‘Medicine doesn’t cure my worries’: Understanding the drivers of mental distress in older Nepalese women living in the UK

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

BACKGROUND

Migrants 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.

METHODS

We 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.

RESULTS

58/5,650 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.

CONCLUSIONS

Language 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.

Perceptions and Experiences of Health and Social Care Utilisation of the UK-Nepali Population

With the growing UK Nepali community, understanding their health and social care needs is an essential to reduce health and social care inequalities. However, very little is known about the health, wellbeing and utilisation of health and social care services among the Nepali population in the UK. Therefore, this study set out to identify health and social care needs of Nepali community. The mixed-methods study was conducted with the Nepali population living in London. It consists of a semi-structured survey (N = 345); three focus group discussions and three key informant interviews. The mean age of the participants was 40.6 (± 17.6). About 28% of our sample reported having chronic health problems. About 60% currently consume alcohol and 21% were smokers. Male participants (35%) more likely to be physically active than females (21%). Registration with a family doctor/general practitioner (GP) was high (96%). However, uptake of disease screening was very low (28%). In the preceding year, 17% had experienced poor mental or emotional health. The findings also suggest language is a key barrier to utilise health and social care among UK Nepali. We suggest removing the language barrier is essential step to improve access to available health and social care services. A culturally sensitive educational initiative creating awareness about the structure of UK health and social care services is required to offer to this community.

Unpacking the Complexity of Migrated Older Adults' Lives in the UK through an Intersectional Lens: A Qualitative Systematic Review

BACKGROUND AND OBJECTIVES

The intersection of population ageing and international migration increases the ethnic and cultural diversity of the UK's older population, which has significant implications for health and care services and requires social inclusion and equal access to welfare. This review aimed to explore the complexity of migrated older adults' lives and analyse how their multiple identity markers interweave and affect their lived experiences.

RESEARCH DESIGN AND METHODS

This review is a qualitative systematic review. Intersectionality was applied as a theoretical scaffold to inform the qualitative thematic synthesis of the data.

RESULTS

A total of 29 studies in the period 2000-2020 were included. Three themes- language barriers, racism and discrimination, negotiating cultural influences, were identified as common challenges faced by migrated older adults. However, the degree of these challenges and the resources to buffer their effects vary dramatically given the significant differences in older migrated adults' gender, socio-economic status (SES), cultural backgrounds and migration pathways.

DISCUSSION AND IMPLICATIONS

Rather than focusing on any single factor, it is required to consider the intersection of age, race, ethnicity, gender, SES, and migration status when understand and address inequality not only between migrated older adults and native older adults, among different migrated older adult groups but also within any certain group. This review calls for the acknowledgment and awareness of policymakers, care and service practitioners and academics on the heterogeneity of migrated older adults.