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Introduction Introduction
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The Swedish example The Swedish example
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Mental health care among migrants in Sweden Mental health care among migrants in Sweden
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Different approaches in responding to migration and cultural diversity Different approaches in responding to migration and cultural diversity
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Separate services for refugees with post-traumatic stress Separate services for refugees with post-traumatic stress
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Responding to cultural variety Responding to cultural variety
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Pros, cons, and the future Pros, cons, and the future
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The German example The German example
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Current situation of the healthcare system Current situation of the healthcare system
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Mental health care services for migrants Mental health care services for migrants
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(Mental) health care utilization by asylum seekers and refugees (Mental) health care utilization by asylum seekers and refugees
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Mental health care utilization by people without a legal status Mental health care utilization by people without a legal status
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History of mental health care services for migrants and asylum seekers: the ‘Interkulturelle Öffnung’ movement History of mental health care services for migrants and asylum seekers: the ‘Interkulturelle Öffnung’ movement
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Pros and cons of the constructions Pros and cons of the constructions
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Future needs Future needs
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The Norwegian example The Norwegian example
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Service delivery for immigrants and refugees Service delivery for immigrants and refugees
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An example: the Transcultural Centre in Stavanger An example: the Transcultural Centre in Stavanger
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How it works How it works
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Pros and cons of the Stavanger Centre Pros and cons of the Stavanger Centre
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Future needs of the Stavanger Centre Future needs of the Stavanger Centre
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Discussion of pros and cons with service models Discussion of pros and cons with service models
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Bridging barriers to mental health care Bridging barriers to mental health care
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Human rights and medical ethics Human rights and medical ethics
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Conclusion Conclusion
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Acknowledgements Acknowledgements
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References References
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52 Separate or integrated services?
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Published:January 2021
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Abstract
In this chapter, we discuss the pros and cons of separate versus integrated services for immigrants and refugees. Our discussion is based on experiences from three high-income countries: Germany, Norway, and Sweden. All three, regardless of general public insurance systems covering healthcare costs, have barriers to mental health care for migrants and refugees. Additionally, their mental health care systems are unaccustomed to responding to cultural variety in patients’ expression of distress, explanatory models of illness, consequences of pre-migratory difficulties, and post-migratory adversities. Attention to post-traumatic stress and social determinants of mental health is also restricted. To bridge barriers and improve access to mental health care for immigrants and refugees, we will comment on the importance of adapting care, training of professionals, and outreach programmes. Also emphasized is the value of culturally sensitive mental health-promoting strategies to improve mental health literacy and reduce stigma among immigrants and refugees.
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