Literature Collection

Migrants are at a higher risk for common mental health problems than the general population but are less likely to seek care. To improve access, the World Health Organization (WHO) recommends the integration of mental health services into primary care. This scoping review aims to provide an overview of the types and characteristics of mental health services provided to migrants in primary care following resettlement in high-income countries. We systematically searched MEDLINE, EMBASE, PsycInfo, Global Health, and other databases from 1 January 2000 to 15 April 2020. The inclusion criteria consisted of all studies published in English, reporting mental health services and practices for refugee, asylum seeker, or undocumented migrant populations, and were conducted in primary care following resettlement in high-income countries. The search identified 1627 citations and we included 19 studies. The majority of the included studies were conducted in North America. Two randomized controlled trials (RCTs) assessed technology-assisted mental health screening, and one assessed integrating intensive psychotherapy and case management in primary care. There was a paucity of studies considering gender, children, seniors, and in European settings. More equity-focused research is required to improve primary mental health care in the context of global mental health.

BACKGROUND: Suicide is a major public health issue. More than one third of patients will visit their GP in the month leading up to a suicide attempt, thus highlighting the key role GPs play in suicide prevention. AIM: To explore the qualitative research on GPs' perspectives of suicide prevention in primary care. DESIGN & SETTING: A systematic scoping review of qualitative studies relating to the research question. METHOD: This review is reported in accordance with Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidance. Articles at full-text review were assessed for inclusion in the study against eligibility criteria (English language, qualitative research, focus on GPs' perspectives of suicide prevention). Data were extracted using a standardised form and a thematic synthesis approach was used to describe the themes elicited from the studies. RESULTS: In total, 2210 abstracts were screened. Twelve studies from seven countries were included at full-text review. The following four main themes were elicited: challenges to managing suicidal behaviour; fragmented relationships with mental health services; personal attitudes of GPs regarding suicidal behaviour; and identified needs to improve suicide prevention in primary care. CONCLUSION: Understanding GPs' perspectives can lead to improved training, resources, and support for primary care professionals, who are frontline providers of mental health care. This scoping review suggested there is a lack of evidence around what approaches GPs find effective in managing suicidality and how relationships can be strengthened with mental health services to deliver person-centred integrated care for those identified at risk of suicide.