Reporting mental health problems of undocumented migrants in Greece: A qualitative exploration

Teunissen, Erik; Tsaparas, Alexandra; Saridaki, Aristoula; Trigoni, Maria; Weel‐Baumgarten, Evelyn van; Weel, Chris van; Muijsenbergh, Maria van den; Lionis, Christos

doi:10.3109/13814788.2015.1136283

Cited by 15 publications

(12 citation statements)

References 17 publications

(25 reference statements)

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“…This could indicate a biased judgement in favour of certain patients, which is in contrast with the universal nature of the public healthcare system. This finding is in line with previous research on Crete, Greece, which indicated a growing societal resistance towards undocumented migrants, as well as a tendency of some GPs to place a higher priority on addressing the health burden of the Greek population as compared with similar health problems of the migrants [ 10 ]. This was particularly evident in Teunissen et al.’s study [ 10 ], which found that GPs’ were disregarding the primary care system regulations in an attempt to serve undocumented migrants and offer them free and unrestricted access to healthcare.…”

Section: Discussionsupporting

confidence: 91%

“…In daily practice, many general practitioners (GPs) at primary healthcare clinics have been serving as gatekeepers for both documented and undocumented migrants and this seems to have placed a high burden to primary care service providers [ 10 ]. The recent financial crisis and the austerity measures have exacerbated this problem resulting in a dysfunctional primary healthcare sector with many cutbacks in healthcare services to vulnerable groups [ 11–15 ].…”

Section: Introductionmentioning

confidence: 99%

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Exploring barriers to primary care for migrants in Greece in times of austerity: Perspectives of service providers

Papadakaki

Lionis

Saridaki

et al. 2017

European Journal of General Practice

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Background: Migration in Europe is increasing at an unprecedented rate. There is an urgent need to develop ‘migrant-sensitive healthcare systems’. However, there are many barriers to healthcare for migrants. Despite Greece’s recent, significant experiences of inward migration during a period of economic austerity, little is known about Greek primary care service providers’ experiences of delivering care to migrants.Objectives: To identify service providers’ views on the barriers to migrant healthcare.Methods: Qualitative study involving six participatory learning and action (PLA) focus group sessions with nine service providers. Data generation was informed by normalization process theory (NPT). Thematic analysis was applied to identify barriers to efficient migrant healthcare.Results: Three main provider and system-related barriers emerged: (a) emphasis on major challenges in healthcare provision, (b) low perceived control and effectiveness to support migrant healthcare, and (c) attention to impoverished local population.Conclusion: The study identified major provider and system-related barriers in the provision of primary healthcare to migrants. It is important for the healthcare system in Greece to provide appropriate supports for communication in cross-cultural consultations for its diversifying population.

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Exploring barriers to primary care for migrants in Greece in times of austerity: Perspectives of service providers

Papadakaki

Lionis

Saridaki

et al. 2017

European Journal of General Practice

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“…A study from the Netherlands also found that undocumented people were referred significantly more often to psychiatrists than psychologists, probably because psychologists would not receive any reimbursement for conceivable psychotherapeutic care 52. For Greece, problems with drug prescription and referrals to mental health institutions due to lack of reimbursement were also described 53. Both studies mention low consultation rates, frequent presentation of mental illness with somatic symptoms and lack of trust as additional barriers 32 53…”

Section: Discussionmentioning

confidence: 99%

“…For Greece, problems with drug prescription and referrals to mental health institutions due to lack of reimbursement were also described 53. Both studies mention low consultation rates, frequent presentation of mental illness with somatic symptoms and lack of trust as additional barriers 32 53…”

Section: Discussionmentioning

confidence: 99%

‘Managing scarcity’– a qualitative study on volunteer-based healthcare for chronically ill, uninsured migrants in Berlin, Germany

