TY - JOUR
T1 - Mental health problems of undocumented migrants in the Netherlands
T2 - A qualitative exploration of recognition, recording, and treatment by general practitioners
AU - Teunissen, Erik
AU - Van Bavel, Eric
AU - Van Den Driessen Mareeuw, Francine
AU - Macfarlane, Anne
AU - Van Weel-Baumgarten, Evelyn
AU - Van Den Muijsenbergh, Maria
AU - Van Weel, Chris
N1 - Publisher Copyright:
© 2015 The Author(s).
PY - 2015/6/1
Y1 - 2015/6/1
N2 - Objective. To explore the views and experiences of general practitioners (GPs) in relation to recognition, recording, and treatment of mental health problems of undocumented migrants (UMs), and to gain insight in the reasons for under-registration of mental health problems in the electronic medical records. Design. Qualitative study design with semi-structured interviews using a topic guide. Subjects and setting. Sixteen GPs in the Netherlands with clinical expertise in the care of UMs. Results. GPs recognized many mental health problems in UMs. Barriers that prevented them from recording these problems and from delivering appropriate care were their low consultation rates, physical presentation of mental health problems, high number of other problems, the UM's lack of trust towards health care professionals, and cultural differences in health beliefs and language barriers. Referrals to mental health care organizations were often seen as problematic by GPs. To overcome these barriers, GPs provided personalized care as far as possible, referred to other primary care professionals such as social workers or mental health care nurses in their practice, and were a little less restrictive in prescribing psychotropics than guidelines recommended. Conclusions. GPs experienced a variety of barriers in engaging with UMs when identifying or suspecting mental health problems. This explains why there is a gap between the high recognition of mental health problems and the low recording of these problems in general practice files. It is recommended that GPs address mental health problems more actively, strive for continuity of care in order to gain trust of the UMs, and look for opportunities to provide mental care that is accessible and acceptable for UMs.
AB - Objective. To explore the views and experiences of general practitioners (GPs) in relation to recognition, recording, and treatment of mental health problems of undocumented migrants (UMs), and to gain insight in the reasons for under-registration of mental health problems in the electronic medical records. Design. Qualitative study design with semi-structured interviews using a topic guide. Subjects and setting. Sixteen GPs in the Netherlands with clinical expertise in the care of UMs. Results. GPs recognized many mental health problems in UMs. Barriers that prevented them from recording these problems and from delivering appropriate care were their low consultation rates, physical presentation of mental health problems, high number of other problems, the UM's lack of trust towards health care professionals, and cultural differences in health beliefs and language barriers. Referrals to mental health care organizations were often seen as problematic by GPs. To overcome these barriers, GPs provided personalized care as far as possible, referred to other primary care professionals such as social workers or mental health care nurses in their practice, and were a little less restrictive in prescribing psychotropics than guidelines recommended. Conclusions. GPs experienced a variety of barriers in engaging with UMs when identifying or suspecting mental health problems. This explains why there is a gap between the high recognition of mental health problems and the low recording of these problems in general practice files. It is recommended that GPs address mental health problems more actively, strive for continuity of care in order to gain trust of the UMs, and look for opportunities to provide mental care that is accessible and acceptable for UMs.
KW - General practice
KW - Mental health
KW - Netherlands
KW - Qualitative research
KW - Transients and migrants
UR - http://www.scopus.com/inward/record.url?scp=84937846688&partnerID=8YFLogxK
U2 - 10.3109/02813432.2015.1041830
DO - 10.3109/02813432.2015.1041830
M3 - Article
C2 - 25961462
AN - SCOPUS:84937846688
SN - 0281-3432
VL - 33
SP - 82
EP - 90
JO - Scandinavian Journal of Primary Health Care
JF - Scandinavian Journal of Primary Health Care
IS - 2
ER -