Access to Virtual Mental Healthcare Services and Support for Refugee and Immigrant Groups: A Scoping Review (2023)

Abstract

"Immigrant and refugee populations face multiple barriers to accessing mental health services. This scoping review applies the (Levesque et al. in Int J Equity Health 12:18, 2013) Patient-Centred Access to Healthcare model in exploring the potential of increased access through virtual mental healthcare services VMHS for these populations by examining the affordability, availability/accommodation, and appropriateness and acceptability of virtual mental health interventions and assessments.

Accessibility depended on individual (e.g., literacy), program (e.g., computer required) and contextual/social factors (e.g., housing characteristics, internet bandwidth). Participation often required financial and technical support, raising important questions about the generalizability and sustainability of VMHS’ [virtual mental healthcare services] accessibility for immigrant and refugee populations. Given limitations in current research (i.e., frequent exclusion of patients with severe mental health issues; limited examination of cultural dimensions; de facto exclusion of those without access to technology), further research appears warranted."

Conclusion

The COVID-19 pandemic made VMHS a necessity, but in so doing opened up new opportunities for increased access to mental health care for various populations, including immigrants and refugees, and it seems likely that virtual approaches will continue to be promoted [14]. This scoping review suggests that the potential of virtual mental healthcare to reach underserved populations may not be achieved because of insufficient consideration of barriers for those already facing the greatest challenges in accessing care (e.g., those with limited language fluency, digital

literacy or access to devices). This includes neglecting whether the additional supports required to make VMHS accessible (e.g., providing devices and financial support for phone or internet services) will be available in programs once they are beyond the testing and research phase, highlighting the importance of more implementation research. A number of common challenges in VMHS accessibility were identified across this diverse range of interventions and populations; however, this scoping review also identified unique barriers determined by systemic, contextual, clinical and personal characteristics for
immigrant and refugee populations. Such obstacles warrant further attention. We propose that working with the intended user population on the planning and delivery of virtual mental health services will help increase accessibility for these populations, both now and in the future.