Experiences with treating immigrants: a qualitative study in mental health services across 16 European countries

Sandhu, Sima; Bjerre, Neele V.; Dauvrin, Marie; Días, Sónia; Gaddini, Andrea; Greacen, Tim; Ioannidis, Elisabeth; Kluge, Ulrike; Jensen, Natasja Koitzsch; Lamkaddem, Majda; Riera, Rosa Puigpinós i; Kósa, Zsigmond; Wihlman, Ulla; Stankūnas, Mindaugas; Straßmayr, Christa; Wahlbeck, Kristian; Welbel, Marta; Priebe, Stefan

doi:10.1007/s00127-012-0528-3

Cited by 99 publications

(99 citation statements)

References 31 publications

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“…The most common reason stated by clinicians for patient delays in treatment initiation (n=5 studies) was the interpretation among patients that the mental health system and its services could not help them. This was reported for Bangladeshi women immigrants in the UK [41], Chinese immigrants in Australia [42] and in the US [59], Asian and African immigrants throughout Europe [56], and elderly blacks and Hispanics in the US [44]. Somatic interpretations of mental illness were the second commonest reason for delays in treatment initiation (n=4 studies).…”

Section: Resultsmentioning

confidence: 90%

“…The most common finding was patient discomfort in discussing emotions with clinicians who were viewed as strangers (n=6 studies). This tendency was reported among cultural and linguistic minorities in Australia [55], Asian and African immigrants in Europe [56], immigrants in Spain [48], and Indian immigrants [45], Dominican immigrants [51], and elderly blacks and Latinos in the United States [44]. One study reported that caregivers of Chinese American patients with dementia minimized problems to clinicians, limiting treatment participation [59].…”

Section: Resultsmentioning

confidence: 99%

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Clinician descriptions of communication strategies to improve treatment engagement by racial/ethnic minorities in mental health services: A systematic review

Aggarwal

Pieh

Dixon

et al. 2016

Patient Education and Counseling

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Objective To describe studies on clinician communication and the engagement of racial/ethnic minority patients in mental health treatment. Methods Authors conducted electronic searches of published and grey literature databases from inception to November 2014, forward citation analyses, and backward bibliographic sampling of included articles. Included studies reported original data on clinician communication strategies to improve minority treatment engagement, defined as initiating, participating, and continuing services. Results Twenty-three studies met inclusion criteria. Low treatment initiation and high treatment discontinuation were related to patient views that the mental health system did not address their understandings of illness, care or stigma. Treatment participation was based more on clinician language use, communication style, and discussions of patient-clinician differences. Conclusion Clinicians may improve treatment initiation and continuation by incorporating patient views of illness into treatment and targeting stigma. Clinicians may improve treatment participation by using simple language, tailoring communication to patient preferences, discussing differences, and demonstrating positive affect. Practice implications Lack of knowledge about the mental health system and somatic symptoms may delay treatment initiation. Discussions of clinician backgrounds, power, and communication style may improve treatment participation. Treatment continuation may improve if clinicians tailor communication and treatment plans congruent with patient expectations.

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Section: Resultsmentioning

confidence: 90%

Section: Resultsmentioning

confidence: 99%

Clinician descriptions of communication strategies to improve treatment engagement by racial/ethnic minorities in mental health services: A systematic review

Aggarwal

Pieh

Dixon

et al. 2016

Patient Education and Counseling

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show abstract

“…Literature from mental health units has also highlighted difficulties with diagnosing mental health problems in patients from different cultural backgrounds [34]. This may be due to language problems, different belief systems making it difficult to differentiate between certain beliefs and symptoms of a mental illness or trying to distinguish post traumatic stress disorder from psychotic symptoms in immigrant patients [35]. Problems with correct diagnosing of patients in the area of mental health have also been reported with other psychiatric diseases such as dementia [36-38] and schizophrenia [39].…”

Section: Discussionmentioning

confidence: 99%

How do general practitioners experience providing care to refugees with mental health problems? A qualitative study from Denmark

et al. 2013

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BackgroundRefugees are a particularly vulnerable group in relation to the development of mental illness and many may have been subjected to torture or other traumatic experiences. General practitioners are gatekeepers for access to several parts of the psychiatric system and knowledge of their patients’ refugee background is crucial to secure adequate care. The aim of this study is to investigate how general practitioners experience providing care to refugees with mental health problems.MethodsThe study was conducted as part of an EU project on European Best Practices in Access, Quality and Appropriateness of Health Services for Immigrants in Europe (EUGATE). Semi-structured interviews were carried out with nine general practitioners in the vicinity of Copenhagen purposively selected from areas with a high proportion of immigrants. The analysis of the interviews is inspired by qualitative content analysis.ResultsOne of the main themes identified in the analysis is communication. This includes the use of professional interpreters and that communication entails more than sharing a common language. Quality of care is another theme that emerges and includes awareness of possible trauma history, limited possibilities for refugees to participate in certain treatments due to language barriers and feelings of hopelessness in the general practitioners. The general practitioners may also choose different referral pathways for refugees and they report that their patients lack understanding regarding the differences between psychological problems and physical symptoms.ConclusionGeneral practitioners experience that providing care to refugees differs from providing care for patients from the majority population. The different strategies employed by the general practitioners in the health care treatment of refugees may be the result of the great diversity in the organisation of general practice in Denmark and the lack of a national strategy in the health care management of refugees. The findings from this study suggest that the development of conversational models for general practitioners including points to be aware of in the treatment of refugee patients may serve as a support in the management of refugee patients in primary care.

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“…Pasientgruppen med en annen språkbakgrunn rommer et stort antall minoriteter med ulike kulturbakgrunner. Pasienter kan risikere å få et dårligere tilbud dersom sykepleierne ikke identifiserer kulturell og språklig bakgrunn (9). Vi forstår begrepet kultur som noe som stadig er i endring.…”

Section: Kulturkompetanseunclassified

Reduserer språkbarrierer på sykehus

Kolbjørnsen¹,

Engeland²

2016

Sykepleien

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Experiences with treating immigrants: a qualitative study in mental health services across 16 European countries

Cited by 99 publications

References 31 publications

Clinician descriptions of communication strategies to improve treatment engagement by racial/ethnic minorities in mental health services: A systematic review

Clinician descriptions of communication strategies to improve treatment engagement by racial/ethnic minorities in mental health services: A systematic review

How do general practitioners experience providing care to refugees with mental health problems? A qualitative study from Denmark

Reduserer språkbarrierer på sykehus

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