Global Mental Health and Services for Migrants in Primary Care Settings in High-Income Countries: A Scoping Review

Abstract

Migrants are at a higher risk for common mental health problems than the general population but are less likely to seek care. To improve access, the World Health Organization (WHO) recommends the integration of mental health services into primary care. This scoping review aims to provide an overview of the types and characteristics of mental health services provided to migrants in primary care following resettlement in high-income countries. We systematically searched MEDLINE, EMBASE, PsycInfo, Global Health, and other databases from 1 January 2000 to 15 April 2020. The inclusion criteria consisted of all studies published in English, reporting mental health services and practices for refugee, asylum seeker, or undocumented migrant populations, and were conducted in primary care following resettlement in high-income countries. The search identified 1627 citations and we included 19 studies. The majority of the included studies were conducted in North America. Two randomized controlled trials (RCTs) assessed technology-assisted mental health screening, and one assessed integrating intensive psychotherapy and case management in primary care. There was a paucity of studies considering gender, children, seniors, and in European settings. More equity-focused research is required to improve primary mental health care in the context of global mental health.

Educational and Training Interventions Aimed at Healthcare Workers in the Detection and Management of People With Mental Health Conditions in South and South-East Asia: A Systematic Review

“…Most of the focus of mental health training was directed toward improving primary healthcare workers' ability to identify, manage, and refer people with mental illness. This finding is consistent with studies in other developing countries (72)(73)(74)(75) as well as research from high income countries with stronger health care systems that report intervening in primary care is effective (76,77). Primary healthcare facilities in countries such as Bangladesh, Pakistan and India can serve between 6,000 and 30,000 people (78)(79)(80).…”

Culturally responsive refugee and migrant health.

“…Given the complex biopsychosocial needs of refugee and migrant populations, integrated primary care can play an important role in supporting the whole-person health care by facilitating access to comprehensive care. Given cultural norms related to mental health and health seeking behaviors, refugee and migrant populations commonly present to primary care with mental health concerns presenting as somatic symptoms; warm handoffs between trusted primary care and behavioral health professionals can help reduce stigma and improve engagement in care (Lu et al, 2020). An interprofessional team, inclusive not only of primary care and behavioral health professionals, but also community health workers, interpreters, case managers, peer navigators, and/or other supports can be particularly important in addressing the diverse needs of the population.…”

The Impact of Mental Health Status on Health Consumption of the Elderly in China

“…The burden of national mental health problems, and their associated social, human rights, and economic consequences [ 1 ] have been recognized by the World Health Organization (WHO), which, in response, has chartered the Mental Health Action Plan 2013–2020 that recognizes the role of mental health in achieving national health [ 2 ]. In China, social reforms have worked to improve living standards, medical security systems, and medical and health consumption.…”