Structural and socio-cultural barriers to accessing mental healthcare among Syrian refugees and asylum seekers in Switzerland

Figures & data

Table 1. Professional background of the participants in KI interviews

Nr.	Syrian key informants (SKI)	Healthcare providers (HCP)	Stakeholders (SH)
1	Administrator of refugee shelter [f]	General practitioner (GP) [f]	Priest of a refugee church [m]
2	Legal consultant at asylum centre [f]	Psychotherapist [f]	Politician [f]
3	Dentist [m]	Gynaecologist & Family doctor (GP) [f]	Municipal refugee coordinator [f]
4	Actress [f]	Head of the psychiatric outpatient clinic [m]	Integration mediator [f]
5	Head of an association of Syrians in Switzerland [m]	Medical director of psychiatric hospital [m]

Full sample N= 14; [] is referred to the gender of the participant (f – female, m – male).

Table 2. Percentages of treatment barriers

Treatment barrier
Structural barriers	Frequency	Socio-cultural barriers	Frequency
Lack of resources	11 (79%)	Mismatch between Western system and Syrian problems and needs	13 (93%)
Language	10 (71%)	Lack of awareness	12 (86%)
Gatekeeper	10 (71%)	Fear of stigma	11 (79%)
Not understanding the system	5 (36%)	Gender aspects	5 (36%)
Bureaucracy and complex procedures	4 (29%)	Basic needs are prioritized	4 (29%)

Full sample N = 14; Barriers or sub-barriers mentioned only once are not included.

Table 3. Percentages of structural treatment barriers

Structural barriers		Subcategory
Name	Frequency	Name	Frequency
Lack of resources	11 (79%)
		Long waiting lists	9 (64%)
		Lack of doctors	8 (57%)
		Lack of financial means	6 (43%)
		Lack of interpreters	5 (36%)
Language	10 (71%)
Gatekeeper	10 (71%)
		Lack of knowledge	5 (36%)
		Restrictive doctor	2 (14%)
		Restrictive social worker	2 (14%)
Not understanding the system	5 (36%)
Bureaucracy and complex procedures	4 (29%)

Full sample N= 14; Barriers or sub-barriers mentioned only once are not included.

Table 4. Percentages of socio-cultural barriers

Socio-cultural barriers		Subcategory
Name	Frequency	Name	Frequency
Mismatch between Western system and Syrian problems and needs	13 (93%)
		Lack of trust in system	3 (21%)
		Fear of mistreatment	3 (21%)
		Distrust of doctors	2 (14%)
		Culturally based explanations of mental illness	1 (7%)
Lack of awareness	12 (86%)
		Lack of mental health awareness	10 (71%)
		Lack of awareness of rights or opportunities	4 (29%)
Fear of stigma	11 (79%)
		Hard to ask for help	7 (50%)
		Need to maintain privacy	3 (21%)
		Psychological problems are taboo	3 (21%)
Gender aspects	5 (36%)
Basic needs are prioritized	4 (29%)

Full sample N= 14; Barriers or sub-barriers mentioned only once are not included.