What stops Korean immigrants from accessing child and adolescent mental health services?

Abstract

Background Access to child and adolescent mental health services by ethnic minorities has been poorly studied. Despite rapid growth of the immigrant Korean population, evidence indicates that few Korean families utilise these services in New Zealand. Those that do tend to present late and with significant morbidity. We sought to understand barriers to service access from Korean parents’ perspectives. Method Seven focus groups were undertaken with 31 Korean parents of children aged 18 and under. The focus groups were semi-structured, held in the Korean language and utilised two case scenarios of common childhood/adolescent mental illnesses around which a set of broad, open-ended questions were posed. All conversations were audiorecorded, transcribed and translated into English. Thematic analysis was conducted using NVivo software. Results Both attitudinal and structural barriers were identified. Attitudinal barriers included attribution of mental illness to external stressors or parenting problems, social stigma, denial or normalization of children’s behaviour, fear of family disempowerment, and mistrust of public mental health services. Structural barriers included parents’ lack of information regarding available services, logistical difficulties in access, communication difficulties, concerns over the quality of translators, and cultural competence of service providers. Conclusion Significant barriers prevent Korean immigrant families from accessing child and adolescent mental health services in New Zealand. Measures to improve access, for example by countering stigma, are urgently required.

Barriers to and Recommendations for Equitable Access to Healthcare for Migrants and Refugees in Aotearoa, New Zealand: An Integrative Review

“…Most studies (n = 12) were qualitative, and one study used a mixed methodology. Although the review focused on both migrants and refugees, the majority of studies (n = 8) focused on refugee populations [ 26 , 33 – 39 ], one article focused on ‘refugee-like migrants’ (legal migrants with refugee-like backgrounds, e.g., migrant family members with refugee backgrounds) [ 5 ], one article was on “new settlers” [ 40 ], and three were on migrants [ 41 – 43 ]. All study participants came from low and middle-income or non-English speaking countries.…”

“…Sample sizes of the studies ranged from nine to sixty participants. The length of stay of participants in Aotearoa prior to the studies also varied, with two studies not stating this information [ 35 , 43 ]. Three studies had an average of four and five years for women and men, respectively [ 33 , 34 , 38 ], one study was between three months to 21 years [ 40 ], one study between six months to three years [ 26 ], two studies with an average of 3.25 years [ 41 , 42 ] and another two studies between 1 and 19 years [ 36 , 37 ].…”

“…The studies predominantly had women participants. Two studies focused on women only [ 36 , 37 ], two studies were women with children [ 41 , 42 ], and one study was with parents though women made up most of the participants [ 43 ]. Of the studies, four studies had a small proportion of men in the sample group [ 26 , 33 – 35 ].…”

“…The lack of healthcare providers’ sensitivity to the cultural backgrounds of migrant and refugee patients was a common theme in most studies [ 26 , 33 – 35 , 39 , 43 ] [ 41 ] and considered as a justification for participants’ lack of trust and dissatisfaction in the health system. In particular for migrants, Park, Loy, Lillis and Menkes [ 43 ] and Akhtar, et al [ 41 ] found participants sought health advise from their community groups or returned to their home country to seek health services.…”

The effect of human educational capital on health entitlement acquisition among migrant workers in China: evidence from the 2018 China Migrants Dynamic Survey

“…Existing research has found significant disparities in the healthcare provisions and access to health information between international migrants in developed countries and residents. Generally, international migrants experience lower levels of healthcare services and face restricted access to health information compared to residents (Walkden et al ., 2018; Bruzelius and Baum, 2019; Ryoko et al ., 2019; Ram et al ., 2020; Albright et al ., 2022; Park et al ., 2022). In developed countries, implementing similar policies toward the migrant population, such as New Zealand, Canada and Australia, migrant workers often encounter challenges in accessing healthcare services equivalent to those accessible to residents (Tosti et al ., 2020; Hamilton et al ., 2019; Istiko et al.…”