Communication difficulties and strategies in migrant mental healthcare: A European survey of health and social care professionals

Background: Globally, one billion people suffer from mental health disorders. Migrant populations face high prevalence rates of some disorders and significant barriers in accessing mental healthcare, including language related barriers. However, knowledge about specific communication difficulties arising from language barriers and mitigation strategies is limited, as is knowledge about country-specific differences.
Objective: This study explores health and social care providers’ (HSCPs’) perceptions of mental health service accessibility for migrants, language-related communication difficulties, mitigation strategies and their perceived effectiveness, and the effectiveness of HSCP training in working with migrants.
Methods: We conducted a cross-sectional survey of HSCPs in nine European countries (n =629).
Results: HSCPs perceive mental health services as largely inaccessible for migrants facing language barriers. Cross-regional comparative analysis identified differences in the frequency of HSCPs’ interactions with migrants seeking support for their mental health where language barriers are present and in how often HSCPs’ reported experiencing communication difficulties when doing so. HSCPs report a lack of training in communicating with migrants across language barriers, with recent training associated with more positive perceptions of its useful ness. Communication difficulties were encountered throughout the care journey. Informal strategies, such as assistance from family and friends, and machine translation, are commonly used but seen as ineffective. Onsite professional/trained interpreters are deemed most effective, yet their availability is limited.
Conclusions: Findings highlight the urgent need for better communication strategies and awareness of the benefits and drawbacks of different strategies to enhance mental health service accessibility for migrants