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Mental health care utilisation and access among refugees and asylum seekers in Europe: A systematic review
Open accessAbstract
BACKGROUND: Refugees and asylum seekers often have increased mental health needs, yet may face barriers in accessing mental health and psychosocial support (MHPSS) services in destination countries. The aim of this systematic review is to examine evidence on MHPSS service utilisation and access among refugees and asylum seekers in European Union Single Market countries. METHODS: Four peer-reviewed and eight grey literature databases were searched for quantitative and qualitative literature from 2007 to 2017. Access was categorised according to Penchansky and Thomas' framework and descriptive analyses were conducted. Quality of studies was assessed by the Newcastle-Ottawa scale and the Critical Appraisal Skills Programme checklist. RESULTS: Twenty-seven articles were included. The findings suggest inadequate MHPSS utilisation. Major barriers to accessing care included language, help-seeking behaviours, lack of awareness, stigma, and negative attitudes towards and by providers. CONCLUSIONS: Refugees and asylum seekers have high mental health needs but under-utilise services in European host countries. This underutilisation may be explained by cultural-specific barriers which need to be tackled to increase treatment demand. Training health providers on cultural models of mental illness may facilitate appropriate identification, referral, and care. Based on these findings, it is crucial to review policies regarding MHPSS provision across the EU.
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“People on the move in Greece face challenges in accessing psychological care and services (Satinsky et al., 2019).”
From Border Pushbacks in Greece: Human Rights Violations and Psychological Impacts (2024) · cites this paper as Satinsky et al., 2019
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“the fact that internet-based interventions are easier to access anonymously, which might be preferable for groups with high levels of mental health stigma (Andersson and Titov, 2014; Satinsky et al., 2019).”
From Investigating the potential of a novel internet-based cognitive behavioural intervention for Dari and Farsi speaking refugee youth: A feasibility study (2022) · cites this paper as Satinsky et al., 2019
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“possible advantages of an internet-based approach include increased access to interventions in the native language of the recipient while using fewer therapist resources”
From Investigating the potential of a novel internet-based cognitive behavioural intervention for Dari and Farsi speaking refugee youth: A feasibility study (2022) · cites this paper as Satinsky et al., 2019
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“Despite the correspondingly high need for diverse psychosocial interventions and treatment, the actual mental health care and its use in the host countries is low (Satinsky et al., 2019).”
From Smartphone-delivered mental health care interventions for refugees: A systematic review of the literature (2023) · cites this paper as Satinsky et al., 2019
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“- Living conditions in refugee camps, detention centres, and on the streets, where many people are crowded into small spaces and provided with few necessities.”
From Border Pushbacks in Greece: Human Rights Violations and Psychological Impacts (2024) · cites this paper as Satinsky et al., 2019
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El-Haj-Mohamad, R., Nohr, L., Niemeyer, H., et al. (2022) · Cambridge Prisms Global Mental Health · doi:10.1017/gmh.2022.61.pr8
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Nohr, L. (2022) · Cambridge Prisms Global Mental Health · doi:10.1017/gmh.2022.61.pr1
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Metadata
- Authors
- Satinsky, E., Fuhr, D. C., Woodward, A., Sondorp, E., & Roberts, B.
- Affiliations
- London School of Hygiene & Tropical Medicine (GB)
- Royal Tropical Institute (NL)
- Corresponding author
- Satinsky, Emily
- Venue
- Health Policy
- Publisher
- Elsevier BV
- Published
- 2019-09
- Volume
- 123
- Issue
- 9
- Pages
- 851-863
- ISSN
- 0168-8510 (ISSN-L)
- OpenAlex
- W2915103606
- Cited by
- 539
- References
- 54
- Citations by year
- 2026: 57 · 2025: 78 · 2024: 110 · 2023: 84 · 2022: 89 · 2021: 64 · 2020: 46 · 2019: 10
- FWCI
- 8.27
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Health Policy (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Migration, Health and Trauma
- Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
- Social Sciences › Law › Migration, Racism, and Human Rights
- Keywords
- refugees, asylum seekers, access to mental health care, psychosocial support, barriers to care, help-seeking, mental health stigma, language barriers, clinician attitudes, European Union, migration and mental health
- MeSH terms
- Mental Disorders, Communication Barriers, Culture, European Union, Health Services Accessibility, Health Services Needs and Demand, Humans, Mental Health Services, Patient Acceptance of Health Care, Refugees, Emigrants and Immigrants
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