Skip to main content
Top
Published in: BMC Public Health 1/2012

Open Access 01-12-2012 | Research article

Good practice in mental health care for socially marginalised groups in Europe: a qualitative study of expert views in 14 countries

Authors: Stefan Priebe, Aleksandra Matanov, Ruth Schor, Christa Straßmayr, Henrique Barros, Margaret M Barry, José Manuel Díaz-Olalla, Edina Gabor, Tim Greacen, Petra Holcnerová, Ulrike Kluge, Vincent Lorant, Jacek Moskalewicz, Aart H Schene, Gloria Macassa, Andrea Gaddini

Published in: BMC Public Health | Issue 1/2012

Login to get access

Abstract

Background

Socially marginalised groups tend to have higher rates of mental disorders than the general population and can be difficult to engage in health care. Providing mental health care for these groups represents a particular challenge, and evidence on good practice is required. This study explored the experiences and views of experts in 14 European countries regarding mental health care for six socially marginalised groups: long-term unemployed; street sex workers; homeless; refugees/asylum seekers; irregular migrants and members of the travelling communities.

Methods

Two highly deprived areas were selected in the capital cities of 14 countries, and experts were interviewed for each of the six marginalised groups. Semi-structured interviews with case vignettes were conducted to explore experiences of good practice and analysed using thematic analysis.

Results

In a total of 154 interviews, four components of good practice were identified across all six groups: a) establishing outreach programmes to identify and engage with individuals with mental disorders; b) facilitating access to services that provide different aspects of health care, including mental health care, and thus reducing the need for further referrals; c) strengthening the collaboration and co-ordination between different services; and d) disseminating information on services both to marginalised groups and to practitioners in the area.

