Mike-Oliver Mösko

University Medical Center Hamburg - Eppendorf · Department of Medical Psychology

Access to mental healthcare for migrants is a global problem, with many challenges and barriers, including the issue of language discordance. Most research on this topic comes from well-resourced countries such as those in Europe, Northern America, and Australasia despite the fact that most migration occurs from poorer contexts, such as many in Afr...

Background Security guards (SGs) play a significant role in health care and are an integral part of many psychiatric institutions. While their main duty is to ensure service users' (SUs) and staff's safety and protect the premises, they are also called upon for other tasks, often ones for which they are not adequately trained. This study aimed to e...

Introduction Assigning qualified interpreters is considered one of the most effective approaches to facilitate communication in language-discordant encounters in mental healthcare. However, particularly in settings with fewer resources, they are not always available and informal practices are often used. Objective This study aimed to investigate i...

Background Migrants and refugees with low language proficiency (LLP) have a higher risk of experiencing certain mental health disorders compared to non-migrant populations. They are also more likely to experience a lack of access to mental healthcare due to language- and culture-related barriers. As part of the MentalHealth4All project, a digital m...

Migrants face higher risks of developing mental health issues, such as posttraumatic stress disorder and psychosis, compared to individuals without a migrant or refugee background. However, they can encounter significant barriers to accessing mental healthcare, due to language difficulties, lack of interpreters, cultural stigma and system-related b...

Background Forced displacement is a significant issue globally, and it affected 112 million people in 2022. Many of these people have found refuge in low- and middle-income countries. Migrants and refugees face complex and specialized health challenges, particularly in the area of mental health. This study aims to provide an in-depth qualitative as...

Background Community interpreters (CIPs) play a crucial role in various community services, including healthcare, when service providers and users do not share a common language. However, there is a lack of evidence-based data on this population globally. This explorative cross-sectional study aims to gain a better understanding of CIPs and their w...

Aims Language barriers significantly contribute to limited access and treatment quality in diabetic health care for ethnic minority groups. The study assesses the extent of linguistic resources and barriers in outpatient diabetes care in Germany. Subject and methods The questionnaire-based explorative cross-sectional study included all certified o...

Introduction In many healthcare contexts globally, where the languages of care providers and patients do not match, miscommunication or non-communication can lead to inaccurate diagnoses and subpar treatment outcomes. In order to bridge these language barriers, a range of informal practices are used, such as family members or staff acting as interp...

The aim of this article is to illustrate the goals, process and results of the first stage of a European project: MentalHealth4All. Partners from 9 different European countries have worked together to design a multilingual validated repository targeted at third-country nationals with limited language proficiency (LLP TCNs) and healthcare providers,...

The support of professional interpreters is an essential component of adequate mental health care for migrants with limited language proficiency. Nevertheless, for varied reasons, only a small proportion of outpatient psychotherapists provide interpreter-mediated psychotherapy for migrants. This study explored the perspectives of psychotherapists w...

Background Community Interpreters (CI) play a crucial role in multilingual communication in health care and community services. Since CIs in Germany are mainly organized on a regional basis, there are no nationwide data available. The aim of this explorative cross-sectional study is to gain a better understanding of the work of CIs in Germany. Met...

Objective The therapeutic alliance (TA) has the highest predictive value concerning the success of psychotherapy. The presented study aimed to explore how the presence of an interpreter affects the TA when working with trauma-affected refugees. Method Semi-structured interviews were conducted with seven psychologists working in an outpatient clini...

To ensure the quality of interpreter-mediated encounters, not only interpreters but also service providers need to be trained. However, most of them lack adequate training. This study aimed to evaluate educational videos as a (self-)learning tool with which to train service providers to work with interpreters. Eight educational videos were develope...

The number of migrant workers in Germany has increased over the last decades and will probably further increase in the context of a growing cultural diversity of the population and shortage of skilled professionals. Since migrant workers face different challenges, they may experience poorer psychosocial work environments than non-migrants. A negati...

Background Universal classroom‐based interventions are a useful method to increase the mental health and resilience in children. Resilience describes the process that leads to a positive development despite adversities. It comprises the seven resources access to material resources, relationships, identity, power and control, cultural adherence, soc...

In this chapter, we discuss the pros and cons of separate versus integrated services for immigrants and refugees. Our discussion is based on experiences from three high-income countries: Germany, Norway, and Sweden. All three, regardless of general public insurance systems covering healthcare costs, have barriers to mental health care for migrants...

Enhancing resilience in children with classroom-based interventions can increase their psychosocial well-being. This study describes the development and pilot evaluation of a universal intervention directed at promoting resilience in culturally and linguistically diverse classes. Two third grade and one fourth grade class were included (N = 60). Th...

