Communication in refugee and migrant mental healthcare:A systematic rapid review on the needs, barriers and strategies of seekers and providers of mental health services

BackgroundMigrants and refugees may not access mental health services due to linguistic and cultural discordance between them and health and social care professionals (HSCPs). The aim of this review is to identify the communication needs and barriers experienced by third-country nationals (TCNs), their carers, and HSCPs, as well as the strategies they use and their preferences when accessing/providing mental health services and language barriers are present.MethodsWe undertook a rapid systematic review of the literature (01/01/2011 – 09/03/2022) on seeking and/or providing mental health services in linguistically discordant settings. Quality appraisal was performed, data was extracted, and evidence was reviewed and synthesised qualitatively.Results58/5,650 papers met the inclusion criteria. Both TCNs (and their carers) and HSCPs experience difficulties when seeking or providing mental health services and language barriers are present. TCNs and HSCPs prefer linguistically and culturally concordant provision of mental health services but professional interpreters are often required. However, their use is not always preferred, nor is it without problems.ConclusionsLanguage barriers impede TCNs’ access to mental health services. Improving language support options and cultural competency in mental health services is crucial to ensure that individuals from diverse linguistic and cultural backgrounds can access and/or provide high-quality mental health services

Understanding uptake and experience of interpreting services in primary care in a South Asian population in the UK

Addressing language barriers in accessing health care may improve equitable access in line with current United Nations Sustainable Development Goals. English proficiency is associated with socioeconomic position, social segregation, and employment, and the intersectionality of ethnicity, immigration status, and lack of language proficiency results in cumulative disadvantage. Guidance for commissioners in the UK states that language and communication requirements should not prevent patients from receiving equitable care. Limited evidence is available on interpreting service uptake and patient experience that is crucial to ensure services reduce ethnic and socioeconomic health inequalities. We aimed to address this evidence gap

Multilingual healthcare communication: Stumbling blocks, solutions, recommendations

Item does not contain fulltextOBJECTIVE: To provide guidance on multilingual and language discordant healthcare communication. DISCUSSION: We provide a critical reflection on common stumbling blocks to securing (professional) language support, as well as on the currently available solutions to language discordance in healthcare. We discuss issues pertaining to i) the assessment of the patient and healthcare professional's language proficiency, ii) the decision making on whether to seek language support, iii) the currently available options of language support and the development of skills that ensure their effective use, iv) the inclusion of professional interpreters in the interprofessional healthcare team, and v) the transition from single- to integrated language support solutions that allow for a more comprehensive approach to multilingual healthcare communication. We present a set of recommendations for good practice. CONCLUSION: Understanding the needs, capabilities and shortcoming of the available language- support solutions and the implications arising from them can enable decision makers to make informed decisions that ensure the quality of communication and care. The integrated use of language-support solutions at different stages of care can create the conditions for effective communication, while promoting patient and family participation in the decision making process. Evidence-based interventions that can inform the implementation of solutions are required

Addressing language as a barrier to healthcare access and quality

nternational migration has increased rapidly over the past 20 years, with an estimated 281 million people living outside their country of birth.1 Similarly, migration to the UK has continued to rise over this period; current annual migration is estimated to be >700 000 per year (net migration of >300 000).2 With migration comes linguistic diversity, and in health care this often translates into linguistic discordance between patients and healthcare professionals. This can result in communication difficulties that lead to lower quality of care and poor outcomes.3 COVID-19 has heightened inequalities in relation to language: communication barriers, defined as barriers in understanding or accessing key information on health care and challenges in reporting on health conditions, are known to have compounded risks for migrants in the context of COVID-19.4 Digitalisation of health care has further amplified inequalities in primary care for migrant groups.