Mental health care utilisation and access among refugees and asylum seekers in Europe: A systematic review

•Refugees and asylum seekers in Europe experience high mental health needs.•This population exhibits low contact coverage of specialist MHPSS services.•This population presents more frequently with physical health complaints.•Barriers to access include: language, stigma, low awareness, and variant h...

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Vydáno v:Health policy (Amsterdam) Ročník 123; číslo 9; s. 851 - 863
Hlavní autoři: Satinsky, Emily, Fuhr, Daniela C., Woodward, Aniek, Sondorp, Egbert, Roberts, Bayard
Médium: Journal Article
Jazyk:angličtina
Vydáno: Ireland Elsevier B.V 01.09.2019
Elsevier Science Ltd
Témata:
Access
Asylum seekers
Attitudes
Barriers
Health needs
Health services utilization
Help seeking behavior
Illnesses
Internal Medicine
Language attitudes
Literary criticism
Mental disorders
Mental health
Mental health care
Mental health services
MHPSS
Political asylum
Psychosocial factors
Psychosocial intervention
Psychosocial support
Referrals
Refugees
Service utilisation
Single market
Skills
Stigma
Systematic review
Access
MHPSS
Service utilisation
Refugees
Asylum seekers
Mental health
ISSN:0168-8510, 1872-6054, 1872-6054
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Shrnutí:•Refugees and asylum seekers in Europe experience high mental health needs.•This population exhibits low contact coverage of specialist MHPSS services.•This population presents more frequently with physical health complaints.•Barriers to access include: language, stigma, low awareness, and variant help-seeking behaviours. Refugees and asylum seekers often have increased mental health needs, yet may face barriers in accessing mental health and psychosocial support (MHPSS) services in destination countries. The aim of this systematic review is to examine evidence on MHPSS service utilisation and access among refugees and asylum seekers in European Union Single Market countries. Four peer-reviewed and eight grey literature databases were searched for quantitative and qualitative literature from 2007 to 2017. Access was categorised according to Penchansky and Thomas’ framework and descriptive analyses were conducted. Quality of studies was assessed by the Newcastle-Ottawa scale and the Critical Appraisal Skills Programme checklist. Twenty-seven articles were included. The findings suggest inadequate MHPSS utilisation. Major barriers to accessing care included language, help-seeking behaviours, lack of awareness, stigma, and negative attitudes towards and by providers. Refugees and asylum seekers have high mental health needs but under-utilise services in European host countries. This underutilisation may be explained by cultural-specific barriers which need to be tackled to increase treatment demand. Training health providers on cultural models of mental illness may facilitate appropriate identification, referral, and care. Based on these findings, it is crucial to review policies regarding MHPSS provision across the EU.
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ObjectType-Evidence Based Healthcare-1
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ISSN:0168-8510
1872-6054
1872-6054
DOI:10.1016/j.healthpol.2019.02.007