Ethnic Disparities in Access to Mental Health Services for Black and Asian Migrants in Major Resettlement Countries.

Ethnic inequalities in high-income countries result in higher risk of mental illness and lower access to healthcare services for migrant populations than the majority White populations. This literature review examined evidence of the responsible barriers. A systematic search of six databases (Psychology and Behavioral Sciences Collection; eBook Collection [EBSCOhost]; CINAHL; GreenFILE; Library, Information Science & Technology Abstracts; and MEDLINE) was done using search terms. Eighteen recent, locally accessible studies conducted in six major resettlement countries were selected following PRISMA guidelines and the extracted evidence was analysed descriptively and thematically. Three main themes of ethnic mental health differentials of Black and Asian migrants were identified: access to services (13 studies), risk of mental illness (7 studies), and experience of care services (7 studies). Their access disparities revealed migrants suffer inequalities in service utilisation (5 studies) and greater obstacles to receiving care (8 studies). Their higher risk of mental illness was related to over-diagnosis of psychosis (2 studies), higher prevalence (4 studies), and exposure to predisposing factors (3 studies). Migrants experienced poorer quality and outcomes of care (3 studies), and use of restraint (2 studies) and seclusion (1 study) and expressed fear and mistrust of services (2 studies). The common ethnic barriers in service delivery were language and cultural difficulties, systemic discrimination and marginalisation, and social stigmatisation. It is proposed that systemic racism as well as communication and cultural difficulties are the core determinants of migrants' ethnic disparities of accessing mental health services in these major host countries.