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The Family-School-Primary Care Triangle and the Access to Mental Health Care Among Migrant and Ethnic Minorities

Abstract

Understanding the concepts of mental health and help seeking behaviours of migrant and ethnic minority families constitutes an important step toward improving the intercultural competence of health and education professionals. This paper addresses these goals among ethnic and migrant minorities in Portugal. For this a multi-informant approach was selected. The study involved nine focus groups (N = 39) conducted with different samples: young immigrants (12–17 years), immigrant parents, teachers and health professionals. The results showed similarities and differences in concepts of mental health, as well as help seeking processes. Stigma continued to be recognized as a barrier in the access to mental health care. The paper argues that providing adequate training on mental health on cultural diversity competencies to health and education professionals can contribute to a better inter-communication and -relation system in the family-school-primary care triangle and thus facilitate access to mental health care for youth.

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References

  1. Abe-Kim J, Takeuchi D, Hong S, Zane N, Sue S, Spencer M, Appel H, Nicdao E, Alegria M. Use of mental health related services among immigrants and US born Asian Americans: results from the National Latino and Asian American Study. Am J Public Health. 2007;97(1):91–8.

    PubMed  Article  Google Scholar 

  2. Alegría M, Canino G, Pescosolido B. A socio-cultural framework for mental health and substance abuse service disparities. In: Sadock BJ, Sadock VA, Ruiz P, editors. Comprehensive textbook of psychiatry. Baltimore: Wolters Kluwer Health, Lippincott Williams & Wilkins; 2009. p. 4370–4379.

    Google Scholar 

  3. American Psychological Association. Ethical principles of psychologists and code of conduct. Washington, DC: American Psychological Association; 2002.

    Google Scholar 

  4. Burns BJ, Costello EJ, Angold A, Tweed D, Stangl D, Farmer EM, Erkanli A. Data watch. Children’s mental health service use across service sectors. Health Aff. 1995;14(3):147–59.

    Article  CAS  Google Scholar 

  5. Carta MG, Bernal M, Hardoy MC, Haro-Abad JM. Migration and mental health in Europe. Clin Pract Epidemiol Mental Health. 2005;1(13).

  6. Castellblanch R, Abrahamson DJ. What focus groups suggest about mental health parity policymaking. Prof Psychol Res Prac. 2003;34(5):540–7.

    Article  Google Scholar 

  7. Fortuna L, Porche M, Alegria M. Political violence, psychosocial trauma, and the context of mental health services use among immigrant Latinos in the United States. Ethnicity Health. 2008;13(5):435–63.

    PubMed  Article  Google Scholar 

  8. Gianella D, Gonçalves M, Höfler S, Inglin S, Borges M, Käppler C, Mohler B. Access to mental health care in children: the AMHC—study. Concepts of mental health and perception of services from the perspective of children, adolescents and their families: In: Rubinelli S, Haes J, editors. Tailoring health messages. Bridging the gap between social and humanistic perspectives on health communication. Proceedings of the international conference. Lugano: Università della Svizzera italiana; 2005: p. 95–100.

  9. Glaser BG, Strauss A. The discovery of grounded theory. New York: Aldine De Gruyter; 1967.

    Google Scholar 

  10. Gonçalves M. Der Zugang von Migrantenkindern zur psychischen Gesundheitsversorgung. Eine Untersuchung mit portugiesisch-sprachigen Familien im multikulturellen Umfeld der Schweiz. Hamburg: Verlag Dr. Kovac; 2009.

    Google Scholar 

  11. Gonçalves M, Käppler C. The access to mental health care in children: Portuguese speaking families living in a multicultural context in Europe. Interam J Psychol. 2010;44(3):411–20.

    Google Scholar 

  12. Helsen M, Vollebergh W, Meeus W. Social support from parents and friends and emotional problems in adolescence. J Youth Adolesc. 2000;29:319–35.

    Article  Google Scholar 

  13. International Organization for Migration. Developing a public health workforce to address migrant health needs in Europe. http://www.migrant-health-europe.org/files/Capacity%20Building%20in%20Healthcare_Background%20Paper(2).pdf, 2009.

  14. John LH, Offord DR, Boyle MH, Racine YA. Factors predicting use of mental health and social services by children 6–16 years old: findings from the Ontario Health Study. Am J Orthopsych. 1995;65:76–86.

    Article  CAS  Google Scholar 

  15. Jones PB, Bebbington P, Foerster A, Lewis SW, Murray RN, Russek A, Sham PC, Toone BK, Wilkins S. Premorbid social underachievement in schizophrenia: results from the Camberwell collaborative psychosis study. Br J Psych. 1993;162:65–71.

    Article  CAS  Google Scholar 

  16. Käppler C, Mohler-Kuo M, Gonçalves M, Gianella D, Peng A, Zehner S, Anastasi B, Nussbaumer D. Psychische Gesundheit und Zugang zu Professioneller Hilfe: Wie denken Kinder, Jugendliche und ihre Eltern? Themenheft des NFP52: Antisoziales Verhalten bei Kindern, Psychosoziale Risiken von Jugendlichen: Was bringt Prävention und Beratung? 2006: p. 18–21.

  17. Kraemer HC, Measelle JR, Ablow JC, Essex MJ, Boyce WT, Kupfer DJ. A new approach to integrating data from multiple informants in psychiatric assessment and research: mixing and matching contexts and perspectives. Am J Psych. 2003;160:1566–77.

