Health professionals’ experiences of and attitudes towards mental healthcare for migrants and refugees in Europe: a qualitative systematic review

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Abstract

Migrants living in Europe constitute over half of the world’s international migrants, are at higher risk of poor mental health than non-migrants, yet also face more barriers in accessing and engaging with services. Furthermore, the quality of care received is shaped by the experiences and attitudes of health professionals. The aim of this review was to identify professionals’ attitudes towards migrants receiving mental healthcare and their perceptions of barriers and facilitators to service provision. Four electronic databases were searched, and 23 studies met the inclusion criteria. Using thematic synthesis, we identified three themes: 1) the management of multifaceted and complex challenges associated with the migrant status; 2) professionals’ emotional responses to working with migrants; and 3) delivering care in the context of cultural difference. Professionals employed multiple strategies to overcome challenges in providing care yet attitudes towards this patient group were polarised. Professionals described mental health issues as being inseparable from material and social disadvantage, highlighting a need for effective collaboration between health services and voluntary organisations, and partnerships with migrant communities. Specialist supervision, reflective practice, increased training for professionals, and the adoption of a person-centred approach are also needed to overcome the current challenges in meeting migrants’ needs. The challenges experienced by health professionals in attempting to meet migrant needs reflect frustrations in being part of a system with insufficient resources and without universal access to care that effectively stigmatises the migrant status.
Keywords: Thematic synthesis; Migrants; Mental health; Mental health services; Healthcare professional attitudes; Europe

Bibliographical metadata

Original languageEnglish
JournalTranscultural Psychiatry
Publication statusAccepted/In press - 30 Oct 2021