The use of outpatient mental health care services of migrants vis-a-vis Dutch natives: equal access?

Int J Soc Psychiatry. 2013 Jun;59(4):342-50. doi: 10.1177/0020764012437129. Epub 2012 Mar 5.

Abstract

Background: Although the use of outpatient mental health care services by migrants in the Netherlands has increased in recent years, whether it aligns with the need for care is unclear.

Aims: To investigate ethnic-related differences in utilization in outpatient mental health care, taking need into account, and to examine whether socio-economic or cultural barriers explain such differences.

Methods: Data for the native population was taken from the second Dutch National Survey of General Practice (N = 7,772). An additional random sample was drawn (N = 1,305) from four migrant groups (Surinamese, Dutch Antilleans, Moroccans and Turks) living in the Netherlands. Participants were surveyed on mental health care utilization, indicators of need, educational level, proficiency in Dutch and acculturation.

Results: Use of outpatient mental health care was about 5% for the indigenous population. Among migrants, percentages of use ranged from 6.5% (Moroccans) to 9.0% (Turks). Corrected for need, however, all non-Dutch groups had a lower chance of service utilization than the native group. Acculturation predicted utilization but did not explain all ethnic-related differences; proficiency in Dutch and health beliefs were not explanatory factors.

Conclusions: In non-Dutch-speaking migrant groups, utilization is about half the level of the native Dutch, suggesting that a substantial gap exists. Our study found that acculturation only partially explains the differences.

Keywords: Outpatient mental health care; acculturation; language mastery; migrants; utilization.

MeSH terms

  • Acculturation
  • Adolescent
  • Adult
  • Ethnicity / psychology
  • Ethnicity / statistics & numerical data
  • Female
  • Health Care Surveys / methods
  • Health Care Surveys / statistics & numerical data
  • Health Services Needs and Demand / statistics & numerical data
  • Humans
  • Language*
  • Male
  • Mental Health Services / statistics & numerical data*
  • Middle Aged
  • Netherlands
  • Outpatients / psychology
  • Outpatients / statistics & numerical data*
  • Patient Acceptance of Health Care / psychology
  • Patient Acceptance of Health Care / statistics & numerical data*
  • Socioeconomic Factors
  • Transients and Migrants / psychology
  • Transients and Migrants / statistics & numerical data*
  • Young Adult