The MiM2M project members have been busy and are happy to share the product of their labour.
The manuscript "Migration and mental health care in South Africa: the question of language in context" is now published in Medical Humanities!
Abstract:
Access to mental healthcare for migrants is a global problem, with many challenges and barriers, including the issue of language discordance. Most research on this topic comes from well-resourced countries such
as those in Europe, Northern America, and Australasia despite the fact that most migration occurs from poorer contexts, such as many in Africa, into more closely situated countries. As an introductory part of a broader
international study, we started out investigating the views of key stakeholders in South Africa on language barriers to accessing mental healthcare for migrants and suggestions for how to address these. Two senior researchers interviewed a total of 10 key stakeholders (mental health and primary healthcare providers, some also users of mental healthcare, policymakers in mental healthcare, and refugee centre coordinators) virtually, using semistructured interviews. Interview recordings were transcribed and the content was analysed. The following key themes emerged from our data: general barriers to mental healthcare; linguistic barriers to mental healthcare; proposed solutions to overcoming language discordance and alternatives suggested by professionals and mental health service users. Issues of language were intertwined with a range of other service delivery and political problems. The issue of lack of language concordance is a major concern in providing mental healthcare for migrants in South Africa. This is, however, by no means the only concern, as access to care in general is poor. Innovative, cost-effective local solutions are needed to bridge the enormous gap between needs and service provision.
We are happy to share the following open access publication in BMJ Open "Usability of technological tools to overcome language barriers in health care: a scoping review protocol".
Abstract:
Introduction In many healthcare contexts globally, where the languages of care providers and patients do not match, miscommunication or non-communication can lead to inaccurate diagnoses and subpar treatment outcomes. In order to bridge these language barriers, a range of informal practices are used, such as family members or staff acting as interpreters, ‘receptive multilingualism’ or machine translation. The development and use of technological tools are increasing, but factors such as translation quality for complex health-related texts vary widely between languages. The objective of this scoping review is to (1) identify and describe the technological tools used in direct patient-provider communication to overcome a language barrier in a healthcare setting, (2) identify how the usability of these tools was evaluated and (3) assess the usability of the technological tools.
Methods and analysis The scoping review will follow the Joanna Briggs Institute methodology. A search strategy using variations of the keywords ‘technological tools’, ‘language barrier’ and ‘healthcare’ will be applied in the following databases and research platforms: PubMed, PsycArticle, Scopus, EBSCOhost, ProQuest and Web of Science. All literature where individuals use a technological tool to overcome a language barrier in a healthcare context will be included and exported into the screening assistant software Rayyan. The search will be limited to articles written in German or English. Two independent reviewers will screen the articles, and all relevant extracted data will be presented in a descriptive summary.
Our manuscript "Uncovering multi-level mental healthcare barriers for migrants: a qualitative analysis across China, Germany, Netherlands, Romania, and South Africa" is now published in BMC Public Health!
Abstract:
Background Forced displacement is a significant issue globally, and it affected 112 million people in 2022. Many of these people have found refuge in low- and middle-income countries. Migrants and refugees face complex and specialized health challenges, particularly in the area of mental health. This study aims to provide an in-depth qualitative assessment of the multi-level barriers that migrants face in accessing mental health services in Germany, Macao (Special Administrative Region of China), the Netherlands, Romania, and South Africa. The ultimate objective is to inform tailored health policy and management practices for this vulnerable population.
Methods Adhering to a qualitative research paradigm, the study centers on stakeholders’ perspectives spanning microsystems, mesosystems, and macrosystems of healthcare. Utilizing a purposive sampling methodology, key informants from the aforementioned geographical locations were engaged in semi-structured interviews. Data underwent thematic content analysis guided by a deductive-inductive approach.
Results The study unveiled three pivotal thematic barriers: language and communication obstacles, cultural impediments, and systemic constraints. The unavailability of professional interpreters universally exacerbated language barriers across all countries. Cultural barriers, stigmatization, and discrimination, specifically within the mental health sector, were found to limit access to healthcare further. Systemic barriers encompassed bureaucratic intricacies and a conspicuous lack of resources, including a failure to recognize the urgency of mental healthcare needs for migrants.
Conclusions This research elucidates the multifaceted, systemic challenges hindering equitable mental healthcare provision for migrants. It posits that sweeping policy reforms are imperative, advocating for the implementation of strategies, such as increasing the availability of language services, enhancing healthcare providers’ capacity, and legal framework and policy change to be more inclusive. The findings substantially contribute to scholarly discourse by providing an interdisciplinary and international lens on the barriers to mental healthcare access for displaced populations.
A big thank you to all co-authors and collaborators for making this happen.
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