Faculty of Medicine, University of Ottawa, 451 Smyth Rd, Ottawa, ON K1H 8M5, Canada.
C.T. Lamont Primary Care Research Centre, Bruyère Research Institute, 85 Primrose Ave, Ottawa, ON K1R 6M1, Canada.
Int J Environ Res Public Health. 2021 May 15;18(10):5266. doi: 10.3390/ijerph18105266.
The COVID-19 pandemic has had a major impact on the mental health of refugees and migrants. This study aimed to assess refugee clinician perspectives on mental health care during the COVID-19 pandemic, specifically access to and delivery of community mental health care services. We utilized a mixed methods design. We surveyed members of a national network of Canadian clinicians caring for refugees and migrants. Seventy-seven clinicians with experience caring for refugee populations, representing an 84% response rate, participated in the online survey, 11 of whom also participated in semi-structured interviews. We report three major themes: exacerbation of mental health issues and inequities in social determinants of health, and decreased access to integrated primary care and community migrant services. Clinicians reported major challenges delivering care during the first 6 months of the pandemic related to access to care and providing virtual care. Clinicians described perspectives on improving the management of refugee mental health, including increasing access to community resources and virtual care. The majority of clinicians reported that technology-assisted psychotherapy appears feasible to arrange, acceptable and may increase health equity for their refugee patients. However, major limitations of virtual care included technological barriers, communication and global mental health issues, and privacy concerns. In summary, the COVID-19 pandemic has exacerbated social and health inequities within refugee and migrant populations in Canada and challenged the way mental health care is traditionally delivered. However, the pandemic has provided new avenues for the delivery of care virtually, albeit not without additional and unique barriers.
COVID-19 大流行对难民和移民的心理健康产生了重大影响。本研究旨在评估难民临床医生在 COVID-19 大流行期间对心理健康护理的看法，特别是获得和提供社区心理健康护理服务的情况。我们采用了混合方法设计。我们调查了为难民和移民提供护理的加拿大临床医生全国网络成员。77 名有照顾难民人口经验的临床医生参加了在线调查，回应率为 84%，其中 11 名还参加了半结构式访谈。我们报告了三个主要主题：心理健康问题和社会决定因素健康不平等的加剧，以及综合初级保健和社区移民服务获取机会的减少。临床医生报告了在大流行的头 6 个月中提供护理方面的主要挑战，包括获取护理和提供虚拟护理的机会。临床医生描述了改善难民心理健康管理的观点，包括增加对社区资源和虚拟护理的获取。大多数临床医生报告说，技术辅助心理治疗似乎可以安排，是可以接受的，并可能为他们的难民患者增加健康公平性。然而，虚拟护理的主要限制包括技术障碍、沟通和全球心理健康问题以及隐私问题。总之，COVID-19 大流行加剧了加拿大难民和移民群体中的社会和健康不平等，并挑战了传统的心理健康护理方式。然而，大流行提供了通过虚拟方式提供护理的新途径，尽管并非没有额外的和独特的障碍。
