Psychosocial Intervention Psychosocial Intervention
Psychosocial Intervention 23 (2014) 105-13 - Vol. 23 No.2 DOI: 10.1016/j.psi.2014.07.007
Transforming health policies through migrant user involvement: Lessons learnt from three European countries
La transformación de las políticas sanitarias mediante la implicación de los usuarios inmigrantes: lecciones aprendidas de tres países europeos
Cláudia De Freitasa,, , Manuel García-Ramirezb, Arild Aambøc, Sandra C. Buttigiegd
a Centre for Research and Studies in Sociology (CIES-IUL), University Institute of Lisbon (ISCTE-IUL). Portugal
b CESPYD, University of Seville, Spain
c NAKMI, Norwegian Centre for Minority Health Research, Oslo University Hospital, Norway
d Department of Health Services Management, Faculty of Health Sciences, University of Malta, Msida, Malta
Abstract

Designing and implementing equitable health policies requires the involvement of all stakeholders. However, disadvantaged groups are under-represented in European health participatory mechanisms. Migrants and ethnic minorities (MEMs), for example, are consistently left out of policy-making fora. Additionally, MEMs lack a voice on the programmes that are intended to benefit them. This can jeopardize the responsiveness of health policies to MEM needs and undermine the development of diversity sensitive care, making way for increased inequities in health. It is necessary therefore to investigate innovative strategies capable of fostering MEMs’ participation. Community psychology is particularly promising in this respect as it aims to mobilize the resources that communities possess, rather than simply teaching people to use services developed by others. Moreover, it highlights collaborative/participatory research approaches, which privilege the involvement of all stakeholders. By employing a community psychology approach, this paper looks at three European countries –the Netherlands, Norway and Spain– and summarizes lessons learnt from their experiences with migrant user involvement. The cases reported address different aspects of involvement, including: community mobilization, sociopolitical development, and creation of community alliances and coalitions. Its analysis offers several insights that can transform policy-making into a more inclusive process.

Keywords
  • User involvement
  • Health policy
  • Health equity
  • Migration
  • Community psychology
Resumen

Diseñar y poner en práctica políticas sanitarias justas precisa de la participación de todos los interesados. No obstante, los grupos desfavorecidos están infrarrepresentados en los mecanismos europeos de participación sanitaria. Por ejemplo, los inmigrantes y minorías étnicas quedan sistemáticamente apartados de los foros de diseño de políticas. Además, estos grupos carecen de opinión sobre los programas pensados en su beneficio, lo cual impide una respuesta de las políticas sanitarias a sus necesidades a la par que frena el desarrollo de una asistencia que tenga en cuenta la diversidad, dando origen a mayores injusticias en sanidad. Es necesario pues investigar en estrategias innovadoras que impulsen la participación de los inmigrantes y minorías étnicas. La psicología comunitaria es especialmente prometedora al respecto ya que busca movilizar los recursos propios de las comunidades más que enseñar a la gente a utilizar los servicios desarrollados por terceros. Además, recalca los enfoques de investigación colaboradores/participativos que privilegian la implicación de los interesados. A través de un enfoque de psicología comunitaria, este trabajo contempla tres países europeos –Holanda, Noruega y España– y resume las lecciones aprendidas de su experiencia con la participación de los usuarios inmigrantes. Los casos aportados abordan diversos aspectos de la participación, como la movilización comunitaria, el desarrollo sociopolítico y la creación de alianzas y coaliciones comunitarias. El análisis ofrece algunas ideas que pueden transformar el diseño de las políticas en un proceso más integrador.

