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Document Type

DNP - University Access Only

Award Date


Degree Name

Doctor of Nursing Practice (DNP)


Graduate Nursing

First Advisor

Kay Foland


Refugee, immigrant, RHS-15, mental health, depression, anxiety, PTSD


Anxiety, depression, and PTSD are known mental health conditions that complicate the resettlement of refugee and immigrant patients living in the United States. A lack of culturally competent mental health screening has been identified as a barrier to effective healthcare for this vulnerable population. The Refugee Health Screener-15 (RHS-15) was studied as a culturally competent mental health screening tool to help identify refugee and immigrant patients presenting to the emergency department for care. Adult patients over the age of 18 who were born in a country other than the United States were included in the study population. Exclusion criteria included patients with under age 18, trauma team activation patients, level 1 or 2 acuity, and patients presenting with mental health complaint. The implementation period was 12 weeks. Patients who screened positive were given optional mental health referral. The main outcome measured was screening result. Screening result was then viewed by gender, race, and ethnicity. The RHS-15 helped identify mental health diagnoses in more than half of the sample population of refugee and immigrant patients, thereby increasing the identification of patients struggling with underlying mental health conditions in the emergency department. The use of the tool also promoted culturally competent care within the emergency department setting.

Library of Congress Subject Headings

Refugees -- Mental health services.
Immigrants -- Mental health services.
Emergency medical services.
Medical screening.


Includes bibliographical references (pages 70-77)



Number of Pages



South Dakota State University


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