Language Barriers and Access to Psychiatric Care: A Systematic Review.
OBJECTIVE
The objective of this study was to synthesize the available evidence regarding the impact of patients' language proficiency on access to psychiatric care.


METHODS
A systematic literature search of PubMed, EMBASE, Medline, and PsycINFO was performed to identify studies published between January 1950 and July 2014 that examined the impact of language proficiency on access to and utilization of psychiatric services in the general population or among patients with psychiatric disorders. The keywords were psychiatry, language, utilization, access, and mental health care. Only articles in English were included. Cross-referencing of the identified articles was also performed.


RESULTS
Eighteen articles from four countries were identified, including 13 from the United States, two from Australia, two from Canada, and one from the Netherlands. These reports were generally consistent in showing a clear association between insufficient language proficiency and underutilization of psychiatric services; 15 studies reported that limited language proficiency was significantly associated with less frequent mental health care visits. Only one article showed an inverse relationship between limited language proficiency and use of mental health services, and two articles reported no association. No published data were found on the effects of linguistic interventions on access to mental health care among people with limited language proficiency.


CONCLUSIONS
It is plausible that limited language proficiency is closely associated with underutilization of psychiatric services. Still, the lack of prospective interventional data clearly highlights the need for further investigations of the impact of language barriers on access to psychiatric care.
The authors are with the Department of Neuropsychiatry, Keio University Medical School, Tokyo (e-mail: yakuri.ra@gmail.com ). Dr. Takeuchi is also with the Schizophrenia Division, Complex Mental Illness Program, Centre for Addiction and Mental Health, Toronto, Ontario, Canada. Some of the data in this article were presented at the International Congress on Schizophrenia Research, Orlando, Florida, April 21-25, 2013.
Ai
A
Ohtani
The authors are with the Department of Neuropsychiatry, Keio University Medical School, Tokyo (e-mail: yakuri.ra@gmail.com ). Dr. Takeuchi is also with the Schizophrenia Division, Complex Mental Illness Program, Centre for Addiction and Mental Health, Toronto, Ontario, Canada. Some of the data in this article were presented at the International Congress on Schizophrenia Research, Orlando, Florida, April 21-25, 2013.
Takefumi
T
Suzuki
The authors are with the Department of Neuropsychiatry, Keio University Medical School, Tokyo (e-mail: yakuri.ra@gmail.com ). Dr. Takeuchi is also with the Schizophrenia Division, Complex Mental Illness Program, Centre for Addiction and Mental Health, Toronto, Ontario, Canada. Some of the data in this article were presented at the International Congress on Schizophrenia Research, Orlando, Florida, April 21-25, 2013.
Hiroyoshi
H
Takeuchi
The authors are with the Department of Neuropsychiatry, Keio University Medical School, Tokyo (e-mail: yakuri.ra@gmail.com ). Dr. Takeuchi is also with the Schizophrenia Division, Complex Mental Illness Program, Centre for Addiction and Mental Health, Toronto, Ontario, Canada. Some of the data in this article were presented at the International Congress on Schizophrenia Research, Orlando, Florida, April 21-25, 2013.
Hiroyuki
H
Uchida
D003144:Communication Barriers; D006297:Health Services Accessibility / Q000592:standards*; D006801:Humans; D008605:Mental Health Services / Q000706:statistics & numerical data*