Keywords
  • Implicación de los usuarios
  • Política sanitaria
  • Equidad sanitaria
  • Inmigración
  • Psicología comunitaria
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References
Balcazar et al., 2012
F.E. Balcazar,Y. Suarez-Balcazar,S.B. Adames,C.B. Keys,M. García-Ramírez,V. Paloma
A case study of liberation among Latino immigrant families who have children with disabilities
American Journal of Community Psychology, 49 (2012), pp. 283-293 http://dx.doi.org/10.1007/s10464-011-9447-9
Balcazar et al., 2010
F.E. Balcazar,Y. Suarez-Balcazar,T. Taylor-Ritzler,C. Keys
Race, culture, and disability: Rehabilitation science and practice
Jones and Bartlett, (2010)
Barnes, 1999
M. Barnes
Users as citizens: Collective action and the local governance of welfare
Social Policy & Administration, 33 (1999), pp. 73-90 http://dx.doi.org/10.1001/jamasurg.2017.0921
Beijers and De Freitas, 2008
H. Beijers,C. De Freitas
Cape Verdeans’ pathways to health: local problems, transnational solutions
Transnational Archipelago. Perspectives of Cape Verdean migration and diaspora, pp. 237-254
Brach and Fraserirector, 2000
C. Brach,I. Fraserirector
Can cultural competency reduce racial and ethnic health disparities? A review and conceptual model
Medical Care Research and Review, 57 (2000), pp. 181-217 http://dx.doi.org/10.1177/1077558700057001S09
Braithwaite et al., 2009
R. Braithwaite,S. Taylor,H. Treadwell
Health disparities in the black community
Jossey Bass, (2009)
Butte, 1991
Butte, D. (1991). Kleurrijk bestaan. Een inventarisatieonderzoek naar social-culturele achtergronden van Kaapverdianen in Rotterdam in relatie tot de risico's van HIV-infectie. Rotterdam: GGD Afdeling Epidemiologie.
Campbell and McLean, 2002
C. Campbell,C. McLean
Ethnic identities, social capital and health inequalities: Factors shaping African-Caribbean participation in local community networks in the UK
Social Science and Medicine, 55 (2002), pp. 643-657
Conklin et al., 2001
Conklin, A., Morris, Z.S., & Nolte, E. (2001). Involving the public in healthcare policy. An update of the research evidence and proposed evaluation framework. RAND Europe Technical Report.
Cornwall, 2004
A. Cornwall
Spaces for transformation? Reflections on issues of power and difference in participation in development
Participation: From tyranny to transformation? Exploring new approaches to participation in development.,
Cotterell et al., 2011
P. Cotterell,G. Harlow,C. Morris
Service user in involvement in cancer care: the impact on service users
Health Expectations, 14 (2011), pp. 159-169 http://dx.doi.org/10.1111/j.1369-7625.2010.00627.x
Crawford et al., 2003
M.J. Crawford,T. Aldridge,K. Bhui,D. Rutter,C. Manley,T. Weaver,N. Fulop
User involvement in the planning and delivery of mental health services: A cross-sectional survey of service users and providers
Acta Psychiatrica Scandinavica, 107 (2003), pp. 410-414 http://dx.doi.org/10.1034/j.1600-0447.2003.00049.x
CSDH, 2008
CSDH. (2008) Closing the gap in a generation: health equity through action on the social determinants of health (Final Report of the Commission on the social Determinants of Health). Geneva: WHO.
De Freitas, 2005
C. De Freitas
Health has no borders: Cape Verdean immigrants in the Netherlands and the transnational quest for health care across Europe
International Journal of Migration Health and Social Care, 1 (2005), pp. 19-36 http://dx.doi.org/10.1108/17479894200500004
De Freitas, 2006
De Freitas, C. (2006). Em busca de um bom médico – Quando ‘a saúde não tem fronteiras’. Percepções dos Cabo-verdianos sobre profissionais de saúde na Holanda. Lisbon: Observatório da Imigração/Alto Comissariado para a Imigração e Minorias etnicas.
De Freitas, 2011
De Freitas, C. (2011). Participation in mental health care by ethnic minority users: Case studies from the Netherlands and Brazil (PhD Dissertation). Utrecht University, Utrecht.
De Freitas, 2013
C. De Freitas
Aiming for inclusion: a case study of motivations for involvement in mental health-care governance by ethnic minority users
Health Expectations, (2013), http://dx.doi.org/10.1111/hex.12082
De Freitas, 2014a
De Freitas, C. (2014). Transformative change in health policy: the impact of participation by socially disadvantaged minority groups. Paper presented at the COST Action IS1103 meeting: Integrating migrant and ethnic minority users’ perspectives in health care: strategies, measurement and impact. CIES, ISCTE-IUL, Lisbon.
De Freitas, 2014b
De Freitas, C. (2014) (in press). Cape Verdean immigrants in the Netherlands: sociodemographic profile, identity and integration. In I. Évora (Ed.), Faces da diáspora: Estudos sobre a migração Cabo-verdiana contemporânea. Lisbon: CEsA/ISEG.
