| 1. |
- Kluge, U, et al.
(författare)
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Health services and the treatment of immigrants : data on service use, interpreting services and immigrant staff members in services across Europe
- 2012
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Ingår i: European psychiatry. - 0924-9338 .- 1778-3585. ; 27:Suppl 2, s. 56-62
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND:The number of immigrants using health services has increased across Europe. For assessing and improving the quality of care provided for immigrants, information is required on how many immigrants use services, what interpreting services are provided and whether staff members are from immigrant groups.METHODS:Structured interviews were conducted with 15 health services (9 primary care, 3 emergency departments, 3 mental health) located in areas with high immigrant populations in each of 16 European countries (n=240). Responses were collected on the availability of data on service use by immigrant patients, the provision of interpreting services and immigrant staff members.RESULTS:Data on service use by immigrants were recorded by only 15% of services. More than 40% of services did not provide any form of interpreting service and 54% of the services reported having no immigrant staff. Mental health services were more likely to use direct interpreting services, and both mental health and emergency services were more likely to have immigrant staff members.DISCUSSION:For assessing and improving the quality of care provided for immigrants, there is a need to improve the availability of data on service use by immigrants in health services throughout Europe and to provide more consistent access to interpreting services.
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| 2. |
- Priebe, S, et al.
(författare)
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Good practice in health care for migrants : views and experiences of care professionals in 16 European countries
- 2011
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Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 11, s. 187-
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundHealth services across Europe provide health care for migrant patients every day. However, little systematic research has explored the views and experiences of health care professionals in different European countries. The aim of this study was to assess the difficulties professionals experience in their service when providing such care and what they consider constitutes good practice to overcome these problems or limit their negative impact on the quality of care.MethodsStructured interviews with open questions and case vignettes were conducted with health care professionals working in areas with high proportion of migrant populations in 16 countries. In each country, professionals in nine primary care practices, three accident and emergency hospital departments, and three community mental health services (total sample = 240) were interviewed about their views and experiences in providing care for migrant patients, i.e. from first generation immigrant populations. Answers were analysed using thematic content analysis.ResultsEight types of problems and seven components of good practice were identified representing all statements in the interviews. The eight problems were: language barriers, difficulties in arranging care for migrants without health care coverage, social deprivation and traumatic experiences, lack of familiarity with the health care system, cultural differences, different understandings of illness and treatment, negative attitudes among staff and patients, and lack of access to medical history. The components of good practice to overcome these problems or limit their impact were: organisational flexibility with sufficient time and resources, good interpreting services, working with families and social services, cultural awareness of staff, educational programmes and information material for migrants, positive and stable relationships with staff, and clear guidelines on the care entitlements of different migrant groups. Problems and good care components were similar across the three types of services.ConclusionsHealth care professionals in different services experience similar difficulties when providing care to migrants. They also have relatively consistent views on what constitutes good practice. The degree to which these components already are part of routine practice varies. Implementing good practice requires sufficient resources and organisational flexibility, positive attitudes, training for staff and the provision of information.
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| 3. |
- Costa, D, et al.
(författare)
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Factors associated with quality of services for marginalized groups with mental health problems in 14 European countries
- 2014
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Ingår i: BMC Health Services Research. - : Springer Science and Business Media LLC. - 1472-6963. ; , s. Art. no. 49-
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Tidskriftsartikel (refereegranskat)abstract
- Background:Different service characteristics are known to influence mental health care delivery. Much less isknown about the impact of contextual factors, such as the socioeconomic circumstances, on the provision of careto socially marginalized groups.The objectives of this work were to assess the organisational characteristics of services providing mental health carefor marginalized groups in 14 European capital cities and to explore the associations between organisationalquality, service features and country-level characteristics.Methods:617 services were assessed in two highly deprived areas in 14 European capital cities. A Quality Index ofService Organisation (QISO) was developed and applied across all sites. Service characteristics and country levelsocioeconomic indicators were tested and related with the Index using linear regressions and random interceptlinear models.Results:The mean (standard deviation) of the QISO score (minimum = 0; maximum = 15) varied from 8.63 (2.23) inIreland to 12.40 (2.07) in Hungary. The number of different programmes provided was the only service characteristicsignificantly correlated with the QISO (p < 0.05). The national Gross Domestic Product (GDP) was inverselyassociated with the QISO. Nearly 15% of the variance of the QISO was attributed to country-level variables, withGDP explaining 12% of this variance.Conclusions:Socioeconomic contextual factors, in particular the national GDP are likely to influence theorganisational quality of services providing mental health care for marginalized groups. Such factors should beconsidered in international comparative studies. Their significance for different types of services should be exploredin further research.Keywords:Mental health services, Quality index of service organization, Socially marginalized groups,Multi-level analysis
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| 4. |
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| 5. |
- Dauvrin, M., et al.
