Linguistic and Cultural Barriers to Access and Utilization of Mental Health Care for Farsi-speaking Newcomers in Quebec

Background: Language and cultural barriers can affect health outcomes, service utilization, patient satisfaction, and overall costs to the health system and society. Newcomers may experience particular challenges in accessing services and information on their experience is needed at multiple levels to include the perspectives of laypeople, patients and consumers, family members and caregivers, health care professionals, community organizations, policy makers, planners, and administrators.

Objectives: In light of the growing number of Farsi-speaking immigrants in Quebec, this study aimed: 1) to identify barriers to access and utilization of mental health care for Farsi-speaking newcomer immigrants and refugees in Quebec; 2) to examine how access and utilization of mental health services can be improved for Farsi-speaking newcomer immigrants and refugees in Quebec.

Methodology: This is a qualitative study of knowledge and attitudes toward mental health services conducted in Montreal over the course of three months, from January to March 2017. We obtained 10 semi-structured key informant interviews with Farsi-speaking health professionals working in Quebec as well as 8 focus groups interviews with community organization and service providers, including 8-10 participants (>18 years old) per group.

Results: Participants confirmed that mental health care services are underutilized by Farsi-speaking immigrants and refugees in Quebec. The barriers to seeking mental health care and/or reasons for not receiving appropriate care from the existing services that participants identified included: 1) language barriers and concerns about confidentiality with the use of interpreters; 2) lack of information about the Quebec mental health care system; 3) cultural differences with non-Farsi-speaking mental health practitioners; and 4) concerns about stigma. Study participants provided some strategies for improving the access to mental health care including 1) having Farsi-speaking mental health professionals and a Farsi mental health center; 2) online resources as well as community-based seminars in Farsi to raise awareness about mental health issues and to facilitate the navigation of mental health services in Quebec; 3) providing a Farsi guidance booklet on mental health care services to be given to the immigrants and refugees when they land in the country. Implications of these findings for improving access to mental health services for newcomers will be discussed.