Please admire me!" When healthcare providers' positive stereotypes of asylum seeker patients contribute to better continuity of care.

2018 
BACKGROUND: Among asylum seekers (AS), mental health conditions are highly prevalent. However this population group has poor access to adequate services and frequently incurs discontinuity of mental healthcare. Many factors explain discontinuity of mental healthcare for asylum seekers. The aim of this study is to evaluate if facilitation of care for AS decreases healthcare provider stereotypes of this population and improves their continuity of care. SUBJECTS AND METHODS: General practitioners (GPs) and mental health professionals (MHPs) were invited to participate in a vignette study, presenting an AS patient manifesting post-traumatic stress symptoms. We randomly manipulated the context of the clinical vignette to create two experimental conditions: facilitated care versus non-facilitated care. In each condition, we measured participants' stereotypes and continuity of care. RESULTS: There was a significant effect of participant's type of stereotypes on continuity of care (F=2.87, p=0.035). However, we found no effect of condition (facilitated vs. non facilitated care) on stereotypes (F=0.11, p=0.95), nor on continuity of care (F=0.35, p=0.55). Furthermore, there was a significant effect of profession (GPs vs MHPs) on continuity of care (F=11.43, p=0.001). Participants' number of consultations per week (F=10.33, p=0.002) and their gender (F=3.69, p=0.030) both have a significant effect on continuity of care. CONCLUSION: Among healthcare providers, we found that "admiration" stereotypes were associated more with continuity of care. Paradoxically, continuity of mental healthcare was better among GPs compared to MHPs. Thus, improvement of continuity of mental healthcare for AS among MHPs should be investigated in further studies.
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