(författare)
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Health care for irregular migrants : Pragmatism across Europe. A qualitative study
- 2012
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Ingår i: BMC Research Notes. - : Springer Science and Business Media LLC. - 1756-0500. ; 5, s. Art. no. 99-
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Tidskriftsartikel (refereegranskat)abstract
- Abstract. Background: Health services in Europe face the challenge of delivering care to a heterogeneous group of irregular migrants (IM). There is little empirical evidence on how health professionals cope with this challenge. This study explores the experiences of health professionals providing care to IM in three types of health care service across 16 European countries. Results: Semi-structured interviews were conducted with health professionals in 144 primary care services, 48 mental health services, and 48 Accident & Emergency departments (total n = 240). Although legal health care entitlement for IM varies across countries, health professionals reported facing similar issues when caring for IM. These issues include access problems, limited communication, and associated legal complications. Differences in the experiences with IM across the three types of services were also explored. Respondents from Accident & Emergency departments reported less of a difference between the care for IM patients and patients in a regular situation than did respondents from primary care and mental health services. Primary care services and mental health services were more concerned with language barriers than Accident & Emergency departments. Notifying the authorities was an uncommon practice, even in countries where health professionals are required to do this. Conclusions: The needs of IM patients and the values of the staff appear to be as important as the national legal framework, with staff in different European countries adopting a similar pragmatic approach to delivering health care to IM. While legislation might help to improve health care for IM, more appropriate organisation and local flexibility are equally important, especially for improving access and care pathways. © 2012 Dauvrin et al; licensee BioMed Central Ltd.
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| 6. |
- Strassmayr, C, et al.
(författare)
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Mental health care for irregular migrants in Europe : Barriers and how they are overcome
- 2012
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Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 12:367, s. Art. no. 367-
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundIrregular 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.MethodsData 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.ResultsExperts 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.ConclusionsEven 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.
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| 7. |
- Welbel, M, et al.
(författare)
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Addiction treatment in deprived urban areas in EU countries: Accessibility of care for people from socially marginalized groups
- 2013
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Ingår i: Drugs. - : Informa UK Limited. - 0968-7637 .- 1465-3370. ; 20:1, s. 74-83
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Tidskriftsartikel (refereegranskat)abstract
- Aim: This study examines the accessibility of addiction treatment within services providing mental health care and support for people from socially marginalized groups in deprived urban areas across EU countries.Methods: Services providing mental health care and support in deprived areas of 14 EU capital cities were assessed with a questionnaire. We analysed the availability and accessibility of those services providing addiction treatment for people from six groups: the long-term unemployed, the homeless, street sex workers, asylum seekers and refugees, irregular migrants and people from travelling communities.Results: While 30% of all the assessed services provided addiction treatment, in 20% of services, addiction was a criterion for exclusion. Among services providing addiction treatment, 77% accepted self-referrals, 63% were open on weekends or in the evening, 60% did not charge any out-of-pocket fees, 35% provided access to interpreters, and 28% ran outreach activities. These results varied substantially among EU capitals.Conclusion: Access to addiction treatment for socially marginalized groups varies across Europe. Some of the models identified may constitute barriers to treatment. Developing care delivery models that facilitate access for vulnerable populations should be a priority for national and European policies.
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| 8. |
- Priebe, S, et al.
(författare)
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Good practice in emergency care: views from practitioners :
- 2011
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Ingår i: Migration and Health in the European Union. - : Open University Press. - 9780335245673
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Bokkapitel (refereegranskat)abstract
- Migrants make up a growing share of European populations. However, all too often their situation is compounded by problems with accessing health and other basic services. There is a need for tailored health policies, but robust data on the health needs of migrants and how best these needs can be met are scarce.Written by a collaboration of authors from three key international organisations (the European Observatory on Health Systems and Policies, the EUPHA Section on Migrant and Ethnic Minority Health, and the International Organization for Migration), as well as leading researchers from across Europe, the book thoroughly explores the different aspects of migration and health in the EU and how they can be addressed by health systems.Structured into five easy-to-follow sections, the volume includes:Contributions from experts from across EuropeKey topics such as: access to human rights and health care; health issues faced by migrants; and the national and European policy response so farConclusions drawn from the latest available evidenceComprehensive information on different aspects of health and migration and how they can best be addressed by health systems is still not easy to find. This book addresses this shortfall and will be of major value to researchers, students, policy-makers and practitioners concerned with migration and health in an increasingly diverse Europe.
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| 9. |
- Priebe, Stefan, et al.
(författare)
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Good practice in mental health care for socially marginalized groups in Europe : a qualitative study in 14 countries
- 2012
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Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; :12, s. 248-
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Tidskriftsartikel (refereegranskat)abstract
- Background:Socially marginalised groups tend to have higher rates of mental disorders than the general populationand can be difficult to engage in health care. Providing mental health care for these groups represents a particularchallenge, and evidence on good practice is required. Thisstudy explored the experiences and views of experts in 14European countries regarding mental health care for six socially marginalised groups: long-term unemployed; street sexworkers; homeless; refugees/asylum seekers; irregular migrants and members of the travelling communities.Methods:Two highly deprived areas were selected in the capital cities of 14 countries, and experts were interviewed foreach of the six marginalised groups. Semi-structured interviews with case vignettes were conducted to exploreexperiences of good practice and analysed using thematic analysis.Results:In a total of 154 interviews, four components of good practice were identified across all six groups: a) establishingoutreach programmes to identify and engage with individuals with mental disorders; b) facilitating access to services thatprovide different aspects of health care, including mental health care, and thus reducing the need for further referrals; c)strengthening the collaboration and co-ordination betweendifferent services; and d) disseminating information onservices both to marginalised groups and to practitioners in the area.Conclusions:Experts across Europe hold similar views on what constitutes good practice in mental health care formarginalised groups. Care may be improved through better service organisation, coordination and information.
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| 10. |
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