Abstract
Introduction: Changes in global immigration policy and the international refugee crisis has led to increased diversity and resettlement of immigrants and refugees in Canada. Immigrant and refugee mental health is a priority due to a steady decline in mental health, increased post migration traumas, structural and cultural forms of discrimination. The COVID-19 pandemic has exacerbated mental health issues, inequities in social determinants of refugee and immigrant health and decreased access to primary care and community services. Integrated care is required to develop better services to meet client needs and reduce fragmentation within healthcare systems, however there is a gap in knowledge about how integrated care is conceptualized to support immigrant and refugee mental health.
Aims and Objectives: The purpose of the study was to explore conceptualizations of integrated care in the context of mental health care of immigrant and refugee populations in Canada. A literature review was conducted and included consultations with a refugee and immigrant service provider and a mental health practitioner. A health equity lens was applied to understand core elements of integrated care for immigrant and refugee populations in Canada.
Key findings: Findings suggest that intersectoral collaboration, coordination of health care and auxiliary professionals, and community-based approaches that address social determinants of immigrant and refugee mental health, can improve access to mental healthcare and mental health outcomes.
Conclusions: Integrated care includes addressing the social determinants of immigrant and refugee mental health as well as better collaboration and coordination among both health and social services. Although core elements of integrated care are consistent with other populations living with chronic care needs, our findings suggest that immigrant and refugees experience inequities in care based on intersecting health and social determinants.
Implications and limitations: Increased collaboration across services, better coordination of care can address both health and social aspects of immigrant and refugee mental health. Future reviews must include consultations with immigrant and refugee groups and a critical analysis of the contexts, mechanisms and outcomes that support integrated care between primary health care services and mental health services.