SATISFACTION OF VIETNAMESE PATIENTS AND THEIR FAMILIES WITH REFUGEE AND MAINSTREAM MENTAL-HEALTH-SERVICES

Objective: The study examined levels of satisfaction with mainstream m ental health services and specialized mental health services for refug ees among Vietnamese psychiatric patients and their relatives. Demogra phic, diagnostic, symptomatic, and service-related issues that might i nfluence satisfaction were investigated. Methods: Eighty-six Vietnames e patients were identified fi om case notes of mainstream inpatient se rvices (N=31), mainstream community services (N=7), and a specialized refugee treatment unit (N=48). During an interview, a scale measuring satisfaction with treatment as well as measures of anxiety, depression , and posttraumatic stress disorder was administered to them. A modifi ed satisfaction scale was administered to 56 relatives. Results: Patie nts and relatives were, on average, moderately satisfied with treatmen t. Patients expressed greater satisfaction with the specialized treatm ent unit for refugees than with mainstream services, a finding that wa s not influenced by diagnostic differences or symptom levels at the ti me patients responded. Further analyses controlling for multiple compa risons revealed that the extent of the information provided and the ea se of negotiating changes in treatment were the most salient variables in distinguishing satisfaction levels across the two types of treatme nt centers. Patients' fluency in English and their relatives' level of education were inversely associated with satisfaction scores, tentati vely suggesting that the greater the ability of patients and their fam ilies to evaluate services, the less likely! they were to express sati sfaction with treatment. Conclusions: Specialized mental health servic es for refugees may be more acceptable to refugee populations than the ir mainstream counterparts, perhaps because better communication with patients and their families is possible in the specialized services. P atients anti families who are in a position to evaluate services fully are more likely to be critical of treatments offered.