De Freitas and Mendes, 2013
C. De Freitas,Á. Mendes
A resiliência da saúde migrante: itinerários terapêuticos plurais e transnacionais
Revista Interdisciplinar da Mobilidade Humana, 21 (2013), pp. 69-92
Dieperink et al., 2002
C. Dieperink,R. Van Dijk,A.I. Wierdsma
GGZ voor allochtonen. Ontwikkelingen in het zorg in de regio Rotterdam, 1990-1998
Maandblad Geestelijke Volksgezondheid, 57 (2002), pp. 87-97
Douglas et al., 2009
M.K. Douglas,J.U. Pierce,M. Rosenkoetter,L.C. Callister,M. Hattar-Pollara,J. Lauderdale,D. Pacquiao
Standards of Practice for Culturally Competent Nursing Care: A Request for Comments
Journal of Transcultural Nursing, 20 (2009), pp. 257-269 http://dx.doi.org/10.1177/1043659609334678
Fawcett et al., 2000
S.B. Fawcett,V.T. Francisco,D. Hyra,A. Piane-andrews,J.A. Schultz,Russos,P. Evensen
Building healthy communities
The society and population health reader, vol. II: A state and community perspective, pp. 75-93
Fischer, 2003
F. Fischer
Reframing public policy: Discursive politics and deliberative practices
Oxford University Press, (2003)
Garcia-Ramirez et al., 2011
M. Garcia-Ramirez,M. de la Mata,V. Paloma,S. Hernandez-Plaza
A liberation psychology approach to acculturative integration of migrant populations
American Journal of Community Psychology, 47 (2011), pp. 86-97 http://dx.doi.org/10.1007/s10464-010-9372-3
García-Ramírez et al., 2012
García-Ramírez, M., Hernández-Plaza, S., Albar, M.J., Luque-Ribelles, V., & Suárez-Balcázar, Y. (2012). Building healthcare stakeholder coalitions: A community psychology approach to user involvement for migrant populations. In D. Ingleby, A. Chiarenza, W. Devillé, & I. Kotsioni (Eds.), Inequalities in health care for migrants and ethnic minorities (COST series on health and diversity, Vol 2). Antwerp/Apeldoorn: Garant.
Garcia-Ramirez et al., 2009
M. Garcia-Ramirez,V. Paloma,Y. Suarez-Balcazar,F. Balcazar
Building international collaborative capacity: Contributions of community psychologists to a European network
American Journal of Community Psychology, 44 (2009), pp. 116-122 http://dx.doi.org/10.1007/s10464-009-9247-7
Gaventa, 2006
J. Gaventa
Perspectives on participation and citizenship
Participatory Citizenship: Identity, Exclusion, Inclusion,
Gbikpi and Grote, 2002
B. Gbikpi,J.R. Grote
From democratic government to participatory governance
Participatory governance: Political and societal implications, pp. 17-34 http://dx.doi.org/10.1007/978-3-663-11003-3_1
Gotaas and Højdahl, 2006
Gotaas, N., & Højdahl, T. (2006). Evaluering av Brobyggerprosjektet – Arbeid overfor unge domfelte men med somalisk og pakistansk bakgrunn (Samarbeidsrapport NIBR/KRUS 2006). Oslo: Norsk institutt for by og regionsforskning.
Huiskamp et al., 2000
Huiskamp, N., Vis, H., Swart, W., & Voorham, T. (2000). Gezond in kaart. Allochtonen, gezondheidsproblemen en preventiemogelijkheden in kaart gebracht. Rotterdam: GGD Rotterdam.
Ingleby, 2012
D. Ingleby
Ethnicity, Migration and the ‚Social Determinants of Health Agenda
Psychosocial Intervention, 21 (2012), pp. 331-341 http://dx.doi.org/10.5093/in2012a29
Ingleby et al., 2005
D. Ingleby,M. Chimienti,P. Hatziprokopiou,M. Ormond,C. De Freitas
The role of health in integration
pp. 89-119
Lindow, 1999
V. Lindow
Power, lies and injustice: The exclusion of service users’ voices
Ethics and community in the health care professions.,
Lohman et al., 2000
J.S. Lohman,R. Rijkschroeff,D. Oudenampsen,L. Verkuyl,K. Van Gelder,R. Van Overbeek
Evaluatie wet medezeggenschap cliënten zorginstelling
The Hague, (2000)
Machado et al., 2009
Machado, M.C., Fernandes, A., Padilla, B., Dias, S., Gomes, I., Dias, A., & Oliveira da Silva, M. (2009). Maternal and child healthcare for immigrant populations. Background paper developed within the framework of the IOM project “Assisting Migrants and Communities (AMAC): Analysis of social determinants of health and health inequalities”. Brussels: International Organization for Migration.