Conclusions

Experts across Europe hold similar views on what constitutes good practice in mental health care for marginalised groups. Care may be improved through better service organisation, coordination and information.
Literature
1.
go back to reference Anderson JG: Marginalization, citizenship and the economy: the capacities of the universalist welfare state in Denmark. The Rationality of the Welfare State. Edited by: Oddvar-Eriksen E, Loftager J. 1996, Scandinavian University Press, Oslo, 155-202. Anderson JG: Marginalization, citizenship and the economy: the capacities of the universalist welfare state in Denmark. The Rationality of the Welfare State. Edited by: Oddvar-Eriksen E, Loftager J. 1996, Scandinavian University Press, Oslo, 155-202.
2.
go back to reference Morgan C, Burns T, Fitzpatrick R, Pinfold V, Priebe S: Social exclusion and mental health: a conceptual and methodological review. Br J Psychiatry. 2007, 191: 477-483. 10.1192/bjp.bp.106.034942.CrossRefPubMed Morgan C, Burns T, Fitzpatrick R, Pinfold V, Priebe S: Social exclusion and mental health: a conceptual and methodological review. Br J Psychiatry. 2007, 191: 477-483. 10.1192/bjp.bp.106.034942.CrossRefPubMed
3.
go back to reference Heikkinen M: Social Networks of the Marginal Young: A Study of Young People's Social Exclusion in Finland. JYS. 2000, 3: 389-406. Heikkinen M: Social Networks of the Marginal Young: A Study of Young People's Social Exclusion in Finland. JYS. 2000, 3: 389-406.
4.
go back to reference Anderson JG: Marginalization, citizenship and the economy: the capacities of the universalist welfare state in Denmark. The Rationality of the Welfare State. Edited by: Oddvar-Eriksen E, Loftager J. 1996, Scandinavian University Press, Oslo, 155-202. Anderson JG: Marginalization, citizenship and the economy: the capacities of the universalist welfare state in Denmark. The Rationality of the Welfare State. Edited by: Oddvar-Eriksen E, Loftager J. 1996, Scandinavian University Press, Oslo, 155-202.
5.
go back to reference Fazel S, Khosla V, Doll H, Geddes J: The prevalence of mental disorders among the homeless in western countries: systematic review and meta-regression analysis. PLoS Med. 2008, 5 (12): e225-10.1371/journal.pmed.0050225.CrossRefPubMedPubMedCentral Fazel S, Khosla V, Doll H, Geddes J: The prevalence of mental disorders among the homeless in western countries: systematic review and meta-regression analysis. PLoS Med. 2008, 5 (12): e225-10.1371/journal.pmed.0050225.CrossRefPubMedPubMedCentral
6.
go back to reference Fazel M, Wheeler J, Danesh J: Prevalence of serious mental disorder in 7000 refugees resettled in western countries: a systematic review. Lancet. 2005, 365 (Pt 9467): 1309-1314.CrossRefPubMed Fazel M, Wheeler J, Danesh J: Prevalence of serious mental disorder in 7000 refugees resettled in western countries: a systematic review. Lancet. 2005, 365 (Pt 9467): 1309-1314.CrossRefPubMed
7.
go back to reference Rössler W, Koch U, Lauber C, Hass A-K, Altwegg M, Ajdacic-Gross V, Landolt K: The mental health of female sex workers. Acta Psychiatr Scand. 2010, 122: 143-152. 10.1111/j.1600-0447.2009.01533.x.CrossRefPubMed Rössler W, Koch U, Lauber C, Hass A-K, Altwegg M, Ajdacic-Gross V, Landolt K: The mental health of female sex workers. Acta Psychiatr Scand. 2010, 122: 143-152. 10.1111/j.1600-0447.2009.01533.x.CrossRefPubMed
17.
go back to reference Shaw M, Galobrades B, Lawlor DA, Lynch J, Wheeler B, Smith GD: The handbook of inequality and socio-economic position: Concepts and measures. 2007, The Policy Press, Bristol, UK Shaw M, Galobrades B, Lawlor DA, Lynch J, Wheeler B, Smith GD: The handbook of inequality and socio-economic position: Concepts and measures. 2007, The Policy Press, Bristol, UK
18.
go back to reference Priebe S, Matanov A, Barros H, Canavan R, Gabor E, Greacen T, Holcnerová P, Kluge U, Nicaise P, Moskalewicz J, Dıaz-Olalla JM, Straßmayr C, Schene AH, Soares JJF, Tulloch S, Gaddini A: Mental health-care provision for marginalized groups across Europe: findings from the PROMO study. European Journal of Public Health. 2012, Advance Access 7thFebruary 2012 Priebe S, Matanov A, Barros H, Canavan R, Gabor E, Greacen T, Holcnerová P, Kluge U, Nicaise P, Moskalewicz J, Dıaz-Olalla JM, Straßmayr C, Schene AH, Soares JJF, Tulloch S, Gaddini A: Mental health-care provision for marginalized groups across Europe: findings from the PROMO study. European Journal of Public Health. 2012, Advance Access 7thFebruary 2012
20.
