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评估 COVID-19 大流行期间难民的虚拟心理健康服务:我们学到了什么,我们将如何规划未来?

Assessing Virtual Mental Health Access for Refugees during the COVID-19 Pandemic Using the Levesque Client-Centered Framework: What Have We Learned and How Will We Plan for the Future?

机构信息

Department of Psychology, York University, Toronto, ON M3J 1P3, Canada.

Center for Refugee Studies, York University, Toronto, ON M3J 1P3, Canada.

出版信息

Int J Environ Res Public Health. 2022 Apr 20;19(9):5001. doi: 10.3390/ijerph19095001.

Abstract

During the COVID-19 pandemic, mental health services rapidly transitioned to virtual care. Although such services can improve access for underserved populations, they may also present unique challenges, especially for refugee newcomers. This study examined the multidimensional nature of access to virtual mental health (VMH) care for refugee newcomers during the COVID-19 pandemic, using Levesque et al.'s Client-Centered Framework for Assessing Access to Health Care. One hundred and eight structured and semi structured interviews were conducted in four Canadian provinces (8 community leaders, 37 newcomer clients, 63 mental health or service providers or managers). Deductive qualitative analysis, based on the Client-Centered Framework, identified several overarching themes: challenges due to the cost and complexity of using technology; comfort for VMH outside clinical settings; sustainability post-COVID-19; and communication and the therapeutic alliance. Mental health organizations, community organizations, and service providers can improve access to (virtual) mental health care for refugee newcomers by addressing cultural and structural barriers, tailoring services, and offering choice and flexibility to newcomers.

摘要

在 COVID-19 大流行期间,心理健康服务迅速转向虚拟护理。尽管此类服务可以改善服务不足人群的可及性,但它们也可能带来独特的挑战,尤其是对于难民新移民。本研究使用 Lévesque 等人的客户为中心的医疗保健获取评估框架,考察了 COVID-19 大流行期间难民新移民获得虚拟心理健康(VMH)护理的多维性质。在加拿大四个省(8 名社区领袖、37 名新移民客户、63 名心理健康或服务提供者或经理)进行了 108 次结构化和半结构化访谈。基于客户为中心的框架的演绎定性分析确定了几个总体主题:由于技术的成本和复杂性而带来的挑战;在临床环境之外对 VMH 的舒适度;COVID-19 后的可持续性;以及沟通和治疗联盟。心理健康组织、社区组织和服务提供者可以通过解决文化和结构性障碍、调整服务以及为新移民提供选择和灵活性来改善难民新移民获得(虚拟)心理健康护理的机会。

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