    Article  Google Scholar 

  18. Krüger RA. Focus groups. 2nd ed. USA: Sage; 1994.

    Google Scholar 

  19. Kuo M, Mohler B, Raudenbush SL, Earls FJ. Assessing exposure to violence using multiple informants: application of hierarchical linear model. J Psychol Psych. 2000;41(8):1049–56.

    Article  CAS  Google Scholar 

  20. Machado MC, Pereira F, Machaqueiro S. Approaches to migrant health in Portugal. Eurohealth. 2010;16(1):30–1.

    Google Scholar 

  21. Madriz E. Focus groups in feminist research. In: Denzin NK, Lincoln YS, editors. Handbook of qualitative research. 2nd ed. USA: Sage; 2000. p. 835–50.

    Google Scholar 

  22. Mayring P. Qualitative Inhaltsanalyse: Grundlagen und Techniken (7. Aufl.). Weinheim: Dt. Studien-Verlag; 2000.

    Google Scholar 

  23. Moleiro C, Silva A, Rodrigues R, Borges V. Health and mental health needs and experiences of minority clients in Portugal. Int J Migration Health Social Care. 2009;5(1):15–24.

    Article  Google Scholar 

  24. Moleiro C, Goncalves M. Saúde na Diversidade: Desenvolvimento de serviços de saúde mental sensíveis à cultura. Análise Psicológica. 2010;28(3):505–15.

    Google Scholar 

  25. Ocak-Schouler M, Haasen C, Heinz A. Migration and transcultural psychiatry in Europe. Euro Psych. 2008;23:1–3.

    Article  Google Scholar 

  26. Organization for Economic Co-Operation and Development. Educating teachers for diversity: meeting the challenge. OECD Publishing; 2010.

  27. Owens PL, Hoagwood K, Horwitz SM, Leaf PJ, Poduska JM, Kellam SG, Ialongo NS. Barriers to children’s mental health services. J Am Acad Child Adolesc Psychiatry. 2002;41(6):731–8.

    PubMed  Article  Google Scholar 

  28. Pierce CD, Reid R. Attention deficit hyperactivity disorder: assessment and treatment of children from culturally different groups. Semin Speech Lang. 2004;25(3):233–40.

    PubMed  Article  Google Scholar 

  29. Portuguese Service of Foreigners and Boarders. http://www.sef.pt/portal/v10/PT/aspx/estatisticas/relatorios.aspx?id_linha=4265&menu_position=4141#0; 2009.

  30. Report of National Commission of Mental Health Services Restructuration in Portugal; 2007.

  31. United Nations. Number of world’s migrants reaches 175 million. http://www.un.org/News/Press/docs/2002/pop844.doc.htm; 2002.

  32. Scholte RHJ, van Lieshout CFM, van Aken MAG. Perceived relational support in adolescence: dimensions, configurations, and adolescent adjustment. J Res Adolesc. 2001;11:71–94.

    Article  Google Scholar 

  33. Shatkin JP, Belfer ML. The global absence of child and adolescent mental health policy. Child Adolesc Mental Health. 2004;9(3):104–8.

    Article  Google Scholar 

  34. Steinhausen HC, Winkler-Metzke C. Seelische Gesundheit und psychische Probleme im Jugendalter: Verbreitung und Bedingungsfaktoren: In: Institut für Sozial- und Präventivmedizin der Universität Zürich, editors. Die Gesundheit Jugendlicher im Kanton Zürich. Serie Gesundheit, Gesundheitsförderung und Gesundheitswesen im Kanton Zürich, im Auftrag der Gesundheitsdirektion Zürich; 2002: p. 51–60.

  35. Stephenson J. Children with mental problems not getting the care they need. JAMA. 2000;284(16):2043–4.

    PubMed  Article  CAS  Google Scholar 

  36. Stewart DW, Shamdasani PN, Rook DW. Focus groups: theory and practice. 2nd ed. Thousand Oaks, CA: Sage; 2007.

    Google Scholar 

  37. Sue DW, Arredondo P, McDavis RJ. Multicultural counseling competencies and standards: a call to the profession. J Couns Dev. 1992;70(4):477–86.

    Article  Google Scholar 

  38. Twenge JM. The age of anxiety? The birth cohort change in anxiety and neuroticism, 1952–1993. J Pers Soc Psychol. 2000;79(6):1007–21.

    PubMed  Article  CAS  Google Scholar 

  39. World Health Organization. Depression. http://www.who.int/mental_health/management/depression/definition/en/; 2010.

  40. Wittchen HU. Epidemiological research in mental disorders: lessons for the next decade of research—the NAPE lecture 1999. Acta Psychiatr Scand. 2000;101(1):2–10.

    PubMed  Article  CAS  Google Scholar 

  41. Yeh C, Pituc S, Atkins M, Kim A. Poverty, loss and resilience: the story of Chinese immigrant youth. J Couns Psychol. 2008;55(1):34–48.

    Article  Google Scholar 

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Correspondence to Marta Gonçalves.

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Gonçalves, M., Moleiro, C. The Family-School-Primary Care Triangle and the Access to Mental Health Care Among Migrant and Ethnic Minorities. J Immigrant Minority Health 14, 682–690 (2012). https://doi.org/10.1007/s10903-011-9527-9

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Keywords

  • Access to mental health concepts
  • Primary strategies of action
  • Help seeking behaviour
  • Migrant and ethnic minority families
  • Intercultural competence