Mental health care for irregular migrants in Europe: barriers and how they are overcome

• Published in: BMC public health Vol. 12; no. 1; p. 367
• Main Authors: Straßmayr, Christa, Matanov, Aleksandra, Priebe, Stefan, Barros, Henrique, Canavan, Reamonn, Díaz-Olalla, José Manuel, Gabor, Edina, Gaddini, Andrea, Greacen, Tim, Holcnerová, Petra, Kluge, Ulrike, Welbel, Marta, Nicaise, Pablo, Schene, Aart H, Soares, Joaquim J F, Katschnig, Heinz
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 20.05.2012; BioMed Central; BMC
• Subjects: Access to care; Attitude of Health Personnel; Barriers to care; Cities; Emergency medical care; Ethics; Europe; Health aspects; Health care; Health care reform; Health sciences; Health Services Accessibility - legislation & jurisprudence; Health Services Research; Humans; Interviews; Irregular migrants; Legal entitlement; Legislation; Medicin och hälsovetenskap; Mental disorders; Mental health care; Mental Health Services - legislation & jurisprudence; Mental Health Services - organization & administration; Mental illness; Migrant labor; Migrants; Migration; Nongovernmental organizations; Overcoming barriers; Psychiatric services; Psychiatry; Psychological aspects; Public health; Qualitative Research; Risk factors; Social exclusion; Social isolation; Transients and Migrants - legislation & jurisprudence; Transients and Migrants - psychology; Europe; Netherlands; Austria; Poland; United Kingdom; France; Germany; Hungary; United Kingdom > UK; Portugal; Spain; Czech Republic; Sweden; Belgium; Ireland; Italy; Mental health care; Access to care; Overcoming barriers; Irregular migrants; Europe; Legal entitlement; Barriers to care
• ISSN: 1471-2458; 1471-2458
• DOI: 10.1186/1471-2458-12-367

Irregular migrants (IMs) are exposed to a wide range of risk factors for developing mental health problems. However, little is known about whether and how they receive mental health care across European countries. The aims of this study were (1) to identify barriers to mental health care for IMs, and (2) to explore ways by which these barriers are overcome in practice. Data from semi-structured interviews with 25 experts in the field of mental health care for IMs in the capital cities of 14 European countries were analysed using thematic analysis. Experts reported a range of barriers to mental health care for IMs. These include the absence of legal entitlements to health care in some countries or a lack of awareness of such entitlements, administrative obstacles, a shortage of culturally sensitive care, the complexity of the social needs of IMs, and their fear of being reported and deported. These barriers can be partly overcome by networks of committed professionals and supportive services. NGOs have become important initial points of contact for IMs, providing mental health care themselves or referring IMs to other suitable services. However, these services are often confronted with the ethical dilemma of either acting according to the legislation and institutional rules or providing care for humanitarian reasons, which involves the risk of acting illegally and providing care without authorisation. Even in countries where access to health care is legally possible for IMs, various other barriers remain. Some of these are common to all migrants, whilst others are specific for IMs. Attempts at improving mental health care for IMs should consider barriers beyond legal entitlement, including communicating information about entitlement to mental health care professionals and patients, providing culturally sensitive care and ensuring sufficient resources.