Mental health problems in undocumented and documented migrants: a survey study

Teunissen, Erik; Bosch, Laura van den; Bavel, Eric van; Mareeuw, Francine van den Driessen; Muijsenbergh, Maria van den; Weel‐Baumgarten, Evelyn van; Weel, Chris van

doi:10.1093/fampra/cmu038

Cited by 22 publications

(36 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Although the prevalence of mental health problems, such as post-traumatic stress disorder, depression and anxiety is high among UMs in the Netherlands, 22 it is unclear from primary healthcare data to what extent professional care is responding to these needs. 23 …”

Section: Introductionmentioning

confidence: 99%

Mental health problems of undocumented migrants (UMs) in the Netherlands: a qualitative exploration of help-seeking behaviour and experiences with primary care

et al. 2014

View full text Add to dashboard Cite

ObjectiveTo explore health-seeking behaviour and experiences of undocumented migrants (UMs) in general practice in relation to mental health problems.DesignQualitative study using semistructured interviews and thematic analysis.Participants15 UMs in the Netherlands, varying in age, gender, country of origin and education; inclusion until theoretical saturation was reached.Setting4 cities in the Netherlands.ResultsUMs consider mental health problems to be directly related to their precarious living conditions. For support, they refer to friends and religion first, the general practitioner (GP) is their last resort. Barriers for seeking help include taboo on mental health problems, lack of knowledge of and trust in GPs competencies regarding mental health and general barriers in accessing healthcare as an UM (lack of knowledge of the right to access healthcare, fear of prosecution, financial constraints and practical difficulties). Once access has been gained, satisfaction with care is high. This is primarily due to the attitude of the GPs and the effectiveness of the treatment. Reasons for dissatisfaction with GP care are an experienced lack of time, lack of personal attention and absence of physical examination. Expectations of the GP vary, medication for mental health problems is not necessarily seen as a good practice.ConclusionsUMs often see their precarious living conditions as an important determinant of their mental health; they do not easily seek help for mental health problems and various barriers hamper access to healthcare for them. Rather than for medication, UMs are looking for encouragement and support from their GP. We recommend that barriers experienced in seeking professional care are tackled at an institutional level as well as at the level of GP.

show abstract

Section: Introductionmentioning

confidence: 99%

Mental health problems of undocumented migrants (UMs) in the Netherlands: a qualitative exploration of help-seeking behaviour and experiences with primary care

et al. 2014

View full text Add to dashboard Cite

show abstract

“…As they all practised in the main areas where many UMs were residing, we think the findings of this study are representive of the Dutch context. The majority of these GPs participated in an earlier survey study [ 13 ], and in this study we showed that their undocumented patients represented the general UM population in the Netherlands.…”

Section: Strenghts and Limitations Of The Studymentioning

confidence: 57%

“…However, despite the above-mentioned rights of UMs to obtain health care and the possible reimbursement for health care professionals (8), there are contradictory reports of the levels of mental health problems presented, recorded, and treated in primary care [ 11–13 ]. While one study showed that mental health problems were frequently presented in primary care [ 11 ], other studies showed low recording rates of mental health problems and low prescription rates of psychotropics [ 12 , 13 ]. These studies indicate a gap between the high prevalence of mental health problems presented by UMs and the low recording of these problems by GPs.…”

Section: Introductionmentioning

confidence: 99%

Mental health problems of undocumented migrants in the Netherlands: A qualitative exploration of recognition, recording, and treatment by general practitioners

Teunissen

Bavel

Mareeuw

et al. 2015

Scandinavian Journal of Primary Health Care

View full text Add to dashboard Cite

Objective. To explore the views and experiences of general practitioners (GPs) in relation to recognition, recording, and treatment of mental health problems of undocumented migrants (UMs), and to gain insight in the reasons for under-registration of mental health problems in the electronic medical records. Design. Qualitative study design with semi-structured interviews using a topic guide. Subjects and setting. Sixteen GPs in the Netherlands with clinical expertise in the care of UMs. Results. GPs recognized many mental health problems in UMs. Barriers that prevented them from recording these problems and from delivering appropriate care were their low consultation rates, physical presentation of mental health problems, high number of other problems, the UM’s lack of trust towards health care professionals, and cultural differences in health beliefs and language barriers. Referrals to mental health care organizations were often seen as problematic by GPs. To overcome these barriers, GPs provided personalized care as far as possible, referred to other primary care professionals such as social workers or mental health care nurses in their practice, and were a little less restrictive in prescribing psychotropics than guidelines recommended. Conclusions. GPs experienced a variety of barriers in engaging with UMs when identifying or suspecting mental health problems. This explains why there is a gap between the high recognition of mental health problems and the low recording of these problems in general practice files. It is recommended that GPs address mental health problems more actively, strive for continuity of care in order to gain trust of the UMs, and look for opportunities to provide mental care that is accessible and acceptable for UMs.

show abstract

“…The finding of medication-based treatment being easier to achieve than psychotherapeutic treatment was likewise described by the Castañeda study 16. 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.…”

Section: Discussionmentioning

confidence: 87%

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

2019

View full text Add to dashboard Cite

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.

show abstract

Mental health problems in undocumented and documented migrants: a survey study

Abstract: UM had less consultations with their GP, and in these consultations, less mental health problems were registered. UM were referred less to psychologists but more often to psychiatrists. GPs are advised to explore and register mental health problems more actively in UM.

Cited by 22 publications

References 7 publications

Mental health problems of undocumented migrants (UMs) in the Netherlands: a qualitative exploration of help-seeking behaviour and experiences with primary care

Mental health problems of undocumented migrants (UMs) in the Netherlands: a qualitative exploration of help-seeking behaviour and experiences with primary care

Mental health problems of undocumented migrants in the Netherlands: A qualitative exploration of recognition, recording, and treatment by general practitioners

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

Contact Info

Product

Resources

About