go back to reference Church S, Henderson M, Barnard M, Hart G: Violence by clients towards female prostitutes in different work settings: questionnaire survey. BMJ. 2001, 322: 524-525. 10.1136/bmj.322.7285.524.CrossRefPubMedPubMedCentral Church S, Henderson M, Barnard M, Hart G: Violence by clients towards female prostitutes in different work settings: questionnaire survey. BMJ. 2001, 322: 524-525. 10.1136/bmj.322.7285.524.CrossRefPubMedPubMedCentral
23.
go back to reference Hsieh HF, Shannon SE: Three Approaches to Qualitative Content Analysis. QHR. 2005, 15: 1277-1288. Hsieh HF, Shannon SE: Three Approaches to Qualitative Content Analysis. QHR. 2005, 15: 1277-1288.
24.
go back to reference Patton MQ: Qualitative Research and Evaluation Methods. 1970, Sage, Thousand Oaks, CA, 3 Patton MQ: Qualitative Research and Evaluation Methods. 1970, Sage, Thousand Oaks, CA, 3
25.
go back to reference Silverman D: Interpreting Qualitative Data. 2001, Sage, London, 2 Silverman D: Interpreting Qualitative Data. 2001, Sage, London, 2
26.
go back to reference Priebe S, Sandhu S, Dias S, Gaddini A, Greacen T, Ioannidis E, Kluge U, Krasnik A, Lamkaddem M, Lorant V, Puigpinósi Riera R, Sarvary A, Soares JJF, Stankunas M, Straßmayr C, Wahlbeck K, Welbel M, Bogic M: Good practice in health care for migrants: views and experiences of care professionals in 16 European countries. BMC Publ Health. 2011, 11: 187-10.1186/1471-2458-11-187.CrossRef Priebe S, Sandhu S, Dias S, Gaddini A, Greacen T, Ioannidis E, Kluge U, Krasnik A, Lamkaddem M, Lorant V, Puigpinósi Riera R, Sarvary A, Soares JJF, Stankunas M, Straßmayr C, Wahlbeck K, Welbel M, Bogic M: Good practice in health care for migrants: views and experiences of care professionals in 16 European countries. BMC Publ Health. 2011, 11: 187-10.1186/1471-2458-11-187.CrossRef
27.
go back to reference Devillé W, Greacen T, Bogic M, Dauvrin M, Dias S, Gaddini A, Jensen NK, Karamanidou C, Kluge U, Mertaniemi R, Riera RP I, Sárváry A, Soares JJ, Stankunas M, Straßmayr C, Welbel M, Priebe S: Health care for immigrants in Europe: Is there still consensus among country experts about principles of good practice? A Delphi study. BMC Public Health. 2011, 11 (1): 699-10.1186/1471-2458-11-699.CrossRefPubMedPubMedCentral Devillé W, Greacen T, Bogic M, Dauvrin M, Dias S, Gaddini A, Jensen NK, Karamanidou C, Kluge U, Mertaniemi R, Riera RP I, Sárváry A, Soares JJ, Stankunas M, Straßmayr C, Welbel M, Priebe S: Health care for immigrants in Europe: Is there still consensus among country experts about principles of good practice? A Delphi study. BMC Public Health. 2011, 11 (1): 699-10.1186/1471-2458-11-699.CrossRefPubMedPubMedCentral
28.
go back to reference Jensen NK, Norredam M, Draebel T, Bogic M, Priebe S, Krasnik A: Providing Medical Care for Undocumented Migrants in Denmark: What Are the Challenges for Health Professionals?. BMC Health Serv. 2011, 11: 154-10.1186/1472-6963-11-154.CrossRef Jensen NK, Norredam M, Draebel T, Bogic M, Priebe S, Krasnik A: Providing Medical Care for Undocumented Migrants in Denmark: What Are the Challenges for Health Professionals?. BMC Health Serv. 2011, 11: 154-10.1186/1472-6963-11-154.CrossRef
29.
go back to reference Watters C, Ingleby D, Bernal M, De Freitas C, De Ruuk N, Van Leeuwen M, Venkatesan S: Good practices in mental health and social care for asylum seekers and refugees. 2003, University of Kent, Report. Canterbury Watters C, Ingleby D, Bernal M, De Freitas C, De Ruuk N, Van Leeuwen M, Venkatesan S: Good practices in mental health and social care for asylum seekers and refugees. 2003, University of Kent, Report. Canterbury
30.
go back to reference Wright NMJ, Tomkins SNE: How can health services effectively meet the health needs of homeless people. Br J Gen Pract. 2006, 56 (Pt 525): 286-293.PubMedPubMedCentral Wright NMJ, Tomkins SNE: How can health services effectively meet the health needs of homeless people. Br J Gen Pract. 2006, 56 (Pt 525): 286-293.PubMedPubMedCentral
31.
go back to reference FEANTSA: The right to health is human right: Ensuring access to health for people who are homeless. 2006, Annual European Report, Brussels FEANTSA: The right to health is human right: Ensuring access to health for people who are homeless. 2006, Annual European Report, Brussels
32.
go back to reference Parry G, Van Cleemput P, Peters J, Walters S, Thomas K, Cooper C: The Health Status of Gypsies and Travellers in England. J Epidemiol Community Health. 2007, 61: 198-204. 10.1136/jech.2006.045997.CrossRefPubMedPubMedCentral Parry G, Van Cleemput P, Peters J, Walters S, Thomas K, Cooper C: The Health Status of Gypsies and Travellers in England. J Epidemiol Community Health. 2007, 61: 198-204. 10.1136/jech.2006.045997.CrossRefPubMedPubMedCentral
