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Barriers and Facilitators to Access Mental Health Services Among Refugee Women in High-Income Countries: A Systematic Review

Background
Based on the Global Trends report from the United Nations High Commissioner for Refugee, in high-income countries, there are 2.7 refuges per 1,000 national population, girls and women account for nearly 50 percent of this refuge population. In these high-income countries, compared with the general population refuge women have higher prevalence of mental illness. To our knowledge this is the first systematic review that addresses access to mental health services for refugee women in high-income countries. Thus, this review was conducted to examine the barriers to and facilitators of access to mental health services for refugee women in high-income countries for refugee resettlement.
Methods
MEDLINE, EMBASE, PsycINFO, and CINAHL databases were searched for research articles with qualitative component (including mixed-method or multi-method with qualitative component), in order to examine barriers and facilitators related to accessing mental health services. Relevant studies were collected on March 14, 2020 and were extracted and critically appraised by multiple authors. A narrative synthesis was conducted with the included studies to gather key synthesis evidence.
Results
Of the four databases searched, 1258 studies were identified with 12 meeting the inclusion criteria. The major barriers identified were language barriers, stigmatization, and the need for culturally sensitive practices to encourage accessing mental health care within a religious and cultural context. There were several studies that indicated how gender roles and biological factors played a role in challenges to accessing mental health services. The major facilitators identified were service availability and awareness in resettlement countries, social support and the resilience of refugee women to ease access of mental health services.
Conclusion
This review revealed socio-economic factors contributed to barriers and facilitators to accessing mental health among women refugees and asylum seekers. Addressing those social determinants of health can reduce barriers and enhance facilitators of access to mental health care for vulnerable populations like refugee women. Although there is a difference in health access policy among the top resettlement courtiers, the review found that there are no significant differences in accessing mental health for refugee and asylum seeker women among leading resettlement countries. The review findings suggest the need for further research on this topic given the potential significance of the findings on refugee and asylum seeker women mental health.

Identiferoai:union.ndltd.org:uottawa.ca/oai:ruor.uottawa.ca:10393/41878
Date15 March 2021
CreatorsDeSa, Sarah C.
ContributorsYaya, Sanni
PublisherUniversité d'Ottawa / University of Ottawa
Source SetsUniversité d’Ottawa
LanguageEnglish
Detected LanguageEnglish
TypeThesis
Formatapplication/pdf

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