Improving access to and engagement with mental health services among young people from refugee backgrounds: service user and provider perspectives

ABSTRACT

Limited research has been conducted worldwide on the experiences that children and young people from refugee backgrounds have with mental health services, despite evidence that they have significant vulnerability to the development of mental health problems and to suicidal behaviour and that those with mental ill-health typically underutilise services. The authors were particularly interested in barriers and facilitators to service access and engagement, and conducted two qualitative research projects to improve understanding of the issues – the first with service providers experienced in the refugee area and the second with young refugee service users. The aim of this project was to compare the perspectives of professionals and service users and to identify similarities and differences. The perspectives of the service users and providers were strikingly similar. The analysis identified 21 implications for policy makers, agencies and practitioners, which ranged from issues concerning cultural sensitivity, background matching and mental health literacy to accessibility, setting boundaries and expectations and implementing a holistic and outreach approach. There is a range of specific, practical measures that policy makers and service providers can introduce to enhance access to and engagement with mental health services for young people from refugee backgrounds.

KEYWORDS:

• mental health service
• access
• utilisation
• young refugee
• asylum seeker
• barriers
• facilitators

Acknowledgements

The authors acknowledge Carmel Guerra and Georgia Paxton who were part of the research teams in Study 1.

Notes on contributors

Erminia Colucci is MSc lead and Lecturer in the Centre for Psychiatry at Queen Mary University of London (UK). Prior to this, she was a Research Fellow, Research programme coordinator and Lecturer at the Global and Cultural Mental Health Unit, Centre for Mental Health at The University of Melbourne (Australia). She is also an ethnographic documentary photographer and film-maker and chair of the WACP SIG on Arts, media and mental health and IASP SIG on Culture and Suicidal behavior.

Madeleine Valibhoy is a fully registered Clinical Psychologist who has several years of experience working at the Victorian Foundation for Survivors of Torture (Melbourne), assisting children, young people and families with a range of emotional and behavioural difficulties, and in her additional role as a Research Fellow she conducted research with young people who have been refugees about their experiences of mental health services.

Josef Szwarc is the Manager of Research and Policy at the Victorian Foundation for Survivors of Torture (Melbourne). He has worked on range of social policy and human rights issues for government and non-goverment agencies in Australia and UK.

Ida Kaplan is Direct Services Manager at the Victorian Foundation for Survivors of Torture (Melbourne). She oversees the development and delivery of client services for refugees who are survivors of torture and trauma. She has developed and delivered training programs for a variety of sectors at state, national and international levels.

Harry Minas is Head of the Global and Cultural Mental Health Unit, Centre for Mental Health, School of Population and Global Health, The University of Melbourne, Coordinator of the Melbourne Refugee Studies Program and Editor-in-Chief of the International Journal of Mental Health Systems.

ORCID

Erminia Colucci http://orcid.org/0000-0001-9714-477X

Additional information

Funding

The research projects were funded by Sidney Myer Fund and Myer Foundation and William Buckland Foundation, with additional financial and technical support provided by the Global and Cultural Mental Health Unit, Centre for Mental Health, The University of Melbourne and the Victorian Foundation for Survivors of Torture.