Background

Meeting the health needs of the increasing groups of immigrants has been a major challenge to public health throughout Europe.  EUGATE brought together a multidisciplinary group from 16 EU member states (Austria, Belgium, Denmark, Finland, France, Germany, Greece, Hungary, Italy, Lithuania, Netherlands, Poland, Portugal, Spain, Sweden and the United Kingdom) to consolidate the currently fragmented knowledge in the field and identify best practice of health care for different immigrant populations.

The study reviewed legislation, policies, and funding arrangements, assessed systems of health care services, and compared models of best practice across European countries for the people concerned. EUGATE defined guidelines for best practice and shared these findings widely among the relevant stakeholder groups in Europe. The overall aim of EUGATE was to identify good practice in the delivery of health care to immigrants.

Research questions

• What are the legislation and directives in European countries regulating health care for immigrants?
• What are the views of experts on what is best practice of health care for immigrants?
• What are the experiences of practitioners of best practice of health care for immigrants?
• What recommendations can be drawn on the findings for best practice of health care for immigrants in Europe?

Research activities

• A review of legislation, policy and adoption of EU directives concerning access to health care showed that most of the participating countries have adopted the seven EU directives most relevant for the selected target group issues.  Only one EU directive is fully adopted by all participating countries. Legal provision for health care varies depending on the target group and their legal status.
• 128 experts from academia, non-governmental organisations (NGOs), policy-making and health care practice identified 10-16 key elements of best health care for immigrants in each participating country, including (i) access to health care, (ii) empowerment of immigrants, (iii) culturally sensitive health services, (iv) general quality of health care, (v) patient-health care provider information, (vi) respect towards immigrants, (vii) networking in and outside mental health services, and (viii) outreach activities.
• 240 interviews conducted with practitioners and administrators/managers in 240 different services (primary care, mental health care and A&E) identified problems and components of good practice.     

Conclusions

• Together, the findings suggest that sufficient resources, organisational flexibility, training of staff, informal material and positive attitudes are crucial elements for quality mental health care to immigrants.

Staff

• Prof. Stefan Priebe
• Dr Sima Sandhu

Associate papers

Sandhu,S., Bjerre, N.V., Dauvrin, M., Dias, S., Gaddini, A., Greacen, T., Ioannidis, E., Kluge, U., Jensen, N.K., Lamkaddem, M., Puigpinós i Riera, R., Kósa Z., Wihlman, U., Stankunas, M., Straßmayr,C., Wahlbeck, K., Welbel, M., & Priebe, S. (2013).  Experiences with treating immigrants: a qualitative study in mental health services across 16 European countries.  Social Psychiatry & Psychiatric Epidemiology, 48: 105-116.

Kluge, U., Bogic, M., Devillé, W., Greacen, T., Dauvrin, M., Dias, S., Gaddini, A., Jensen, N.K., Ioannidis-Kapolou, E., Mertaniemi, R., Puigpinós i Riera, R., Sandhu, S., Sarvary, A., Soares, J.J.F., Stankunas,M., Straßmayr, C., Welbel, M., Heinz, A., & Priebe, S. (2012).  Health services and the treatment of immigrants: data on service use, interpreting services and immigrant staff members in services across Europe.  European Psychiatry, 27: S56-S62.

Dauvrin, M., Lorant, V., Sandhu, S., Devillé, W., Dia, H., Dias, S., Gaddini, A., Ioannidi, E., Kluge, U., Jensen, N.K., Mertaniemi, R., Puigpinós i Riera, R., Sarvary, A., Straßmayr, C., Stankunas, M., Soares, J.J.F., Welbel, M., & Priebe, S. (2012).  Health care for irregular migrants in Europe: when pragmatism is more important than legislation.  BMC Research Notes, 5:99. DOI: 10.1186/1756-0500-5-99.

Priebe, S., Sandhu, S., Dias S., Gaddini, A., Greacen, T., Ioannidis, E., Kluge, U., Krasnik, A., Lamkaddem, M., Lorant, V., Puigpinós i Riera, R., Sarvary, A., Soares, J.J.F, Stankunas, M., Straßmayr,C., Wahlbeck, K., Welbel, M., & Bogic, M. (2011).  Good practice in health care for migrants: views and experiences of care professionals in 16 European countries.  BMC Public Health, 11:187.  DOI:10.1186/1471-2458-11-187.

Priebe S, Bogic M, Adany R, Bjerre NV, Dauvrin M, Devillé W, Dias S, Gaddini A, Greacen T, Kluge U, Ioannidis E, Jensen NK, Puigpinós i Riera R, Soares JJF, Stankunas M, Straßmayr C, Wahlbeck K, Welbel M, McCabe R for the EUGATE group (2011). Good practice in emergency care: Views from practitioners.  In: Rechel, B., Mladovsky P, Devillé W, Rijks B, Petrova-Benedict R, McKee, M (Eds.), Migration and Health in Europe (European Observatory on Health). Maidenhead: Open University Press.

Devillé W, Greacen T , Bogic M, Dauvrin M, Dias S, Gaddini A, Jensen NK, Karamanidou C, Kluge U, Mertaniemi R, Puigpinós i Riera R, Sarvary A , Soares JJF, Stankunas M, Straßmayr C, Wahlbeck K, Welbel M, Priebe S (2011) Health care for immigrants in Europe: is there still consensus among country experts about principles of good practice? A Delphi study.  BMC Public Health, 11:699

Jensen NK, Norredam M, Draebel T, Bogic M, Priebe S, Krasnik A (2011) Providing medical care for undocumented migrants in Denmark: What are the challenges for health professionals? BMC Health Services Research, 11:154

Jensen NK, Nielsen SS, Krasnik A. (2010) Expert opinion on ‘best practices’ in the delivery of health care services to immigrants in Denmark. Danish Medical Bulletin, 57(8):A4170

Funder

General Directorate of Health and Consumer Protection (DG SANCO) of the European Union