title: Mental health care for irregular migrants in Europe: barriers and how they are overcome.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Ludwig Boltzmann Institute for Social Psychiatry, Lazarettgasse 14A-912, 1090 Vienna, Austria. christa.strassmayr@lubis.lbg.ac.at
authors.forename: Christa
authors.initials: C
authors.lastname: Straßmayr
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Matanov
authors.forename: Stefan
authors.initials: S
authors.lastname: Priebe
authors.forename: Henrique
authors.initials: H
authors.lastname: Barros
authors.forename: Reamonn
authors.initials: R
authors.lastname: Canavan
authors.forename: José Manuel
authors.initials: JM
authors.lastname: Díaz-Olalla
authors.forename: Edina
authors.initials: E
authors.lastname: Gabor
authors.forename: Andrea
authors.initials: A
authors.lastname: Gaddini
authors.forename: Tim
authors.initials: T
authors.lastname: Greacen
authors.forename: Petra
authors.initials: P
authors.lastname: Holcnerová
authors.forename: Ulrike
authors.initials: U
authors.lastname: Kluge
authors.forename: Marta
authors.initials: M
authors.lastname: Welbel
authors.forename: Pablo
authors.initials: P
authors.lastname: Nicaise
authors.forename: Aart H
authors.initials: AH
authors.lastname: Schene
authors.forename: Joaquim J F
authors.initials: JJ
authors.lastname: Soares
authors.forename: Heinz
authors.initials: H
authors.lastname: Katschnig
mesh_terms: D001291:Attitude of Health Personnel; D005060:Europe; D006297:Health Services Accessibility / Q000331:legislation & jurisprudence; D006302:Health Services Research; D006801:Humans; D008605:Mental Health Services / Q000331:legislation & jurisprudence / Q000458:organization & administration*; D036301:Qualitative Research; D014171:Transients and Migrants / Q000331:legislation & jurisprudence / Q000523:psychology*