Good practice in mental health care for socially marginalised groups in Europe: a qualitative study of expert views in 14 countries

BMC Public Health

Andrea Gaddini^1,10  Gloria Macassa^1,11  Aart H Schene²  Jacek Moskalewicz⁷  Vincent Lorant³  Ulrike Kluge^1,12  Petra Holcnerová^1,13  Tim Greacen⁸  Edina Gabor⁵  José Manuel Díaz-Olalla⁶  Margaret M Barry⁹  Henrique Barros¹  Christa Straßmayr⁴  Ruth Schor^1,14  Aleksandra Matanov^1,14  Stefan Priebe^1,14 

[1] Department of Hygiene and Epidemiology, University of Porto Medical School, Porto, Portugal;Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands;Institute of Health and Society (IRSS), Université Catholique de Louvain, Bruxelles, Belgium;Ludwig Boltzmann Institute for Social Psychiatry, Vienna, Austria;National Institute for Health Development, Budapest, Hungary;Madrid Salud, Madrid, Spain;Institute of Psychiatry and Neurology, Warsaw, Poland;Laboratoire de recherche, Etablissement Public de Santé Maison Blanche, Paris, France;Health Promotion Research Centre, National University of Ireland Galway, Galway, Ireland;Laziosanità ASP - Public Health Agency, Lazio Region, Rome, Italy;Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden;Clinic for Psychiatry and Psychotherapy, Charité, University Medicine Berlin, Berlin, Germany;Department of Psychiatry, 1st Faculty of Medicine, Charles University, Prague, Czech Republic;Unit for Social and Community Psychiatry, Queen Mary University of London, London, UK

关键词: Autonomy;    Good practice;    Health care systems;    Mental health care;    Marginalisation;   

Others  :  1163727
DOI  :  10.1186/1471-2458-12-248

 received in 2011-10-25, accepted in 2012-03-19,  发布年份 2012

【 摘 要 】

Background

Socially marginalised groups tend to have higher rates of mental disorders than the general population and can be difficult to engage in health care. Providing mental health care for these groups represents a particular challenge, and evidence on good practice is required. This study explored the experiences and views of experts in 14 European countries regarding mental health care for six socially marginalised groups: long-term unemployed; street sex workers; 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 for each of the six marginalised groups. Semi-structured interviews with case vignettes were conducted to explore experiences 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) establishing outreach programmes to identify and engage with individuals with mental disorders; b) facilitating access to services that provide different aspects of health care, including mental health care, and thus reducing the need for further referrals; c) strengthening the collaboration and co-ordination between different services; and d) disseminating information on services 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 for marginalised groups. Care may be improved through better service organisation, coordination and information.

【 授权许可】

   
2012 Priebe et al; licensee BioMed Central Ltd.

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