Ludwig Boltzmann Institute for Social Psychiatry, Lazarettgasse 14A-912, 1090 Vienna, Austria.
BMC Public Health. 2012 May 20;12:367. doi: 10.1186/1471-2458-12-367.
Irregular migrants (IMs) are exposed to a wide range of risk factors for developing mental health problems. However, little is known about whether and how they receive mental health care across European countries. The aims of this study were (1) to identify barriers to mental health care for IMs, and (2) to explore ways by which these barriers are overcome in practice.
Data from semi-structured interviews with 25 experts in the field of mental health care for IMs in the capital cities of 14 European countries were analysed using thematic analysis.
Experts reported a range of barriers to mental health care for IMs. These include the absence of legal entitlements to health care in some countries or a lack of awareness of such entitlements, administrative obstacles, a shortage of culturally sensitive care, the complexity of the social needs of IMs, and their fear of being reported and deported. These barriers can be partly overcome by networks of committed professionals and supportive services. NGOs have become important initial points of contact for IMs, providing mental health care themselves or referring IMs to other suitable services. However, these services are often confronted with the ethical dilemma of either acting according to the legislation and institutional rules or providing care for humanitarian reasons, which involves the risk of acting illegally and providing care without authorisation.
Even in countries where access to health care is legally possible for IMs, various other barriers remain. Some of these are common to all migrants, whilst others are specific for IMs. Attempts at improving mental health care for IMs should consider barriers beyond legal entitlement, including communicating information about entitlement to mental health care professionals and patients, providing culturally sensitive care and ensuring sufficient resources.
非正常移民（IM）面临着广泛的心理健康问题风险因素。然而，人们对他们在欧洲国家是否以及如何获得心理健康护理知之甚少。本研究的目的是：（1）确定非正常移民获得心理健康护理的障碍，（2）探讨在实践中克服这些障碍的方法。
对来自 14 个欧洲国家首都的 25 名非正常移民心理健康护理专家的半结构化访谈数据进行了主题分析。
专家报告了非正常移民获得心理健康护理的一系列障碍。这些障碍包括在某些国家缺乏获得医疗保健的法律权利或对这些权利缺乏认识、行政障碍、缺乏文化敏感的护理、非正常移民复杂的社会需求以及他们对被举报和被驱逐出境的恐惧。这些障碍可以通过有承诺的专业人员和支持性服务网络部分克服。非政府组织已成为非正常移民的重要初始接触点，它们本身提供心理健康护理，或向其他合适的服务机构转介非正常移民。然而，这些服务机构经常面临着要么根据立法和机构规则行事，要么出于人道主义原因提供护理的道德困境，这涉及到违法和未经授权提供护理的风险。
即使在非正常移民在法律上可以获得医疗保健的国家，也存在各种其他障碍。其中一些障碍对所有移民都适用，而另一些障碍则是针对非正常移民的。改善非正常移民心理健康护理的尝试应考虑到法律权利以外的障碍，包括向心理健康护理专业人员和患者传达有关获得心理健康护理的权利信息、提供文化敏感的护理以及确保足够的资源。