Patient/innen mit Migrationshintergrund nehmen Angebote der psychosomatischen Rehabilitation seltener in Anspruch und erreichen niedrigere Behandlungserfolge als Patient/innen ohne Migrationshintergrund. In der Gesundheitsversorgung begegnen Patient/innen mit Migrationshintergrund verschiedenen Prozessbarrieren und individuellen Hindernissen, die d...

Der vorliegende Beitrag befasst sich mit unterschiedlichen Aspekten im Kontext von Mehrsprachigkeit in der Gesundheitsversorgung. Vor dem Hintergrund der gesundheitlichen Versorgung von Menschen mit Migrationshintergrund werden Sprachbarrieren und Ressourcen aus Sicht der Patient/innen und der Behandler/innen vorgestellt. Den Abschluss bilden nachh...

Zusammenfassung Geflüchtete Fachkräfte erleben verschiedene Barrieren auf dem Arbeitsmarkt, von denen einige in einem Interkulturellen Coaching adressiert werden können. Dieser Artikel beleuchtet die Entwicklung, Durchführung und Evaluation eines Interkulturellen Coachings für geflüchtete Personen in Gesundheitsberufen. Die Entwicklung und Erprobun...

Mental health and cultural and linguistic diversity in classrooms are part of students’ lives. Both factors can lower the achievements of students and classrooms and pose a challenge for teachers. Yet, little is known about the effects on other areas of school life besides achievements. Also, the consequences for classmates and teachers as well as...

Refugee health professionals are a vulnerable group in a host country’s labour market as they experience several barriers on their path to labour market integration. This study aims to identify challenges refugee health professionals and their supervisors experience at their workplaces and strategies they have developed to overcome these barriers....

This "Quality standards and minimum requirements for the qualification of interpreters in social work settings in Germany" brochure presents the results of the two-year "BetweenLanguages" research project. The project was co-funded by the Asylum, Migration and Integration Fund of the European Union. An extensive database was developed on the basi...

Introduction Healthcare systems around the world are looking for solutions to the growing problem of mental disorders. RECOVER is the synonym for an evidence-based, stepped and cross-sectoral coordinated care service model for mental disorders. RECOVER implements a cross-sectoral network with managed care, comprehensive psychological, somatic and s...

In times of demographic change, most developed countries are increasingly looking to cover the growing domestic demand for healthcare by hiring nurses from abroad. The evidence concerning the health of immigrant care workers is inconsistent since studies report that it is either better or more impaired than that of their non-immigrant counterparts....

In der vorliegenden Broschüre „Qualitätsstandards und Mindestanforderungen für die Qualifizierung von Dolmetscher*innen in der sozialen Arbeit in Deutschland“ werden die Ergebnisse des zweijährigen Forschungsprojektes „ZwischenSprachen“ vorgestellt. Das Projekt wurde kofinanziert durch den Asyl-, Migrations- und Integrationsfonds der Europäischen U...

Background Refugee health professionals experience several barriers on their path to re-entering their original occupations in host countries. Several training programmes exist in order to address these barriers and enable a successful labour market integration.Objective: This study aims to evaluate a specific orientation programme for the labour m...

Background Immigrant health professionals are a particularly vulnerable group in a host country’s labour market, as they face several barriers when re-entering their occupations. International studies indicate that early interventions can increase the employability of immigrants. Qualification programmes are one of these early interventions that ca...

Zusammenfassung Ziel der Studie 24-Stunden-Betreuungskräfte, die in deutschen Privathaushalten haushalts- und personennahe Dienstleistungen für ältere pflegebedürftige Menschen erbringen, stammen meist aus dem Ausland. Diese Arbeitsverhältnisse liegen in der Regel außerhalb tariflich oder arbeitsrechtlich verbindlicher Vereinbarungen. Betreuungskrä...

Background Culturally and linguistically diverse patients access healthcare services less than the host populations and are confronted with different barriers such as language barriers, legal restrictions or differences in health beliefs. In order to reduce these disparities, the promotion of cultural competence in healthcare organizations has been...

Im Rahmen von Fokusgruppen werden allgemeine Erfahrungen auf Patienten- und Therapeutenseite im transkulturellen Psychotherapiegeschehen sowie spezifisch die Bedeutsamkeit von Vorwissen von Therapeuten über die Kultur eines Patienten untersucht und mittels qualitativer Inhaltsanalyse ausgewertet. Hierbei wird deutlich, dass sehr hilfreich für das t...

Background: There is substantial research about the occupational health of nurses worldwide. However, empirical evidence about the psychosocial health of migrant and minority nurses in outpatient settings in Germany in comparison to that of autochthonous nurses is lacking. Objectives: This study aims to identify work-related stressors, resources...

