Quality of Psychiatric Care for Immigrants and People With a Non-English Language Preference: A Systematic Scoping Review.

Abstract

Objective: Immigrants and persons with a non-English language preference (NELP) face unique challenges in the mental health care system. This systematic scoping review aimed to evaluate the literature for disparities in psychiatric care delivery, beyond access and utilization barriers, experienced by these two populations.

Methods: The authors queried four databases: PubMed, PsycInfo, Web of Science, and CINAHL. Studies published between August 1993 and August 2023 were selected if they had a population that included immigrants to English-language countries or patients with a NELP and a mental illness, had a relevant comparison group, and included outcome measures focused on quality of psychiatric care delivery. Studies focusing solely on care access or utilization, studies without original data, case reports, and commentaries were excluded.

Results: The search identified 2,860 studies. Seventeen studies were included for full-text review (Cohen's κ=0.96). Large variability was found in the measures of quality used in the studies. Outcome variables were involuntary treatment rate, symptom management, unmet needs, medication use and monitoring, diagnosis, and psychiatric referral. Immigrants were more likely than nonimmigrants to receive involuntary treatments in all seven pertinent studies. An insufficient number of studies focused on other outcome measures, limiting analyses.

Conclusions: Many studies highlighted differences in care, especially with regard to involuntary hospitalization. Outcome measures varied and deviated from established quality metrics. Insufficient data were available to determine whether the identified differences in care represent a care delivery gap. Studies that use standardized measures would assist in evaluating the quality of care received by immigrants and patients with a NELP.