2019

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ObjectivesIn Germany, healthcare for people lacking legal residency status and European Union citizens without health insurance is often provided by non-governmental organisations. Scientific studies assessing the situation of the patients with chronic diseases in this context are scarce. We aimed to characterise medical care for chronically ill migrants without health insurance and outline its possibilities and limitations from the treating physicians’ perspective.DesignQualitative semi-structured interviews; qualitative content analysis.SettingOrganisations and facilities providing healthcare for uninsured migrants: free clinics, medical practices and public health services.Participants14 physicians working regularly in healthcare for uninsured migrants.ResultsDelayed contact to the healthcare system was frequently addressed in the interviews. Care was described as constrained by a scarcity of resources that often impedes adequate treatment for many conditions, most pronounced in the case of oncological diseases or chronic viral infections (HIV, hepatitis). For other chronic conditions such as cardiovascular diseases or diabetes, some diagnostics and basic medications were described as partially available, while management of complications or rehabilitative measures are frequently unfeasible. For the patients with mental health problems, attainability of psychotherapeutic treatment is reported as severely limited. Care is predominantly described as fragmented with limitations to information flow and continuity. Which level of care a patient receives appears to depend markedly on the respective non-governmental organisation and the individual commitment, subjective decisions and personal connections of the treating physician.ConclusionsRestrictions in medical care for uninsured migrants have even more impact on chronically ill patients. Volunteer-based care often constitutes an inadequate compensation for regular access to the healthcare system, as it is strongly influenced by the limitation of its resources and its arbitrariness.

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“…Both documented and undocumented migrants are recognized as a group facing numerous barriers to accessing adequate health services in host countries [4, 5], due to, among others, language, marginalization, bureaucracy, and fear of deportation. These hold true in Greece, where a previous study confirmed cultural and language barriers to accessing mental health services by undocumented migrants [6]. Papadakaki et al [7] reported on the outcomes of the RESTORE project in Crete, Greece, where health care providers mentioned feeling powerless about supporting migrant healthcare with such low capacity in the system, due to primarily fiscal constraints.…”

Section: Introductionmentioning

confidence: 86%

Health and health needs of migrants in detention in Greece: shedding light to an unknown reality

et al. 2019

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BackgroundPopulation movements have been increasing over the past years in Europe due to socioeconomic factors, global turbulence and conflicts, especially in the area of Middle East. The presence of migrant populations in Europe challenges health systems due to increased requirements for health care provision. However, to date there is limited published data on the burden of disease among this population (in Greece and elsewhere). Our objective was to record burden of disease of undocumented migrants hosted in a Detention Center and therefore generate data for migrant and public health planning.MethodsEpidemiological data have been collected for 4756 male migrants hosted in a Detention Center from mid 2013 to mid 2015. Of them, 1427 have used health services in the Center, which maintained a detailed record of their medical history and tests.ResultsThe majority of the study population was aged between 18 and 40 years old. Among those who used health services, most suffered from respiratory (45.6%) and digestive (30.1%) diseases. Injury, poisoning and other external causes accounted for 19.6% of service use, diseases of the skin and subcutaneous tissue for 18.7%, and factors affecting health status and contact with health services for 16.7%. Prevalence of communicable diseases was 15.9% amongst migrants randomly tested.ConclusionSystematic screening and monitoring of diseases and use of health services by migrants in detention centers allows for an evidence based understanding of the burden of disease related to these populations and the investment required to effectively manage it, thus providing critical input to appropriate health planning. Surveillance for communicable diseases amongst migrants in detention centers would also allow for a true picture of the impact of their presence on public health indicators and help address related prejudices and stigma.

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Reporting mental health problems of undocumented migrants in Greece: A qualitative exploration

Cited by 15 publications

References 17 publications

Exploring barriers to primary care for migrants in Greece in times of austerity: Perspectives of service providers

Exploring barriers to primary care for migrants in Greece in times of austerity: Perspectives of service providers

‘Managing scarcity’– a qualitative study on volunteer-based healthcare for chronically ill, uninsured migrants in Berlin, Germany

Health and health needs of migrants in detention in Greece: shedding light to an unknown reality

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