International Journal of Environmental Research and Public Health
Volume 11, Issue 9, 2014, Pages 9739-9759

Patient experienced continuity of care in the psychiatric healthcare system—a study including immigrants, refugees and ethnic Danes (Article) (Open Access)

Jensen N.K.* , Johansen K.S. , Kastrup M. , Krasnik A. , Norredam M.
  • a The Danish Research Centre for Migration, Ethnicity and Health (MESU), Section for Health Services Research, Department of Public Health, Copenhagen University, Øster Farimagsgade 5, Copenhagen, 1014, Denmark
  • b KORA, The Danish Institute for Local and Regional Government Research, Købmagergade 22, Copenhagen, 1150, Denmark
  • c Competence Center for Transcultural Psychiatry, Psychiatric Center Ballerup, Niels Andersens Vej 65, Hellerup, 2900, Denmark
  • d The Danish Research Centre for Migration, Ethnicity and Health (MESU), Section for Health Services Research, Department of Public Health, Copenhagen University, Øster Farimagsgade 5, Copenhagen, 1014, Denmark
  • e The Danish Research Centre for Migration, Ethnicity and Health (MESU), Section for Health Services Research, Department of Public Health, Copenhagen University, Øster Farimagsgade 5, Copenhagen, 1014, Denmark, Section of Immigrant Medicine, Department of Infectious Disease, Copenhagen University Hospital, Hvidovre Hospital, Kettegård Alle 30, Hvidovre, 2650, Denmark

Abstract

Aim: The purpose of this study was to investigate continuity of care in the psychiatric healthcare system from the perspective of patients, including vulnerable groups such as immigrants and refugees. Method: The study is based on 19 narrative interviews conducted with 15 patients with diverse migration backgrounds (immigrants, descendents, refugees, and ethnic Danes). Patients were recruited from a community psychiatric centre situated in an area with a high proportion of immigrants and refugees. Data were analysed through the lens of a theoretical framework of continuity of care in psychiatry, developed in 2004 by Joyce et al., which encompasses four domains: accessibility, individualised care, relationship base and service delivery. Results: Investigating continuity of care, we found issues of specific concern to immigrants and refugees, but also commonalities across the groups. For accessibility, areas pertinent to immigrants and refugees include lack of knowledge concerning mental illness and obligations towards children. In terms of individualised care, trauma, additional vulnerability, and taboo concerning mental illness were of specific concern. In the domain of service delivery, social services included assistance with immigration papers for immigrants and refugees. In the relationship base domain, no differences were identified. Implications for priority area: The treatment courses of patients in the psychiatric field are complex and diverse and the patient perspective of continuity of care provides important insight into the delivery of care. The study highlights the importance of person-centred care irrespective of migration background though it may be beneficial to have an awareness of areas that may be of more specific concern to immigrants and refugees. Conclusions: The study sheds light on concerns specific to immigrants and refugees in a framework of continuity of care, but also commonalities across the patient groups. © 2014 by the authors; licensee MDPI, Basel, Switzerland.

Author Keywords

Migration immigrants Psychiatry Continuity of care Health care system Illness narratives Mental illness Refugees

Index Keywords

patient care vulnerable population immigrant refugee mental health service mental health human immigration Refugees access to information middle aged Denmark ethnic group controlled study Dane (people) Social Work mental health care Mental Disorders Humans migrant conceptual framework male Emigrants and Immigrants female accessibility clinical article personalized medicine health services Continuity of Patient Care vulnerability Article health care adult health care access patient attitude health care system Delivery of Health Care health literacy health care availability health care delivery
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84908081474&doi=10.3390%2fijerph110909739&partnerID=40&md5=d375055652513a8e36018e4cf9011499
DOI: 10.3390/ijerph110909739
ISSN: 16617827
Cited by: 8
Original Language: English