Although refugees are at an increased risk to suffer from mental disorders, as compared to other immigrants, little is known about possible differences in treatment response and service utilization.

The current study includes data from two separate samples of Iraqi refugees and Arab immigrants. Prevalence of physician-diagnosed mental disorders along with treatment response and utilization data was collected from medical records or by surveys. Data was collected from 307 refugees and 326 immigrant controls.

The prevalence of depression was significantly greater in refugees as compared to immigrants (54% vs. 26%; p< .001). There were no differences between groups in diagnosed anxiety disorders. In addition, self reported complaints of depression (33% vs. 3.1%; p< .001), anxiety (20% vs. 4%; p< .001), and sleep difficulties (15% vs. 2%; p< .001) were more prevalent among refugees than immigrants. In general, treatment response was poor for both groups; however, for longer term patients, treatment response was significantly better (44% recovery vs. 15% recovery; p< .001) for immigrants than refugees. Typical common psychosomatic symptoms were more prevalent and associated with increased health care utilization in refugees as compared to immigrants.

Results suggest that treatment offered to refugees is far from effective. There is a need to review health systems factors in order to promote cost-effective and timely mental health services for refugees, not least with the current influx of Iraqi refugees commonly suffering from mental and adjustment disorders.