Immigrant Mothers’ Perspectives of Barriers and Facilitators in Accessing Mental Health Care for Their Children

2020 ◽  
Vol 31 (6) ◽  
pp. 598-605
Author(s):  
Mia Tulli ◽  
Bukola Salami ◽  
Lule Begashaw ◽  
Salima Meherali ◽  
Sophie Yohani ◽  
...  

Introduction: Data on immigrant and refugees’ access to services in Canada typically focus on adult populations generally but not children specifically. To fill this gap, this study explored immigrant and refugee mothers’ perceptions of barriers and facilitators for mental health care for their children in Edmonton, Alberta, Canada. Method: In this qualitative descriptive study, researchers conducted 18 semistructured interviews with immigrant and refugee mothers who live in Edmonton, self-identify as women, and have children living in Canada. Results: Barriers included financial strain, lack of information, racism/discrimination, language barriers, stigma, feeling isolated, and feeling unheard by service providers. Facilitators included schools offering services, personal levels of higher education, and free services. Discussion: Nurses can improve access to mental health services by addressing issues related to racism within the health system, by creating awareness related to mental health, and by providing trained interpreters to help bridge barriers in communications.

2002 ◽  
Vol 26 (6) ◽  
pp. 222-224 ◽  
Author(s):  
D. Murphy ◽  
D. Ndegwa ◽  
A. Kanani ◽  
C. Rojas-Jaimes ◽  
A. Webster

What follows is an attempt to describe the provision of mental health care for refugees (including asylum seekers). Our views are based on our work with refugees in inner-London and on consultation with service providers.


1996 ◽  
Vol 26 (4) ◽  
pp. 221-225 ◽  
Author(s):  
Christopher R. Stones

A survey of attitudes held by a large sample of university students as well as by smaller samples of psychologists, general medical practitioners, members of the public, psychiatric hospital staff and patients in the central eastern Cape toward mental illness and mental health-care service providers was conducted during the early part of 1994. It was found that marked differences existed between the different samples and that the extent of a person's knowledge about mental illness, as well as the degree of contact with mental-health professionals and their services, were important influences on the attitudes of respondents. In particular, third-year psychology students tended to be more negatively disposed to psychiatric treatment than those students in their first year of study. Conversely, the attitudes of final-year students toward the discipline of psychology were more positive than those held by students in their first year of studying psychology. Within both the student and the patient samples, only a small minority indicated that they would first seek help from general medical practitioners if they were ever to contemplate taking their own lives or if they were seriously mentally ill. Psychiatric patients and service providers indicated their confidence in psychiatric treatment and the psychiatrist was considered to be the most appropriate professional to deal with mental illness. Members of the general public were found to be more optimistic than psychologists about the efficacy of psychological and psychiatric treatment, but less so than general medical practitioners. Although mental health-care professionals were viewed in a favourable light, most respondents indicated that they would nevertheless prefer to approach a friend in times of psychological distress.


Author(s):  
Anoop Krishna Gupta ◽  
Sulochana Joshi ◽  
Bikram Kafle ◽  
Ranjan Thapa ◽  
Manisha Chapagai ◽  
...  

Abstract Background Pathways to care studies are feasible and tested means of finding the actual routes taken by patients before reaching proper care. In view of the predominance of nonprofessional service providers and the lack of previous large studies on pathways in Nepal, this multicenter study is needed. The aim of the study was to trace the various pathways and carers involved in mental health care; assess clinical variables such as the duration of untreated illness, clinical presentation and treatment; and compare geographically and culturally diverse landscapes. Methods This was a cross-sectional, convenience sampling study performed at 14 centers where new cases were being taken. The World Health Organization Study of the Pathways-to-Care Schedule was applied. The Nepali version of the encounter form was used. The data were collected between 17 September and 16 October 2020 and were analyzed using the Statistical Package for the Social Sciences (SPSS). Additionally, perspectives from local investigators were collected and discussed. Results Most of the first carers were native/religious faith healers (28.2%), followed by psychiatrists (26%). The median duration for the first psychiatric consultation was 3 weeks. The duration of untreated illness was 30.72 ± 80.34 (median: 4) weeks, and the time taken for this journey was 94.99 ± 274.58 (median: 30) min. The longest delay from the onset of illness to psychiatric care was for epilepsy {90.0 ± 199.0 (median: 25.5)} weeks, followed by neurotic illness {22.89 ± 73.45 (median: 2)} and psychotic illness {10.54 ± 18.28 (median: 2)} weeks. Overall, most patients with severe mental illnesses (SMIs) had their first contact with faithhealers (49%), then met with medical doctors (13%) or psychiatrists (28%). Marked differences in clinical presentation surfaced when hilly centers were compared with the Terai belt. Conclusions Faith healers, general practitioners and hospital doctors are major carers, and the means of educating them for proper referral can be considered. The investigators see several hindrances and opportunities in the studied pathways. The employment of more mental health professionals and better mental health advocacy, public awareness programs and school education are suggested strategies to improve proper mental health care.