Mladovsky et al., 2012
P. Mladovsky,B. Rechel,D. Ingleby,M. McKee
Responding to diversity: An exploratory study of migrant health policies in Europe
Mohanty, 2007
R. Mohanty
Gendered subjects, the state and participatory spaces: The politics of domesticating participation in rural India
Spaces for change? The politics of participation in new democratic arenas.,
Montesanti, 2014
Montesanti, S.R. (2014). The Participation of Marginalized Populations in Health Services Planning and Decision Making. Open Access Dissertations and Theses.(Paper 8578).
Nelson, 2013
G. Nelson
Community psychology and transformative policy change in the neo-liberal era
American Journal of Community Psychology, 52 (2013), pp. 211-223 http://dx.doi.org/10.1007/s10464-013-9591-5
Nelson et al., 2014
Nelson, G., D’Ailly, H., Ochocka, J., Janzen, R. Maiter, S. & Jacobson, N. (2014) (in press). Planning transformative change for mental health services for diverse cultural-linguistic communities. In G. Nelson, B. Kloos & J. Ornelas (Eds.), Community psychology and community mental health: Towards transformative change. Miami: APA, Society for Community Research and Action.
Oliver et al., 2007
M.I. Oliver,P. Baraza,E. Martínez
La salud y la mujer inmigrante
Manual de Atención Sanitaria a Inmigrantes. Guía para Profesionales, pp. 77-106
Padilla et al., 2009
B. Padilla,R. Portugal,D. Ingleby,C. De Freitas,J. Lebas
Health and migration in the European Union: Good practices
Health and migration in the European Union: Better health for all in an inclusive society.,
Paloma et al., 2014
Paloma, V., García-Ramírez, M., & Camacho, C. (2014) (in press). Wellbeing and social justice among Moroccan migrants in Southern Spain. American Journal of Community Psychology
Paloma et al., 2010
V. Paloma,M. Garcia-Ramirez,M. de la Mata,Association AMAL-Andaluza
Acculturative integration, self and citizenship construction: The experience of Amal-Andaluza, a grassroots organization of Moroccan women in Andalusia
International Journal of Intercultural Relations, 34 (2010), pp. 101-113
Papadopoulos and Warin, 2007
Y. Papadopoulos,P. Warin
Are innovative, participatory and deliberative procedures in policy making democratic and effective?
European Journal of Political Research, 46 (2007), pp. 445-472 http://dx.doi.org/10.1111/j.1475-6765.2007.00696.x
Pawson, 2006
R. Pawson
Evidence-based policy: A realist perspective
Sage, (2006)
Pedregal et al., 2011
Pedregal, B., Brugué, Q., Del Moral, L., Ballester, A., Espluga, J., Ferrer, G., Parés, M. (2011, June/July). Deliberative democracy and water policy: Public participation in water resources planning in Spain. Paper presented at the XIV Seminar on Geography of Water, Cagliari, Italy.
Popay, 2014
Popay, J. (2014). Participation for who and what? Politicians want increased legitimacy; managers want quality improvement; professionals want to share responsibility; so what do ‘ordinary’ people want? Paper presented at the COST Action IS1103 meeting Integrating migrant and ethnic minority users’ perspectives in health care: strategies, measurement and impact. CIES, ISCTE-IUL, Lisbon.
Popay et al., 2010
J. Popay,M. Whitehead,D.J. Hunter
Editorial. Injustice is killing people on a large scale: but what is to be done about it?
Journal of Public Health, 32 (2010), pp. 148-149 http://dx.doi.org/10.1093/pubmed/fdq029
Portugal et al., 2007
Portugal, R., Padilla, P., Ingleby, D., De Freitas, C., Lebas, J., & Miguel J. P. (2007). Good practices on health and migration in the EU. Final Report for the Conference Health and migration in the EU: Better health for all in an inclusive society. Instituto Nacional de Saúde Ricardo Jorge, Lisbon.
