Bassey Archibong, Zaka Rachael
Warwick Medical School University of Warwick Coventry UK.
Public Health Chall. 2024 May 19;3(2):e181. doi: 10.1002/puh2.181. eCollection 2024 Jun.
African immigrants in the United Kingdom (UK) face unique challenges in accessing mental health services (MHSs), in contrast to their peers born in the UK, contributing to their worsening mental and physical health outcomes. This study aims to uncover barriers to MHS utilization and proffer evidence-based recommendations toward addressing the mental health needs of African immigrants residing in the UK.
A systematic literature search was conducted across six databases: Medline, PsycINFO, Web of Science, CIHNAL, Scopus, and Embase published up to September 2022. To assess methodological quality of the included studies, the Critical Appraisal Skills Program qualitative checklist and the Mixed Methods Appraisal Tool Version 2018 were used. Consecutively, a deductive thematic analysis was employed to group related barriers within overarching themes.
The study selection process yielded eight studies conducted in the UK, encompassing African populations identifying as African/Afro-Caribbean origin, Somali refugees, and ethnic minorities of Black/British descent. The findings highlight the complex interplay of key barriers such as stigma, residential instability, cultural influences, discrimination, and accessibility issues, among others, that continue to hinder African populations from accessing and utilizing MHSs. These barriers were categorized into predisposing,enabling and need factors (themes), aligning with Anderson's model of health service utilization, reflecting a comprehensive range of challenges affecting this population.
This systematic review illuminates the myriad barriers faced by African immigrants in utilizing MHSs in the UK, underlining the urgent need for targeted interventions. The findings advocate for the development of culturally sensitive, affordable, and accessible MHSs and policies that address the personal, sociocultural, and structural barriers identified. Collaboration across key stakeholders is highly recommended for advancing equitable and inclusive MHSs for all.
与在英国出生的同龄人相比，在英国的非洲移民在获得心理健康服务方面面临独特挑战，这导致他们的身心健康状况不断恶化。本研究旨在揭示心理健康服务利用的障碍，并提出基于证据的建议，以满足居住在英国的非洲移民的心理健康需求。
对六个数据库进行了系统的文献检索：截至2022年9月发表的Medline、PsycINFO、科学网、护理及健康领域数据库、Scopus和Embase。为了评估纳入研究的方法学质量，使用了批判性评估技能计划定性清单和2018年版混合方法评估工具。随后，采用演绎主题分析将相关障碍归为总体主题下的类别。
研究选择过程产生了八项在英国进行的研究，涵盖了认定为非洲/非裔加勒比血统、索马里难民以及黑人/英国血统少数民族的非洲人群。研究结果突出了耻辱感、居住不稳定、文化影响、歧视和可及性问题等关键障碍之间的复杂相互作用，这些障碍继续阻碍非洲人群获得和利用心理健康服务。这些障碍被归类为诱发因素、促成因素和需求因素（主题），与安德森的卫生服务利用模型一致，反映了影响这一人群的一系列全面挑战。
这项系统评价阐明了非洲移民在英国利用心理健康服务时面临的众多障碍，强调了针对性干预的迫切需求。研究结果主张制定具有文化敏感性、负担得起且可及的心理健康服务和政策，以解决已确定的个人、社会文化和结构性障碍。强烈建议关键利益相关者之间开展合作，以推进面向所有人的公平和包容性心理健康服务。
