Objective To identify the factors that prevent or hinder access to mental healthcare services for refugees, asylum seekers and migrants. Design An umbrella review was conducted on scoping reviews, systematic reviews, meta-analyses and meta-syntheses published between January 2013 and December 2023. Data sources The databases searched (on 11 December 2023) included PubMed (via NCBI, including MEDLINE), Embase (via Embase.com), Web of Science Core Collection, Scopus and the Cochrane Database of Systematic Reviews (via Cochrane Library). Search strings were categorised as concepts, wherein concept one was population (refugees, asylum seekers and migrants), concept two was mental health services and concept three was the type of review (systematic review, meta-analysis, scoping review or literature review). Eligibility criteria for selecting studies Reviews were included if study participants were refugees, asylum seekers and migrants. Additionally, mental health-providing services or organisations and mental health providers were included. Excluded study participants were people with a migration background and second- or third-generation migrants. Data extraction and synthesis Two independent reviewers screened the identified articles on title and The 48 full-text articles were assessed in detail against inclusion and exclusion criteria by the two researchers and one person from the Belgian Superior Health Council. Results 18 reviews were included. The extensive literature review identified various factors that prevent and restrict access to mental healthcare services for individuals with a recent migration background. Among the eight concepts of barriers, the most frequently mentioned were stigma and stigmatisation, language and communication challenges, financial obstacles, cultural barriers (including religious beliefs and faith) and issues with service delivery. Additionally, differences in culture, education and gender were recognised as factors limiting access to mental health services. Recommendations for policy and practice included implementing a multidisciplinary and multi-agency approach to facilitate access for newly arriving migrants and refugees, increasing financial allocations for translation and interpretation services, enabling policies to promote mental health utilisation and introducing educational programmes at the grassroot level among migrants and refugees. Conclusion Policy implementation should address the identified barriers and be routinely assessed for efficacy in service delivery and uptake. Future research should focus on enabling the utilisation of mental healthcare services among migrants, asylum seekers, and refugees.

Introduction: Patients often seek after-hours medical care due to urgent concerns, convenience or limited access to their regular providers. In Belgium, such care is primarily delivered through general practitioner cooperatives (GPCs), where regional general practitioners collaborate and rotate shifts. Patients may present at GPCs either directly or after calling the national helpline (1733). While doctor–patient communication has been widely studied, interactions between patients and reception staff have received little attention. These initial encounters can strongly shape patients’ comfort and perceptions of care. Methods: This ethnographic study used a dual-method approach to examine communication during initial interactions between patients and reception staff at an after-hours clinic. The methods included: (1) interactive observations of the registration process at the reception desk, supported by detailed field notes and (2) semistructured interviews with on-duty reception staff, focusing on their perceived ability to assist patients, particularly when facing language barriers or communication challenges. Results: Over a 4-week period, more than 60 hours of observational data were collected, offering valuable insights into patient flow, the languages spoken in the practice and the frequency of home visits. The observations also highlighted various strategies used to overcome communication challenges, such as involving accompanying persons, relying on non-verbal gestures and using technological aids. In addition, thematic analyses of the interviews conducted with five staff members revealed three key themes: professional experience, communication and self-reflection. Among these, communication emerged as a central concern, with language barrier cases consistently identified as a daily challenge in practice. Conclusion: This study highlights the critical yet often overlooked role of reception staff in ensuring equitable access to healthcare in linguistically diverse settings. The findings underscore the need to equip front-desk personnel with appropriate tools, training and institutional support to enable culturally and linguistically competent service delivery at the first point of contact.

Background Medical consultation is an interactive communicative process in which the doctor and the patient take turns to formulate and allow for the construction of the interaction. Communication challenges between patients and healthcare professionals during consultations can lead to miscommunication or complete breakdowns in interaction. Language barriers are a primary contributor to these difficulties. With increasing migration, the number of non-native language-speaking patients seeking medical care has risen substantially. Aim To explore the experiences of medical and allied healthcare professionals in Belgium when encountering language barriers during patient communication in clinical settings. Method A quantitative, multilingual, cross-sectional survey study was conducted in Belgium to examine the experiences of healthcare professionals during patient interactions involving language barriers. Results A total of 179 healthcare professionals completed the survey. All respondents reported encountering patients with whom communication was hindered by language barriers. Patients’ body language and lack of responsiveness were key indicators of these barriers. The professional role of respondents significantly influenced the type of alternative communication technique employed (p = 0.00171). Speech-to-text translation was the preferred strategy, reported by 54% (n = 97) of participants, followed by ad hoc interpretation by accompanying people or other staff members. Conclusion Language barriers impact all categories of healthcare providers, regardless of their professional role—whether during treatment, registration, discharge, or medication collection. Implementing strategies such as targeted communication training, greater use of professional interpreters, and culturally adapted health education tools may help mitigate these challenges and enhance patient–provider communication.