The Family-School-Primary Care Triangle and the Access to Mental Health Care Among Migrant and Ethnic Minorities

Abstract

Understanding the concepts of mental health and help seeking behaviours of migrant and ethnic minority families constitutes an important step toward improving the intercultural competence of health and education professionals. This paper addresses these goals among ethnic and migrant minorities in Portugal. For this a multi-informant approach was selected. The study involved nine focus groups (N = 39) conducted with different samples: young immigrants (12-17 years), immigrant parents, teachers and health professionals. The results showed similarities and differences in concepts of mental health, as well as help seeking processes. Stigma continued to be recognized as a barrier in the access to mental health care. The paper argues that providing adequate training on mental health on cultural diversity competencies to health and education professionals can contribute to a better inter-communication and -relation system in the family-school-primary care triangle and thus facilitate access to mental health care for youth.

What do parents perceive are the barriers and facilitators to accessing psychological treatment for mental health problems in children and adolescents? A systematic review of qualitative and quantitative studies

“…The cost of mental health services was reported to be a barrier by more than 10% of participants across almost half of quantitative studies [26, 37, 46–53]; and among a smaller number of qualitative studies [54–58]. With a few exceptions, these studies were all conducted in USA and participants were typically not mental health service users.…”

“…The most commonly reported barrier related to concerns surrounding the consequences of help seeking, however, was the barrier posed by the perceived negative attitudes among other people. The ‘stigma’ associated with mental health problems or attending mental health services was reported as a barrier in studies from different countries and cultures, including 11 (46%) qualitative studies [45, 54, 55, 57, 58, 60, 61, 63, 69, 71, 75], and among at least 10% of participants in six (25%) quantitative studies [40, 41, 46, 47, 49]. More ‘personal stigma’ or negative self-evaluation among parents, and discomfort talking about a child’s difficulties; a desire to solve problems within the family; and the role of advice from family/friends, were also all highlighted as deterring or encouraging help seeking in several quantitative and qualitative studies.…”

Use of the emergency department as a first point of contact for mental health care by immigrant youth in Canada: a population-based study

“…The important differences in outpatient delivery of mental health services between immigrants and non-immigrants may reflect differences in culture, 11,24,25 language proficiency, 26 health system navigation 9,27 and referral biases by health care providers. 24,28,29 Stigma and acceptance of mental illness influence care-seeking behaviours 30,31 and may largely be shaped by culture and ethnicity. Familial and social support networks for addressing mental illness may differ between ethnic groups, including high rates of care-seeking from faith-based organizations for psychosis among black and Asian people.…”

“…1, 2010 and Mar. 31,2014. Incident emergency department visits were defined as any unscheduled emergency department visit for a mental health condition where the individual had had no mental healthrelated emergency department visit or hospital admission in the preceding 2 years.…”

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“…scouts, sports team, music band) can add great value to the enhancing of youth mental health care capacity and competencies in primary care and school setting [3]. Qualitative [4] and quantitative [5] data, including national and immigrant samples, from Portugal showed many similarities regarding the perspective of children/youth, and caregivers with the results from Switzerland [6,7]. For example, «Not taking drugs» was a consensual concept regarding mental health among children and caregivers in both countries as well as the perception of mental distress as «something that has to be taken seriously».…”