Healthcare provision inside immigration removal centres: A social identity analysis of trust, legitimacy and disengagement

Uncovering multi-level mental healthcare barriers for migrants: a qualitative analysis across China, Germany, Netherlands, Romania, and South Africa

BACKGROUND

Forced displacement is a significant issue globally, and it affected 112 million people in 2022. Many of these people have found refuge in low- and middle-income countries. Migrants and refugees face complex and specialized health challenges, particularly in the area of mental health. This study aims to provide an in-depth qualitative assessment of the multi-level barriers that migrants face in accessing mental health services in Germany, Macao (Special Administrative Region of China), the Netherlands, Romania, and South Africa. The ultimate objective is to inform tailored health policy and management practices for this vulnerable population.

METHODS

Adhering to a qualitative research paradigm, the study centers on stakeholders' perspectives spanning microsystems, mesosystems, and macrosystems of healthcare. Utilizing a purposive sampling methodology, key informants from the aforementioned geographical locations were engaged in semi-structured interviews. Data underwent thematic content analysis guided by a deductive-inductive approach.

RESULTS

The study unveiled three pivotal thematic barriers: language and communication obstacles, cultural impediments, and systemic constraints. The unavailability of professional interpreters universally exacerbated language barriers across all countries. Cultural barriers, stigmatization, and discrimination, specifically within the mental health sector, were found to limit access to healthcare further. Systemic barriers encompassed bureaucratic intricacies and a conspicuous lack of resources, including a failure to recognize the urgency of mental healthcare needs for migrants.

CONCLUSIONS

This research elucidates the multifaceted, systemic challenges hindering equitable mental healthcare provision for migrants. It posits that sweeping policy reforms are imperative, advocating for the implementation of strategies, such as increasing the availability of language services, enhancing healthcare providers' capacity, and legal framework and policy change to be more inclusive. The findings substantially contribute to scholarly discourse by providing an interdisciplinary and international lens on the barriers to mental healthcare access for displaced populations.

Who helps and why? A longitudinal exploration of volunteer role identity, between-group closeness, and community identification as predictors of coordinated helping during the COVID-19 pandemic

Mutual aid groups have allowed community members to respond collectively to the COVID-19 pandemic, providing essential support to the vulnerable. While research has begun to explore the benefits of participating in these groups, there is a lack of work investigating who is likely to engage in this form of aid-giving, although early accounts suggest that existing volunteers have played a significant part in the mutual aid phenomena. Taking a social identity approach, the present study sought to identify what social psychological processes predict this continued engagement by exploring predictors of coordinated COVID-19 aid-giving for pre-existing volunteers. A two-wave longitudinal online survey study (N = 214) revealed that volunteer role identity among existing volunteers at T1 (pre-pandemic) was positively associated with volunteer-beneficiary between-group closeness at T1, which in turn was positively associated with community identification at T1. This in turn positively predicted coordinated COVID-19 aid-giving at T2 (3 months later). This paper therefore reveals the intra- and intergroup predictors of pandemic-related coordinated aid-giving in pre-existing volunteers. Implications for voluntary organisations and emergency voluntary aid provision are discussed.