Uncovering multi-level mental healthcare barriers for migrants: a qualitative analysis across China, Germany, Netherlands, Romania, and South Africa.

BACKGROUND: Forced displacement is a significant issue globally, and it affected 112 million people in 2022. Many of these people have found refuge in low- and middle-income countries. Migrants and refugees face complex and specialized health challenges, particularly in the area of mental health. This study aims to provide an in-depth qualitative assessment of the multi-level barriers that migrants face in accessing mental health services in Germany, Macao (Special Administrative Region of China), the Netherlands, Romania, and South Africa. The ultimate objective is to inform tailored health policy and management practices for this vulnerable population. METHODS: Adhering to a qualitative research paradigm, the study centers on stakeholders' perspectives spanning microsystems, mesosystems, and macrosystems of healthcare. Utilizing a purposive sampling methodology, key informants from the aforementioned geographical locations were engaged in semi-structured interviews. Data underwent thematic content analysis guided by a deductive-inductive approach. RESULTS: The study unveiled three pivotal thematic barriers: language and communication obstacles, cultural impediments, and systemic constraints. The unavailability of professional interpreters universally exacerbated language barriers across all countries. Cultural barriers, stigmatization, and discrimination, specifically within the mental health sector, were found to limit access to healthcare further. Systemic barriers encompassed bureaucratic intricacies and a conspicuous lack of resources, including a failure to recognize the urgency of mental healthcare needs for migrants. CONCLUSIONS: This research elucidates the multifaceted, systemic challenges hindering equitable mental healthcare provision for migrants. It posits that sweeping policy reforms are imperative, advocating for the implementation of strategies, such as increasing the availability of language services, enhancing healthcare providers' capacity, and legal framework and policy change to be more inclusive. The findings substantially contribute to scholarly discourse by providing an interdisciplinary and international lens on the barriers to mental healthcare access for displaced populations.

Literacy development of English language learners: the outcomes of an intervention programme in grade R.

This study aims to contribute to the knowledge base on the status and development of emergent literacy skills of learners receiving formal education in their second or additional language. The focus is on young English language learners (ELLs), i.e. learners whose home language is not English but who have English as their language of teaching and learning. This article reports on a study that investigated ELLs' emergent literacy skills prior to entering grade 1 and then evaluated the effectiveness of an evidence-based stimulation programme on early literacy skills in the South African context. Using a quasi-experimental design, ELLs' emergent literacy skills were assessed with an adapted version of 8 of the subtests of the Emergent Literacy Assessment battery (Willenberg, 2004) and were compared to those of English first language (L1) and of ELL control groups, both before and after the 8-week purpose-designed programme. While learners showed significant improvement on 6 of the 8 subtests, the programme did not significantly improve ELLs' skills in comparison to those of the control groups. Possible independent variables contributing to the dearth of intervention effect include socio-economic status, learners' L1, and teacher- and classroom-specific characteristics, all of which were considered in this study. Clinical implications for speech-language therapists with regard to assessment, intervention, service delivery and outcome measures are highlighted.