Experiences with treating immigrants: a qualitative study in mental health services across 16 European countries.
OBJECTIVE
While there has been systematic research on the experiences of immigrant patients in mental health services within certain European countries, little research has explored the experiences of mental health professionals in the delivery of services to immigrants across Europe. This study sought to explore professionals' experiences of delivering care to immigrants in districts densely populated with immigrants across Europe.


METHODS
Forty-eight semi-structured interviews were conducted with mental health care professionals working in 16 European countries. Professionals in each country were recruited from three areas with the highest proportion of immigrants. For the purpose of this study, immigrants were defined as first-generation immigrants born outside the country of current residence, including regular immigrants, irregular immigrants, asylum seekers, refugees and victims of human trafficking. Interviews were transcribed and analysed using thematic analysis.


RESULTS
The interviews highlighted specific challenges to treating immigrants in mental health services across all 16 countries including complications with diagnosis, difficulty in developing trust and increased risk of marginalisation.


CONCLUSIONS
Although mental health service delivery varies between and within European countries, consistent challenges exist in the experiences of mental health professionals delivering services in communities with high proportions of immigrants. Improvements to practice should include training in reaching appropriate diagnoses, a focus on building trusting relationships and measures to counter marginalisation.
Unit for Social and Community Psychiatry, Barts and the London School of Medicine and Dentistry, Newham Centre for Mental Health, Queen Mary University of London, London, E13 8SP, UK. s.sandhu@qmul.ac.uk
Sima
S
Sandhu
Neele V
NV
Bjerre
Marie
M
Dauvrin
Sónia
S
Dias
Andrea
A
Gaddini
Tim
T
Greacen
Elisabeth
E
Ioannidis
Ulrike
U
Kluge
Natasja K
NK
Jensen
Majda
M
Lamkaddem
Rosa
R
Puigpinós i Riera
Zsigmond
Z
Kósa
Ulla
U
Wihlman
Mindaugas
M
Stankunas
Christa
C
Straßmayr
Kristian
K
Wahlbeck
Marta
M
Welbel
Stefan
S
Priebe
D000328:Adult; D001291:Attitude of Health Personnel; D003144:Communication Barriers; D054521:Cultural Competency; D003469:Culture; D054242:Emigrants and Immigrants / Q000523:psychology* / Q000706:statistics & numerical data; D005060:Europe / Q000453:epidemiology; D005260:Female; D006282:Health Personnel / Q000523:psychology*; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D001523:Mental Disorders / Q000208:ethnology* / Q000628:therapy*; D008605:Mental Health Services / Q000458:organization & administration*; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D011369:Professional-Patient Relations; D036301:Qualitative Research; D012036:Refugees / Q000523:psychology / Q000706:statistics & numerical data; D014171:Transients and Migrants / Q000523:psychology / Q000706:statistics & numerical data; D035502:Trust