34.
go back to reference Priebe S, Watts J, Chase M, Matanov A: Processes of disengagement and engagement in assertive outreach patients: qualitative study. BJPsych. 2005, 187: 438-443.PubMed Priebe S, Watts J, Chase M, Matanov A: Processes of disengagement and engagement in assertive outreach patients: qualitative study. BJPsych. 2005, 187: 438-443.PubMed
35.
go back to reference Burns T, Catty J, Dash M, Roberts C, Lockwood A, Marshall M: Use of intensive case management to reduce time in hospital in people with severe mental illness: systematic review and meta-regression. BMJ. 2007, 335 (7615): 336-10.1136/bmj.39251.599259.55.CrossRefPubMedPubMedCentral Burns T, Catty J, Dash M, Roberts C, Lockwood A, Marshall M: Use of intensive case management to reduce time in hospital in people with severe mental illness: systematic review and meta-regression. BMJ. 2007, 335 (7615): 336-10.1136/bmj.39251.599259.55.CrossRefPubMedPubMedCentral
39.
go back to reference Høyer G, Kjellin L, Engberg M, Kaltiala-Heino R, Nilstun T, Sigurjónsdóttir M, Syse A: Paternalism and autonomy: a presentation of a Nordic study on the use of coercion in the mental health care system. Int J Law Psychiatr. 2002, 25: 93-108. 10.1016/S0160-2527(01)00108-X.CrossRef Høyer G, Kjellin L, Engberg M, Kaltiala-Heino R, Nilstun T, Sigurjónsdóttir M, Syse A: Paternalism and autonomy: a presentation of a Nordic study on the use of coercion in the mental health care system. Int J Law Psychiatr. 2002, 25: 93-108. 10.1016/S0160-2527(01)00108-X.CrossRef
40.
go back to reference Crossley M: Resistance and Health Promotion. HEJ. 2001, 60 (3): 197-204. Crossley M: Resistance and Health Promotion. HEJ. 2001, 60 (3): 197-204.
41.
go back to reference Bilton H: Happiness matters: Homeless people’s views about breaking the link between homelessness and mental ill health. 2009, St’Mungo’s, London Bilton H: Happiness matters: Homeless people’s views about breaking the link between homelessness and mental ill health. 2009, St’Mungo’s, London
42.
go back to reference Craig T, Bayliss E, Klein O, Manning P, Reader L: The Homeless Mentally Ill Initiative: an evaluation of four clinical teams. 1995, Department of Health, London Craig T, Bayliss E, Klein O, Manning P, Reader L: The Homeless Mentally Ill Initiative: an evaluation of four clinical teams. 1995, Department of Health, London
47.
go back to reference Priebe S, Matanov A, Barros H, Canavan R, Gabor E, Greacen T, Holcnerová P, Kluge U, Nicaise P, Moskalewicz J, Dıaz-Olalla JM, Straßmayr C, Schene AH, Soares JJF, Tulloch S, Gaddini A: Mental health-care provision for marginalized groups across Europe: findings from the PROMO study. European Journal of Public Health. 2012, Advance Access 7th February 2012 Priebe S, Matanov A, Barros H, Canavan R, Gabor E, Greacen T, Holcnerová P, Kluge U, Nicaise P, Moskalewicz J, Dıaz-Olalla JM, Straßmayr C, Schene AH, Soares JJF, Tulloch S, Gaddini A: Mental health-care provision for marginalized groups across Europe: findings from the PROMO study. European Journal of Public Health. 2012, Advance Access 7th February 2012
48.
go back to reference Priebe S, Sandhu S, Dias S, Gaddini A, Greacen T, Ioannidis E, Kluge U, Krasnik A, Lamkaddem M, Lorant V, Puigpinósi Riera R, Sarvary A, Soares JJF, Stankunas M, Straßmayr C, Wahlbeck K, Welbel M, Bogic M: Good practice in health care for migrants: views and experiences of care professionals in 16 European countries. BMC Publ Health. 2011, 11: 187-10.1186/1471-2458-11-187.CrossRef Priebe S, Sandhu S, Dias S, Gaddini A, Greacen T, Ioannidis E, Kluge U, Krasnik A, Lamkaddem M, Lorant V, Puigpinósi Riera R, Sarvary A, Soares JJF, Stankunas M, Straßmayr C, Wahlbeck K, Welbel M, Bogic M: Good practice in health care for migrants: views and experiences of care professionals in 16 European countries. BMC Publ Health. 2011, 11: 187-10.1186/1471-2458-11-187.CrossRef
Metadata
Title
Good practice in mental health care for socially marginalised groups in Europe: a qualitative study of expert views in 14 countries
Authors
Stefan Priebe
Aleksandra Matanov
Ruth Schor
Christa Straßmayr
Henrique Barros
Margaret M Barry
José Manuel Díaz-Olalla
Edina Gabor
Tim Greacen
Petra Holcnerová
Ulrike Kluge
Vincent Lorant
Jacek Moskalewicz
Aart H Schene
Gloria Macassa
Andrea Gaddini
Publication date
01-12-2012
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2012
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-12-248

Other articles of this Issue 1/2012

BMC Public Health 1/2012 Go to the issue