Linguistic and cultural barriers to access and utilization of mental health care for Farsi-speaking newcomers in Quebec

• Published in: International journal of migration, health and social care health and social care, 2020-12, Vol.16 (4), p.495-510
• Main Authors: Mianji, Fahimeh, Tomaro, Jann, Kirmayer, Laurence J
• Format: Article
• Language: English
• Subjects: Access; Barriers; Clinical outcomes; Community; Community mental health services; Community organizations; Confidentiality; Cultural differences; Culture; Emergency medical care; Ethnic groups; Focus groups; Funding; Health care; Health care expenditures; Health disparities; Health problems; Health services; Health services utilization; Health status; Immigrants; Immigration; Inequality; Interviews; Language; Language attitudes; Linguistics; Medical personnel; Mental disorders; Mental health; Mental health care; Mental health services; Migration; Minority & ethnic groups; Minority groups; Newcomers; Noncitizens; Patient satisfaction; Persian language; Population; Primary care; Qualitative research; Refugees; Stigma
• ISSN: 1747-9894; 2042-8650
• DOI: 10.1108/IJMHSC-08-2019-0074

Purpose In light of the growing number of refugees and immigrants in Canada, this paper aims to identify barriers to mental health services for newcomer immigrants and refugees in Quebec and to examine how mental health services can be improved for these populations. Design/methodology/approach In this qualitative study, semi-structured individual interviews with Farsi-speaking health professionals and focus group interviews with participants from community organizations in Quebec were conducted. Findings Participants, both health-care professionals and community members, reported that mental health services are not readily accessible to Farsi-speaking immigrants and refugees. Structural barriers, language barriers, cultural safety and stigma were identified as obstacles to accessing care. Recommended strategies for improving access to mental health care are discussed. Originality/value Multiple studies have found that language and cultural barriers are associated with health inequalities and under-utilization of mental health services among linguistic and ethnic minorities. However, there are limited data on many groups and contexts, and a need to better understand how language barriers affect health outcomes, service utilization, patient satisfaction or overall costs to the health system or to society. In response to this gap, the present study explores how access to mental health services for Farsi-speaking newcomers may be limited by structural and linguistic barriers and cultural differences and as well as to identify strategies that can reduce the identified barriers. Abstrait Objet Compte tenu du nombre croissant de réfugiés et d'immigrants au Canada, cette étude vise à identifier les obstacles aux services de santé mentale pour les nouveaux arrivants immigrants et réfugiés au Québec et à examiner comment les services de santé mentale peuvent être améliorés pour ces populations. Conception/méthodologie/approche Dans cette étude qualitative, des entretiens individuels semi-structurés avec professionnels de la santé parlant le Farsi et entretiens avec des participants des organisations communautaires au Québec ont été menées. Résultats Les participants, tant des professionnels de la santé que des membres de la communauté, ont déclaré que les services de santé mentale sont inaccessibles aux immigrants et réfugiés parlant le Farsi. Obstacles structurels, les barrières linguistiques, la sécurité culturelle et la stigmatisation ont été identifiées comme d