In terms of the number of respondents, Survey on Well-Being among Foreign Born Population (FinMonik) is so far the most extensive survey carried out among the population with foreign background in Finland. It comprises a wide range of self-reported data, including information on the respondent’s health, well-being and access to care, which can be widely utilized in planning and assessing integration, health and welfare policies. A mixed-method approach (an electronic questionnaire, a paper questionnaire and phone interviews) was used in collecting the data which consists of responses by 6836 respondents aged 18–64 years. All response types included, the response rate was 53.1% (n = 6836). This study describes in detail the methods used in the FinMonik survey. In addition, we describe the demographics of the respondents partaking in each response format. The aim of the study is to promote the development of mixed-method survey as a way of collecting reliable data that can be used to enhance foreign-born people’s health, well-being and access to health care. The survey responses will be used as a baseline in observing the respondents’ well-being through the register-based data available in several national registers on health, medicine use and access to care as well as the data collected in the study Impact of Coronavirus Epidemic on Well-Being among Foreign Born Population Study (MigCOVID). Furthermore, the FinMonik study protocol will be repeated every four years.

Background Previous international studies show that perceived unjust treatment is relatively common among people with foreign background (PFB) in medical services. This study examines the association between unjust treatment in medical settings and unmet need for general practitioner's (GP) services among PFB in Finland. Methods The data for this study were drawn from Survey on work and well-being among people of foreign origin (UTH) (N = 5449, response rate 66%), conducted in 2014-2015. Respondent characteristics were weighted and summarized, and multivariable logistic regressions were performed to assess the adjusted odds ratios (OR) of association between self-assessed unjust treatment and unmet need for medical care. The analyses were conducted in a three-step process where the first model tested the association between unjust treatment in medical care settings and unmet need for GP services, second model adjusted this association by sociodemographic factors, and the third model further adjusted the previous models by migration related factors. Results PFB reporting unjust treatment were significantly more likely to experience unmet need for GP services, even after controlling for other tested factors (OR = 8.73, 95% CI 6.18-12.33, p<.001). Besides unjust treatment, only employment status was associated with unmet need for GP services (OR = 1.43, 95% CI 1.08-1.89, p = 0.123) in the final model. Immigration related factors were not associated with unmet need for care in this model. Conclusions Perceived unjust treatment in medical settings is strongly associated with unmet need for GP services. Key messages Cultural sensitive treatment could affect the inequities in unmet need for GP services between PFB and overall population. Ensuring cultural competence throughout organizational structures, and not just for individual employees, could create an environment to promote equal treatment of all clients.

IntroductionPrevious migrant population studies have shown that immigrants experience high level of psychological load and difficulties in accessing care. This is especially prevalent in those with refugee background. To tackle this issue, the PALOMA2 project (National support system for refugee mental health work and the knowhow dissemination) establishes a National PALOMA Centre of Expertise (PALOMA COE) for mental health work among refugees.ObjectivesThe PALOMA COE consists of all five University Hospital Areas and an NGO representative. The PALOMA COE work is becoming a permanent part of the Finnish health care structure. Each represented region has their own specific strengths and challenges, and the formation of Regional PALOMA COEs is planned accordingly. Together these Regional PALOMA COEs form the National PALOMA COE. Here we dive deeper into the Tampere University Hospital Region’s formation of PALOMA COE.MethodsPsychiatric Clinic for Refugees (PCR) has been working for over 24 years in the Tampere City area. PCR has a long history of PALOMA COE work in forms of clinical work, consulting and training professionals working with refugee mental health. From the beginning of 2021, PCR is integrating with Tampere University Hospital.ResultsAs a part of the integration process, the PALOMA COE work has a possibility to expand to the entire University Hospital area and better fulfill the specific needs of the entire region.ConclusionsThe integration will improve the resources, quality and access to mental health care among people with refugee background.

Issue Previous migrant population studies have shown that immigrants experience higher level of psychological load than the overall population. This is especially prevalent in those with refugee background. The PALOMA project (Developing National Mental Health Policies for Refugees) was launched in 2016 to tackle this wellbeing cap. One outcome of the project was a PALOMA handbook, which includes recommendations as well as methods and tools for decision-makers, supervisors and professionals for promoting refugees' mental health and preventing, identifying and treating the problems. During the PALOMA project, the need for national coordination, establishing regional Centre of Expertises and support on refugees mental health work was recognized. Results To fulfill this need, the PALOMA2 project (National support system for refugee mental health work and the knowhow dissemination) started in February 2019. The PALOMA2-project establishes a Centre of Expertise for mental health work among refugees. The project personnel includes five regional experts, that each know the specific strengths and challenges of their region, and an expert from the 3rd sector, that ensures that the target group's and the 3rd sector's voice is heard throughout the project. Each of these six experts also pilot two tools from the PALOMA handbook. Lessons As a result of the PALOMA work, the mental health and mental health work with the refugees will be improved. The PALOMA Centre of Expertise will be a place of consultation, influencing, education, networking, developing and work guidance, and it will help all professionals that work in the field. Key messages The PALOMA Centre of Expertise is involved in developing different services in ways that improve refugee’s mental health and equal access for the developed services. The PALOMA Centre of Expertise will be a permanent part of the Finnish social and health care structure.