Barriers and facilitators affecting mental health service use among migrants and refugees in Australia: a systematic review

Objective Migrants, particularly refugees, are at risk of poorer mental health (MH) outcomes than members of host populations. Despite this, migrants and refugees in Australia significantly under-utilise MH services, yet factors preventing or enabling access are poorly understood. This systematic review identified and synthesised barriers to and facilitators of MH service utilisation among migrants and refugees in Australia to inform accessible, culturally-appropriate service development.Method Six databases (PsycINFO, Web of Science, Scopus, CINAHL via EBSCO, PubMed and Embase) were searched, identifying 45 studies meeting eligibility criteria.Results Narrative synthesis identified three overarching themes impacting service use: system-level challenges, MH knowledge, and culture and community. These findings extended extant reviews by demonstrating that these themes are evident across diverse services, organisations and communities and by providing a discussion of group-specific barriers, facilitators and recommendations. Community-based interventions demonstrate potential to overcome multiple barriers simultaneously.Conclusions Sufficient funding should be allocated to the community services sector to support migrant and refugee MH.