In dem Buchkapitel werden zunächst epidemiologische Grundlagen zum Thema Migration und Gesundheit dargestellt. Anschließend werden relevante Aspekte der gesundheitlichen Versorgungsqualität von Patienten mit Migrationshintergrund näher beleuchtet. Unter der Perspektive der Strukturqualität werden die Versorgungslage, Mitarbeitende mit Migrationshin...

Objectives: Globally, life expectancy together with multimorbidity and chronic diseases are increasing. Nurses from abroad are increasingly hired to meet the growing demand for healthcare workers. The present knowledge about migrant nurses’ health is neither systematically ordered nor evaluated yet. Thus, this review systematically identifies and s...

Zielstellung: Weltweit steigen die Lebenserwartung der Menschen und damit die Anzahl und das Ausmaß multimorbider und chronischer Erkrankungen. Die dadurch erhöhte Nachfrage nach Gesundheitspersonal wird auch durch Anwerbung ausländischer Pflegekräften gedeckt. Der Wissenstand über Pflegekräfte mit Migrationshintergrund ist bislang nicht systematis...

Background Acculturation is a long-term, multi-dimensional process occurring when subjects of different cultures stay in continuous contact. Previous studies have suggested that elevated rates of depression among different migrant groups might be due to patterns of acculturation and migration related risk factors. This paper focused on prevalence r...

Introduction Globally, life expectancy together with multimorbidity and chronic diseases are increasing. This leads to a growing demand for care and hence for healthcare personnel and nurses. To meet this demand, healthcare workers from abroad are increasingly hired. The nurses’ workplace in general is characterized by physically and psychologicall...

Entire search strings for databases (Medline, PsycINFO, CINAHL and Web of Science). (DOCX)

Detailed study characteristics of included studies. (XLSX)

List of excluded full texts. (XLSX)

PRISMA-Checklist. (DOCX)

Background This paper focuses on the lifetime prevalence of mental disorders in individuals with Turkish migration backgrounds in Germany, as there is a lack of reliable epidemiological data on this subject. Methods In total, 662 adults with Turkish migration backgrounds were interviewed in Hamburg and Berlin by trained, bilingual interviewers usi...

The Composite International Diagnostic Interview (CIDI), which has been widely applied in epidemiological research, is a standardized, clinically structured interview that enables the diagnosis of mental disorders based on DSM and ICD criteria. The computerized DIA-X CIDI Version 2.8 investigated in this study is an adaptation of the German DIA-X/M...

Einleitung: Die fortschreitende Globalisierung führt dazu, dass interkulturelle Aspekte auch in der therapeutischen Arbeit zunehmend an Bedeutung gewinnen, worauf das psychosoziale Versorgungssystem im Allgemeinen und Psychotherapeuten im Besonderen bislang unzureichend vorbereitet sind. Im deutschsprachigen Raum gab es bislang keine systematischen...

Background: There is a lack of reliable epidemiological data on prevalence and comorbidity rates of mental disorders in the migrant population in Germany. Despite existing national and international data on the extent of psychosocial burdens in migrant populations the prevalence among the study population remains unclear. The aim of this study was...

Background: Cultural competence of healthcare professionals (HCPs) is recognized as a strategy to reduce cultural disparities in healthcare. However, standardised, valid and reliable instruments to assess HCPs' cultural competence are notably lacking. The present study aims to 1) identify the core components of cultural competence from a healthcar...

Overview of the study procedures for the development and psychometric evaluation of the CCCHP. (PDF)

Cross-Cultural Competence instrument for Healthcare Professionals (CCCHP-27) (English version). (PDF)

Detailed description of methods. (DOCX)

Fragebogen zur Erhebung Interkultureller Kompetenz in der Gesundheitsversorgung (CCCHP-27) [Cross-Cultural Competence instrument for Healthcare Professionals (CCCHP -27)] (original German version). (PDF)

The need for intercultural opening of supply facilities for improving access and treatment of people with migration background is acknowledged in Germany. The purpose of the survey was to determine the current state of intercultural opening of psychosocial services in one Berlin district. 127 representatives of institutions were interviewed using a...

Objectives: Families with migrant backgrounds (MB) are exposed to several psychosocial risk factors that increase the likelihood of impaired child development, in particular. Questions: We investigated whether families with MB differ from families without MB regarding their psychosocial stressors in the period of pregnancy and birth. Method: As par...

Immigrants and refugees, especially those who are newly settled, often have poor knowledge about how the health-care system works, what help they can obtain, and how to communicate their suffering and need for help in an understandable way in the new context. It is therefore necessary for health and mental health professionals to be sensitive to cu...

Throughout recent history Germany has gone through different phases of substantial migration movements. Currently almost 20% of the general population has a so-called migration background. Recent political milestones paved the way for Germany to move from being an informal to a formal immigration country. Still people with a migration background do...

