Health care seeking among detained undocumented migrants: a cross-sectional study

Abstract

BackgroundAs in many European countries, access to care is decreased for undocumented migrants in the Netherlands due to legislation. Studies on the health of undocumented migrants in Europe are scarce and focus on care-seeking migrants. Not much is known on those who do not seek care.MethodsThis cross-sectional study includes both respondents who did and did not seek care, namely undocumented migrants who have been incarcerated in a detention centre while awaiting expulsion to their country of origin. A consecutive sample of all new arrivals was studied. Data were collected through structured interviews and reviews of medical records.ResultsAmong the 224 male migrants who arrived at the detention centre between May and July 2008, 173 persons were interviewed. 122 respondents met inclusion criteria. Only half of the undocumented migrants in this study knew how to get access to medical care in the Netherlands if in need. Forty-six percent of respondents reported to have sought medical help during their stay in the Netherlands while having no health insurance (n = 57). Care was sought most frequently for injuries and dental problems. About 25% of these care seekers reported to have been denied care by a health care provider. Asian migrants were significantly less likely to seek care when compared to other ethnic groups, independent from age, chronic health problems and length of stay in the Netherlands.ConclusionThe study underlines the need for a better education of undocumented patients and providers concerning the opportunities for health care in the Netherlands. Moreover, there is a need to further clarify the reasons for the denial of care to undocumented patients, as well as the barriers to health care as perceived by undocumented migrants.

Analysis of Prehospital Care of Migrants Who Arrive Intermittently at the Coasts of Southern Spain

“…For instance, in a cross-sectional study performed in the center for migrants of Lampedusa (Italy), attending migrants crossing the so-called "central Mediterranean route" [33] the most frequent diagnosis was scabies, skin infections, pediculosis and dermatitis, and also respiratory infections and varicella were the most represented infectious diseases, just quite different from the problems identified in this study, perhaps due to the specific characteristics of this route, very different from the route of the Strait of Gibraltar. Moreover, as mentioned, health problems related to exposure to high temperatures are especially frequent in illegal migratory movements such as across the Mexico-Arizona border [26,27] or, for example, it has been reported in immigrants who illegally access other countries in northern Europe such as the Netherlands, seeking care most frequently for injuries and dental problems [34]. Other studies also highlighted the mental health problems that have been identified among humanitarian migrants who access countries such as Australia where premigration potentially traumatic events and postmigration stressors were positively associated with posttraumatic stress disorder and severe mental illness [35], aspects that we have not detected in our study.…”

Obstetric and Medico-Legal Challenges Posed by Sudden Immigrant Shift in a Southern Mediterranean Island

“…The same quoted Canadian experience further concludes that these crucial psycho-social and religious elements are "often overlooked in Canadian maternity settings [10]. " If looked for, the odds are in favour of the same conclusion in general, in Malta, as indeed elsewhere, such as Holland where :"These groups face similar problems, that is, the initial lack of knowledge on the Dutch health care system, language problems and difficulties arising in the communication with health care providers who have a different cultural background than the patient [11]. Such an ethnic barrier, at times in spite of correct interpretation (not to be universally assumed), has multiple facets from the moment of the patient entering the doctor's office to the point of departure.…”

“…Between 2008 and 2012 Malta received, on average, the highest number of asylum seekers compared to its national population: 21.7 applicants per 1,000 inhabitants [4][5][6][7][8][9][10][11]. In 2011, most of these asylum applications were submitted by nationals of Somalia, Nigeria, Eritrea and Syria [12].…”

Effectiveness of a peer-refugee delivered psychological intervention to reduce psychological distress among adult Syrian refugees in the Netherlands: study protocol

“…Despite the availability of specialized mental health services, there are numerous barriers to the delivery and uptake of psychological interventions for refugees (WHO, 2015). These include communication difficulties such as language barriers and interpreter costs (Satinsky, Fuhr, Woodward, Sondorp, & Roberts, 2019), stigma around mental illness (Hassan, Ventevogel, Jefee-Bahloul, Barkil-Oteo, & Kirmayer, 2016), waitlists (Satinsky et al, 2019), and difficulties navigating within a foreign health care system (Dorn et al, 2011). Treatment programmes usually focus on single psychiatric disorders (such as PTSD), whereas many refugees suffer from multiple psychological problems (Thabet, Abed, & Vostanis, 2004).…”