Effectiveness of Primary Health Care Services in Addressing Mental Health Needs of Minority Refugee Population in New Zealand

Abstract

Many people are displaced from their country of origin and become refugees, mostly due to armed conflicts, political violence and human rights abuse. Refugees have complex mental, physical, and social health problems related to their traumatic background and the experiences they have endured during their refugee journey. The aim of this qualitative exploratory study was to examine the effectiveness of primary health care services in addressing mental health needs of Bhutanese refugee women resettled in New Zealand. This study included focus group discussion with Bhutanese women and men followed by interviews with health service providers. The findings of this study highlighted inadequacies and constraints in addressing Bhutanese refugee women's mental health needs in New Zealand and provided evidence for recommendations to address these inadequacies.

Health-related needs and barriers for forcibly displaced women: a systematic review

“…Access to services is limited by two factors: national rules for provision of services, i.e. certain services are covered according to the insurance plan accessible to refugees and others are for-payment only [16,19], and understanding of the functioning of healthcare provision [17,[20][21][22]. This can be limited due to language barriers or to the difficulties associated with navigating an unknown system [20].…”

“…Communication, specifically language barriers, is one of the most frequently mentioned hurdles for integration and successful meeting of healthcare needs [16,19,20,22]. Women have been identified as frequently lagging behind in language acquisition due to several factors.…”

“…This leads to a persistent dependency on translation and interpreter services. Interpreter services are not structurally provided in many contexts and even if translators are available, distrust in their abilities or intentions might be present [16,20,22]. Sometimes this is due to the translator being from a rival ethnic group in the home country or to simple distrust in the translation process.…”

“…Women consequently recur to engaging family members and friends as translators [16,20,22] limiting the breadth of subjects that can be openly discussed with the healthcare provider. For example, if children take up the role of translators any discussion about reproduction, contraception or sexuality will not be addressed.…”

“…Cultural/spiritual aspects The main cultural differences described lie within the conceptualization of health and disease overall in different cultures. Many non-Western cultures conceive health in a holistic manner and refugees struggle with the pragmatic, disease-oriented approach in many countries of arrival [20,22,26,27].…”