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      Health Professionals’ Experiences with Treatment Engagement Among Immigrants with Co-occurring Substance Use- and Mental Health Disorders in Norway

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          Abstract

          Immigrants face barriers in seeking and accessing mental health and addiction services. Health professionals are crucial in providing and promoting healthcare and it is important to understand their experiences in order to enhance the access of mental healthcare. The aim of this paper is to explore and describe health professionals’ experiences with treatment engagement among immigrants with co-occurring substance use disorders (SUD) and mental health disorders (MHD) in Norwegian mental health and addiction services. Within a collaborative approach, 3 focus group interviews were conducted with health professionals, who had provided various mental health and addiction care services to immigrants with co-occurring SUD and MHD. The focus group interviews were transcribed verbatim and analyzed using systematic text condensation. The analysis resulted in 5 main categories: (1) difficulties due to language barriers, (2) difficulties due to lack of culturally competent services, (3) difficulties due to social factors, (4) being curious and flexible improves the user-provider relationship, and (5) increasing access to mental health and addiction services. This study provides an enhanced understanding of how health professionals’ experienced treatment engagement among immigrants with co-occurring SUD and MHD in the Norwegian context. Implications of the findings for clinical practice and future research are discussed.

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          Systematic text condensation: a strategy for qualitative analysis.

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            Cultural humility versus cultural competence: a critical distinction in defining physician training outcomes in multicultural education.

            Researchers and program developers in medical education presently face the challenge of implementing and evaluating curricula that teach medical students and house staff how to effectively and respectfully deliver health care to the increasingly diverse populations of the United States. Inherent in this challenge is clearly defining educational and training outcomes consistent with this imperative. The traditional notion of competence in clinical training as a detached mastery of a theoretically finite body of knowledge may not be appropriate for this area of physician education. Cultural humility is proposed as a more suitable goal in multicultural medical education. Cultural humility incorporates a lifelong commitment to self-evaluation and self-critique, to redressing the power imbalances in the patient-physician dynamic, and to developing mutually beneficial and nonpaternalistic clinical and advocacy partnerships with communities on behalf of individuals and defined populations.
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              Qualitative research. Introducing focus groups.

              This paper introduces focus group methodology, gives advice on group composition, running the groups, and analysing the results. Focus groups have advantages for researchers in the field of health and medicine: they do not discriminate against people who cannot read or write and they can encourage participation from people reluctant to be interviewed on their own or who feel they have nothing to say.
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                Author and article information

                Journal
                Subst Abuse
                Subst Abuse
                SAT
                spsat
                Substance Abuse: Research and Treatment
                SAGE Publications (Sage UK: London, England )
                1178-2218
                6 July 2021
                2021
                : 15
                : 11782218211028667
                Affiliations
                [1 ]Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders (NK-ROP), Innlandet Hospital Trust, and University of South-Eastern Norway, Norway
                [2 ]Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders (NK-ROP), Innlandet Hospital Trust, and Faculty of Health and Social Sciences, Norway University of Applied Sciences, Norway
                [3 ]Norwegian Institute of Public Health, Oslo, Norway
                [4 ]Drammen Municipal Mental Health and Drug Addiction Services, Drammen, Norway
                [5 ]University of South-Eastern Norway, Norway
                Author notes
                [*]Prabhjot Kour, Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders (NK-ROP), Innlandet Hospital Trust, Kjonerud kompetansesenter, Løvstadvegen 7, Ottestad 2312, Norway. Email: prabhjot.kour@ 123456usn.no
                Author information
                https://orcid.org/0000-0001-5716-6683
                https://orcid.org/0000-0002-6061-0033
                Article
                10.1177_11782218211028667
                10.1177/11782218211028667
                8264731
                34285497
                6aec017e-6288-440a-98ef-922bd59deb6a
                © The Author(s) 2021

                This article is distributed under the terms of the Creative Commons Attribution 4.0 License ( https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages ( https://us.sagepub.com/en-us/nam/open-access-at-sage).

                History
                : 4 November 2020
                : 7 June 2021
                Funding
                Funded by: sykehuset innlandet hf, FundRef https://doi.org/10.13039/501100013398;
                Categories
                Original Research
                Custom metadata
                January-December 2021
                ts1

                Health & Social care
                co-occurring substance use and mental health disorders,immigrants,health professionals,mental health and addiction services,qualitative methods,lived experiences,norway

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