Satisfaction with mental health treatment among patients with a non-Western migrant background: a survey in a Danish specialized outpatient mental health clinic

Abstract

Background Global migration increases ethnic and cultural diversity and demands mental health services to adapt to provide all patients with equal access to good quality care. Patient satisfaction surveys can inform this service delivery, thus we explored patient satisfaction among non-Western migrants receiving treatment in a Danish specialized outpatient mental health clinic [Competence Centre for Transcultural Psychiatry (CTP)]. Methods We used multivariate logistic regression models to estimate associations between ‘Overall treatment satisfaction’ and treatment-related items plus potential confounders from a cross-sectional patient satisfaction survey (n = 686). The satisfaction questionnaire was a self-report measurement tool developed locally at CTP. Participants were non-Western migrants above 18 years with Post-Traumatic Stress Disorder (PTSD) or depression diagnoses according to ICD-10. Results Most participants (n = 497; 82.6%) reported overall satisfaction with their mental health treatment, but less than half (n = 311; 48.8%) reported an improvement in health and situation after end of treatment. Participants who experienced a subjective improvement in their health and situation had significantly higher odds of being satisfied with their mental health treatment [odds ratio (OR) = 8.5, 95% confidence interval (CI): 4.0–18.1]. Perceptions of influence on the treatment course (OR = 4.7, 95% CI: 2.4–9.2), and of understanding and respect for one’s cultural background (OR = 3.4, 95% CI: 1.5–7.6) were significantly associated with treatment satisfaction. Age and sex were insignificant in the final regression model. Conclusions Implications for practice based on our findings are to enhance person-centred care and shared decision-making with all patients regardless of cultural background and to prioritize pre- and postgraduate training in cultural competences and cultural humility for healthcare providers.

Detection and treatment of mental disorders in patients with coronary heart disease (MenDis-CHD): A cross-sectional study

“…In the course of shared decision-making, it appears to be beneficial that the physician recommends and discusses in-depth diagnosis and treatment of MDs with the patient after a positive MD screening. The shared decision on MD treatment can also increase adherence, which in turn can improve patient satisfaction and quality of life [35].…”

Do outcomes of psychiatric hospital treatment differ for migrants and non-migrants?

“…In this study, the sample of more than 7,000 patients across 5 European countries was large and provided considerable statistical power to adjust differences between migrants and non-migrants for potentially confounding characteristics of the patients. This is essential for such a comparison since migrants and non-migrants differ in a range of socio-demographic and clinical characteristics, and these characteristics need to be taken into account in a meaningful statistical analysis [5,7,13,24]. Patients were studied in routine care and outcomes were not influenced by the research process.…”

“…Yet, there is a lack of large-scale research on whether outcomes of psychiatric treatments are truly different for migrant groups, and this applies to objective outcomes as well as patients' subjective appraisal of it [12]. Patient satisfaction is known to be a key indicator of quality of care [13,14], and is described as "an expression of the gap between the expected and the perceived quality of a service [11, page 69]. Higher levels of satisfaction with inpatient care have been shown to be associated with lower readmission rates to hospital and lower disability levels within 1 year [15][16][17], better adherence to medication and treatment, and a reduction in psychotic symptoms up to three 3 years later [16,18,19].…”

Migrants’ perceptions of health system responsiveness and satisfaction with health workers in a South African Province

“…HSR), their satisfaction with, and their experiences of the health system [11]. In high-income countries, several studies have described the experiences and perceptions of migrants of the health care systems in their host countries [12][13][14][15][16][17][18][19][20]. A 2010 review of migrants using health care services in high-income countries demonstrated negative associations between patient satisfaction scores and gender, age and education levels [10].…”

“…In the UK (UK), studies have found that gypsies, travellers and minority ethnic groups experienced high levels of inequalities in the access and/or the quality of care they received in the public healthcare system [15,16]. In Germany [17,18] and Denmark [19], studies found that migrant patients' satisfaction with health care services were influenced by communication by, and cultural sensitivity of, health care providers. A 2016 qualitative study that explored HIV-positive migrants' experiences in the Swedish health care system found that they appreciated access to free antiretroviral therapy, but felt discrimination in health care settings outside of the infectious diseases clinics [21].…”