Culture, migration, Brexit, and COVID-19: managing the mental health of patients from Central and Eastern Europe

SETTING THE MENTAL HEALTH SCENE

Central and Eastern Europeans in the UK are more likely to live in inadequate housing, have physically demanding employment, lack financial security, and have limited support networks compared with UK nationals.⁴ Rates of common mental health conditions are disproportionately high, including anxiety, mood disorders, alcohol misuse, and suicide.^5,6 Healthcare models within Central and Eastern Europe differ to the UK, including the option for direct access to specialist services through commercial providers.⁷ Patients’ expectations for a doctor-led consultation style, rather than shared or self-care, can lead to dissatisfaction with UK general practice.⁸ Further differences in expectations include the inacceptability of non-physical assessment, assessing fitness to work, and thresholds for referral to secondary care.^7,8

Central and Eastern Europeans infrequently attend general practice with mental health concerns, including prior to suicide, and may see diagnosis as an inappropriate medicalisation of distress.⁵ Even when mental health or wellbeing concerns are recognised by the clinician and patient, views on their management often differ. The National Institute for Health and Care …