Evidence map›Paper›PMID 41555282›Full record

SynthesisBMC psychiatry2026

Perceived barriers to access mental health services for refugees and asylum seekers: a systematic review of qualitative studies.

Rebecca Thiel, Léon Gerardo Kreis, Silvia Schneider, Hans-Helmut König, Christian Brettschneider

Abstract readSystematic Review
In one paragraph

Synthesis in BMC psychiatry, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Rebecca ThielDepartment of Health Economics and Health Service Research, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
Léon Gerardo KreisDepartment of Health Economics and Health Service Research, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
Silvia SchneiderDepartment of Clinical Child and Adolescent Psychology, Mental Health Research and Treatment Center, Ruhr-University Bochum, Massenbergstraße 9-13, 44787, Bochum, Germany.
Hans-Helmut KönigDepartment of Health Economics and Health Service Research, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
Christian BrettschneiderDepartment of Health Economics and Health Service Research, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany. c.brettschneider@uke.de.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPrevious experience of violence and other traumata as well as post-migration stressors affect the mental health of refugees and asylum seekers. There is a fundamental gap between mental health needs and care utilization. To address this gap, it is important to understand the perceived access barriers to mental health care among refugees and asylum seekers. This review analyzed the barriers using Penchansky and Thomas’ (1981) concept of access.

methodsA systematic review of qualitative studies was conducted in April 2024 by two independent reviewers. The search included three databases: PubMed, Web of Science and PsycINFO. Studies published since 2013, with self-reported barriers or hurdles to access mental health services by legal adult refugees or asylum seekers were included. Information about the study design and setting, participant characteristics, and reported barriers to mental health care utilization were extracted. Risk of bias was assessed by the Mixed Methods Appraisal Tool. Due to the high heterogeneity, a narrative analysis was chosen.

results25 studies were identified. Barriers were social and cultural factors as well as a lack of awareness. Here, most prominent was the negative stigmatization of mental health and misinformation about mental health services. Furthermore, language barriers hinder refugees and asylum seekers to seek help. Accommodation was a rarely mentioned barrier. DISCUSSION: The reported access barriers occurred in a specific combination of country of origin and destinations. In contrast to previous studies, we identified the refugees’ and asylum seekers’ fear of experiencing discrimination and the perceived lack of benefits of therapy as barriers. Refugees and asylum seekers had a preference to solve mental health problems by getting support in their social environment. Epistemic injustice and the relationship between different barriers highlight the complexity of access barriers. The generalizability might be limited.

conclusionSelf-reported access barriers among refugees and asylum seekers are multidimensional. Access barriers occur within the health care system as well as within the refugees’ and asylum seekers’ community. A rise in awareness, acceptability, and availability of mental health services is needed to ensure adequate care. Furthermore, cultural and religious differences between the providers and the refugees and asylum seekers should be considered.

Indexed as

Health Services AccessibilityMental Health ServicesPatient Acceptance of Health CareRefugeesHumansQualitative ResearchSocial StigmaBarriersMental healthRefugeeTreatment

Identifiers

PMID41555282
PMCPMC12849350

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.