This study undertakes a scoping review of reviews on barriers to accessing mental health care for refugees and asylum seekers in high-income countries. By assessing mental health care access using the Levesque's conceptual framework, we identify barriers along the patient care pathway and highlight research gaps. Following PRISMA-ScR guidelines, 10 relevant systematic and scoping reviews were identified and analyzed. Seven common barriers were identified, that could be located across different stages of the conceptual framework. Demand-side barriers included: (1) refugees' understanding of mental illness, (2) fear of stigma, (3) lack of awareness of services, (4) attitudes towards formal treatment; while supply-side barriers comprised: (5) language barriers, (6) practical and structural issues, and (7) providers' attitudes and competence. There was a focus on demand-side barriers as key determinants for low service use. We observed a paucity of quantitative studies linking barriers and indicators of access to care. In the context of well-established mental health care systems, previous research has largely explained low access through peculiarities of refugees and asylum seekers, thereby neglecting the role of supply-side factors (including system structures and attitudes of service providers). We discuss how future research can critically question prevailing assumptions and contribute to rigorous evidence.

中文翻译：

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高收入国家难民和寻求庇护者获得精神卫生保健的障碍：将需求和供应方因素映射到概念框架的范围界定审查


本研究对高收入国家难民和寻求庇护者获得精神卫生保健的障碍进行了范围审查。通过使用 Levesque 的概念框架评估精神卫生保健的可及性，我们确定了患者护理途径中的障碍并强调了研究差距。根据 PRISMA-ScR 指南，确定并分析了 10 项相关的系统性和范围界定审查。确定了七个常见障碍，这些障碍可能位于概念框架的不同阶段。需求方障碍包括：（1）难民对精神疾病的了解，（2）对耻辱的恐惧，（3）缺乏服务意识，（4）对正规治疗的态度；供应方障碍包括：（5）语言障碍，（6）实际和结构性问题，以及（7）供应商的态度和能力。人们关注需求方障碍，将其视为服务利用率低的关键决定因素。我们观察到缺乏将障碍和获得护理的指标联系起来的定量研究。在精神卫生保健体系完善的背景下，以往的研究很大程度上通过难民和寻求庇护者的特殊性来解释获取服务的机会低下，从而忽视了供给方因素（包括系统结构和服务提供者的态度）的作用。我们讨论未来的研究如何批判性地质疑普遍的假设并提供严格的证据。