‘I Feel That There Is Someone Who Can Listen to Me’: A Mixed-Method Study on Asylum Seekers’ Experience of the Cultural Formulation Interview

Abstract

Asylum seekers face significant mental health difficulties. An assessment of cultural and contextual factors is necessary for a thorough evaluation of their mental illness. The Cultural Formulation Interview (CFI) can be a useful tool for this purpose, though further research is needed in diverse clinical settings and with varied populations to evaluate it as a cross-cultural assessment tool. Therefore, this study aims to map out asylum seekers’ experience of the CFI in a real-life clinical context, applying a mixed-method design. The CFI Debriefing Instrument for Patients (n = 63) data were quantitatively analysed. Semi-structured debriefing interviews (n = 61) underwent thematic framework analysis. The study demonstrates how asylum seekers rated the CFI moderately acceptable (6.74; SD: 3.24). Feasibility obtained a modest score (0.44; SD: 0.85). Clinical utility seemed to be perceived slightly higher (1.04; SD: 0.51). Thematic framework analysis identified facilitators such as the CFI's ability to ask relevant and understandable questions, stimulating in-depth conversations, new insights, and the patient–clinician relationship. However, barriers included the number and difficulty of the questions, the unclear benefit of the CFI, painful confrontation with the past and their suffering, and emotional distress. This study underscores asylum seekers’ nuanced experience of the CFI. Aspects proper to working with asylum seekers (e.g., impact of trauma, loss) must be considered when implementing the CFI. We formulate attention points to promote the use of the CFI as a tailored instrument to address asylum seekers’ mental health needs safely.