How do general practitioners experience providing care to refugees with mental health problems? A qualitative study from Denmark

BMC Family Practice

Research Article

Allan Krasnik¹  Marie Norredam¹  Natasja Koitzsch Jensen¹  Stefan Priebe² 

[1] The Danish Research Centre for Migration, Ethnicity and Health, Section for Health Services Research, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1014, Copenhagen, Denmark;Unit for Social and Community Psychiatry, Queen Mary University of London, Newham Centre for Mental Health, E13 8SP, London, United Kingdom;

关键词: Primary care;    Refugees;    Migration;    Trans-cultural psychiatry;    Mental health;    Categorisation;   

DOI  :  10.1186/1471-2296-14-17

 received in 2012-06-07, accepted in 2013-01-10,  发布年份 2013

来源: Springer

【 摘 要 】

BackgroundRefugees are a particularly vulnerable group in relation to the development of mental illness and many may have been subjected to torture or other traumatic experiences. General practitioners are gatekeepers for access to several parts of the psychiatric system and knowledge of their patients’ refugee background is crucial to secure adequate care. The aim of this study is to investigate how general practitioners experience providing care to refugees with mental health problems.MethodsThe study was conducted as part of an EU project on European Best Practices in Access, Quality and Appropriateness of Health Services for Immigrants in Europe (EUGATE). Semi-structured interviews were carried out with nine general practitioners in the vicinity of Copenhagen purposively selected from areas with a high proportion of immigrants. The analysis of the interviews is inspired by qualitative content analysis.ResultsOne of the main themes identified in the analysis is communication. This includes the use of professional interpreters and that communication entails more than sharing a common language. Quality of care is another theme that emerges and includes awareness of possible trauma history, limited possibilities for refugees to participate in certain treatments due to language barriers and feelings of hopelessness in the general practitioners. The general practitioners may also choose different referral pathways for refugees and they report that their patients lack understanding regarding the differences between psychological problems and physical symptoms.ConclusionGeneral practitioners experience that providing care to refugees differs from providing care for patients from the majority population. The different strategies employed by the general practitioners in the health care treatment of refugees may be the result of the great diversity in the organisation of general practice in Denmark and the lack of a national strategy in the health care management of refugees. The findings from this study suggest that the development of conversational models for general practitioners including points to be aware of in the treatment of refugee patients may serve as a support in the management of refugee patients in primary care.

【 授权许可】

CC BY   
© Jensen et al.; licensee BioMed Central Ltd. 2013