Inequalities in mental health care and social services utilisation by immigrant women

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Abstract
Background: The basic assumption of public health policy for immigrants is that they ought to have equal access to health services compared to other population groups In Dutch society. However, little research is done on the actual use of mental health services by immigrants and literature seems to indicate inequalities in services utilisation by immigrant women. Methods: This study was conducted in Amsterdam, The Netherlands. Data on service utilisation were drawn from patient registers and came from care providers who were asked to keep up registration for some time to count the number of immigrant women referred to and in treatment. Results: Surinamese, Antillean, Turkish and Moroccan women made considerably less use of mental health care services than native-born women. On the other hand, immigrant women more frequently used social work facilities and women crisis intervention centres. Overall, they consulted the latter organizations nearly 1.5 times more frequently than mental health care services. The differences in service utilisation between the four immigrant groups are also discussed. Conclusions: This study explores the reasons for the ethnic differences in service utilisation. It argues that cultural and supply factors are largely responsible for the ethnic differences in use of mental health services. The differential use of social services is mainly ascribed to the socioeconomic status of the women concerned. The results imply that a care policy may improve the accessibility of mental health services for immigrant women. The most promising measure is by employing more ethnic and bilingual care providers.

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