Prilleltensky, 2012
I. Prilleltensky
Wellness as fairness
American Journal of Community Psychology, 49 (2012), pp. 1-21 http://dx.doi.org/10.1007/s10464-011-9448-8
Renedo and Marston, 2011
A. Renedo,C. Marston
Healthcare professionals’ representations of ‘patient and public involvement’ and creation of ‘patient identities’: Implications for the development of inclusive and bottom-up community participation initiatives
Journal of Community & Applied Social Psychology, 21 (2011), pp. 268-280 http://dx.doi.org/10.1055/s-0036-1597244
Rose et al., 2004
Rose, D., Fleischmann, P., Tonkiss, F., Campbell, P., & Wykes, T. (2004). User and carer involvement in change management in a mental health context: Review of the literature. Report to the National Co-ordinating Centre for NHS Service Delivery and Organisation R&D (NCCSDO), London: NCCSDO.
Snape et al., 2014
D. Snape,J. Kirkham,J. Preston,J. Popay,N. Britten,Collins,A. Jacoby
Exploring areas of consensus and conflict around values underpinning public involvement in health and social care research: a modified Delphi study
British Medical Journal Open, 4 (2014), pp. e004217 http://dx.doi.org/10.1136/bmjopen-2013-004217
Sozomenou et al., 2000
Sozomenou, A., Mitchell, P., Fitzgerald, M.H., Malak, A., & Silove, D. (2000). Mental health consumer participation in a culturally diverse society. Sydney: Australian Transcultural Mental Health Work, Management Unit.
Strooij, 1996
Strooij, H. (1996). Eilanden aan de Maas. De migratieen integratiegeschiedenis van de Rotterdamse Kaapverdianen (PhD Dissertation). Utrecht University, Utrecht.
Suarez-Balcazar and Kinney, 2006
Y. Suarez-Balcazar,L. Kinney
Realities and myths of safety issues for community researchers working in a marginalized African American community
American Journal of Community Psychology, 37 (2006), pp. 303-309 http://dx.doi.org/10.1007/s10464-006-9056-1
Søholt, 1996
Søholt, S. (1996). Primærmedisinsk verksted. Kartlegging av erfaringer med en pakistansk/norsk helseopplysningsgruppe Byggforsknotat 1, 1996, bygd, miljø og samfunn. Oslo: Norges byggforskningsinstitutt.
Søholt, 1997
Søholt, S. (1997). Helsefremmende ledelse, En evaluering av gruppeledere med innvandrerbakgrunn. Prosjektrapport 225, 1997 Oslo: Norgesbyggforskningsinstitutt.
Søholt et al., 2009
Søholt, S., Ibrahim,Y. A. H., & Hansen, S.J. (2009). Women, War Traumas, Mental Health and Bread-winning. An evaluation of the Dandelion project in Mogadishu, Somalia 2005-2009. Oslo: NIBR.
Tambuyzer et al., 2014
E. Tambuyzer,G. Pieters,C. Van Audenhove
Patient involvement in mental health care: One size does not fit all
Health Expectations, 17 (2014), pp. 138-150 http://dx.doi.org/10.1111/j.1369-7625.2011.00743.x
Tse et al., 2012
S. Tse,J. Tang,A.K. Dip
Patient involvement in mental health care: Culture, communication and caution
Health Expectations, (2012), http://dx.doi.org/10.1111/hex.12014
Wandersman, 2003
A. Wandersman
Community science: Bridging the gap between science and practice with community-centered models
American Journal of Community Psychology, 31 (2003), pp. 227-242
Wandersman et al., 2000
A. Wandersman,P. Imm,M. Chinman,S. Kaftarian
Getting to outcomes: a results-based approach to accountability
Evaluation and Program Planning, 23 (2000), pp. 389-395
Westhues, 2012
A. Westhues
Becoming acquainted with social policy
Canadian social policy: Issues and perspectives, 5th ed., pp. 3-20
WHO, 2006
WHO. (2006). Ninth futures forum on health systems governance and public participation. Copenhagen: WHO Regional Office for Europe.
WHO, 2010
WHO. (2010) How health systems can address health inequities linked to migration and ethnicity. Copenhagen: WHO Regional Office for Euro.
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Psychosocial Intervention 23 (2014) 105-13 - Vol. 23 No.2 DOI: 10.1016/j.psi.2014.07.007
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