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Separate or integrated services? 

Separate or integrated services?
Separate or integrated services?

Sofie Bäärnhielm

, Mike Mösko

, and Aina Basilier Vaage

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date: 18 May 2021

In this chapter, we discuss the pros and cons of separate versus integrated services for immigrants and refugees. Our discussion is based on experiences from three high-income countries: Germany, Norway, and Sweden. All three, regardless of general public insurance systems covering healthcare costs, have barriers to mental health care for migrants and refugees. Additionally, their mental health care systems are unaccustomed to responding to cultural variety in patients’ expression of distress, explanatory models of illness, consequences of pre-migratory difficulties, and post-migratory adversities. Attention to post-traumatic stress and social determinants of mental health is also restricted. To bridge barriers and improve access to mental health care for immigrants and refugees, we will comment on the importance of adapting care, training of professionals, and outreach programmes. Also emphasized is the value of culturally sensitive mental health-promoting strategies to improve mental health literacy and reduce stigma among immigrants and refugees.

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