2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Kyaw Lin ◽  
Sun Lin ◽  
Than Tun Sein

PurposeMyanmar has an insufficient number of mental health workers with few institutional facilities resulting in a significant treatment gap. Although few mental health services are integrated into primary health care (PHC), the challenges are unknown. This study aimed to assess the challenges perceived by providers in the service delivery of satellite mental health care (SMHC) in two sample townships in Yangon.Design/methodology/approachThe research was based on a case study design by applying a qualitative approach using in-depth interviews (IDIs). In the three types of service providers, a total of six staff participated as interviewees. These consisted of two team leaders, two clinical specialists providing consultations to clients and two mental health nurses.FindingsProviders perceived the following as major challenges in the provision of services: unstable financial resources and management, insufficient human resources and capacity of service providers, restricted outpatient services, the lack of a functional referral system, overcrowding, inadequate individual consultation time, long-waiting hours, finite opening days and hours and poor setting of infrastructure, resulting in lack of privacy.Research limitations/implicationsIn the absence of similar studies in Myanmar, findings could not be placed in the context of the national literature for comparison. Further, the study involved a limited number of respondents, which may have affected the findings.Originality/valueAlthough the challenges revealed were not uncommon in mental health services in developing countries, this study focused on a specific model of mental health care integrated into general healthcare settings in Myanmar. The findings offer a benchmark on efforts to develop decentralized mental health services in Myanmar and provide input for future in-depth studies.


2017 ◽  
Author(s):  
Milou A Feijt ◽  
Yvonne AW de Kort ◽  
Inge MB Bongers ◽  
Wijnand A IJsselsteijn

BACKGROUND The internet offers major opportunities in supporting mental health care, and a variety of technology-mediated mental and behavioral health services have been developed. Yet, despite growing evidence for the effectiveness of these services, their acceptance and use in clinical practice remains low. So far, the current literature still lacks a structured insight into the experienced drivers and barriers to the adoption of electronic mental health (eMental health) from the perspective of clinical psychologists. OBJECTIVE The aim of this study was to gain an in-depth and comprehensive understanding of the drivers and barriers for psychologists in adopting eMental health tools, adding to previous work by also assessing drivers and analyzing relationships among these factors, and subsequently by developing a structured representation of the obtained findings. METHODS The study adopted a qualitative descriptive approach consisting of in-depth semistructured interviews with clinical psychologists working in the Netherlands (N=12). On the basis of the findings, a model was constructed that was then examined through a communicative validation. RESULTS In general, a key driver for psychologists to adopt eMental health is the belief and experience that it can be beneficial to them or their clients. Perceived advantages that are novel to literature include the acceleration of the treatment process, increased intimacy of the therapeutic relationship, and new treatment possibilities due to eMental health. More importantly, a relation was found between the extent to which psychologists have adopted eMental health and the particular drivers and barriers they experience. This differentiation is incorporated in the Levels of Adoption of eMental Health (LAMH) model that was developed during this study to provide a structured representation of the factors that influence the adoption of eMental health. CONCLUSIONS The study identified both barriers and drivers, several of which are new to the literature and found a relationship between the nature and importance of the various drivers and barriers perceived by psychologists and the extent to which they have adopted eMental health. These findings were structured in a conceptual model to further enhance the current understanding. The LAMH model facilitates further research on the process of adopting eMental health, which will subsequently enable targeted recommendations with respect to technology, training, and clinical practice to ensure that mental health care professionals as well as their clients will benefit optimally from the current (and future) range of available eMental health options.


2015 ◽  
Vol 30 (3) ◽  
pp. 431-440 ◽  
Author(s):  
Meryam Schouler-Ocak ◽  
Iris T. Graef-Calliess ◽  
Ilaria Tarricone ◽  
Adil Qureshi ◽  
Marianne C. Kastrup ◽  
...  

AbstractThe stress of migration as well as social factors and changes related to the receiving society may lead to the manifestation of psychiatric disorders in vulnerable individuals after migration. The diversity of cultures, ethnicities, races and reasons for migration poses a challenge for those seeking to understand how illness is experienced by immigrants whose backgrounds differ significantly from their clinicians. Cultural competence represents good clinical practice and can be defined as such that a clinician regards each patient in the context of the patient's own culture as well as from the perspective of the clinician's cultural values and prejudices. The EPA Guidance on cultural competence training outlines some of the key issues related to cultural competence and how to deal with these. It points out that cultural competence represents a comprehensive response to the mental health care needs of immigrant patients and requires knowledge, skills and attitudes which can improve the effectiveness of psychiatric treatment. To reach these aims, both individual and organizational competence are needed, as well as teaching competence in terms of educational leadership. The WPA Guidance on Mental Health and Mental Health Care for Migrants and the EPA Guidance on Mental Health Care for Migrants list a series of recommendations for policy makers, service providers and clinicians; these are aimed at improving mental health care for immigrants. The authors of this paper would like to underline these recommendations and, focusing on cultural competency and training, believe that they will be of positive value.


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