USSR in different host countries (Austria, Germany and Israel)"
Further research interests: Refukey, https://refukey.org/