Als ein Instrument zur Überwindung der Zugangs- und Behandlungsbarrieren von Patienten mit Migrationshintergrund im Gesundheitssystem dienen interkulturelle Trainings mit dem Ziel der Steigerung der interkulturellen Sensibilität und Kompetenz der Behandler. Es werden die Bedarfe solcher Maßnahmen aus unterschiedlichen Perspektiven, deren konzeptuel...

One instrument to overcome utilisation and treatment barriers for patients with a migration background in health care services are cross-cultural trainings following the goal of enhancing cross-cultural sensitivity and competence for health care providers. The needs for such trainings from different perspectives, their conceptual spectrum as well a...

There are inequalities in health among migrants and local populations in Europe. Due to migration, Germany, Norway and Sweden have become ethnic culturally diverse nations. There are barriers to mental health care access for refugees, migrants and minorities, and problems with quality of culturally sensitive care in the three countries. This is des...

The treatment of patients from an immigrant population can be very challenging for professionals in mental health care services. One instrument to overcome barriers between patients and caregivers is training to increase cross-cultural competence. In addition to know-ledge transfer, such training focuses on the process of self-reflection on ones ow...

Die in diesem Beitrag vorgestellte Studie stellt empirische Daten zum Stand der interkulturellen Öffnung in der ambulanten psychotherapeutischen Versorgung in Berlin bereit. Von den ambulant tätigen Mitgliedern der Psychotherapeutenkammer Berlin nahmen 395 an der Befragung durch die Kammer teil. Trotz einer eingeschränkten Repräsentativität der Sti...

Detailed knowledge about the mental health of immigrants in Europe is limited due to a lack of representative data. Part of the problem is the difficult accessibility to and the participation of immigrants.AimsThe international research project “Mental Health and Immigration” (see: www.segemi.de) funded by the VW-foundation, is aiming to provide th...

Lower participation rates of ethnic minorities in health research studies and potential participation barriers are commonly reported. Four semi-structured focus groups of individuals with Turkish migration backgrounds living in Germany were conducted to identify potential participation barriers. Documented statements and superscripted presentation...

Globalization and cultural diversity challenge mental health care in Europe. Sensitivity to culture in mental health care benefits effective delivery of care to the individual patient and can be a contribution to the larger project of building a tolerant multicultural society. Pivotal for improving cultural sensitivity in mental health care is know...

Unlabelled: Mental healthcare services need to be sensitive towards the cultural needs of patients. Cross-cultural opening is an organizational process to fulfil these needs. This study aims to provide representative structural and procedural data regarding the use of German outpatient mental healthcare services by allochthonous patients, the dive...

Data available from the recruitment process for a population-based survey on psychological well-being in women of Turkish origin aged 18–75 years was subjected to post-hoc analysis to examine effects of different recruitment approaches and reasons for non-response. A random sample of 80,000 women was drawn from the Berlin population registry and 38...

Die psychosoziale Versorgung für Patienten mit Migrationshintergrund ist mit hohen Zugangsbarrieren verbunden. Auch für Professionelle in der psychosozialen Versorgung stellt die Behandlung von Patienten mit Migrationshintergrund mitunter eine große Herausforderung dar. Als einen Baustein zur Überwindung wahrgenommener kultureller Behandlungsbarrie...

Based on the German original questionnaire of the "Hamburger modules for measuring generic aspects of psycho-social health in the therapeutic practice" (HEALTH-49) a Turkish speaking version (T-HEALTH-49) was cross-cultural sensitively developed. The psychometric properties have been analysed by means of a clinical sample of Turkish speaking patien...

Untersucht wurde, ob in der stationären Rehabilitation von Patienten mit psychischen/psychosomatischen Störungen Menschen mit Migrationshintergrund seltener behandelt werden, stärker belastet sind, weniger von der Behandlung profitieren und ein höheres Risiko für einen negativen Behandlungserfolg haben. Auf Grundlage einer prospektiven Stichprobe (...

It was evaluated in an inpatient rehabilitation setting whether patients with mental or psychosomatic disorders people with a migration background are treated less frequently, profit less from the treatment, and have a higher risk for a negative outcome. On the basis of a prospective sample (n=25,066), the healthcare utilization of inpatient rehabi...

Fragestellung, Ziele: Für die Behandlung von Patienten mit chronischen psychischen Erkrankungen stellt sich die Frage, inwiefern sie dabei unterstützt werden können, gesundheitsförderliche Einstellungen und Verhaltensweisen (Ressourcen) zu entwickeln bzw. gesundheitsschädliche Einstellungen und Verhaltensweisen zu reduzieren. Bisher fehlen zur Über...

Treatments of patients with chronic mental disorders are increasingly focusing on salutogenetic aims to support human health and well-being. Up to now, standardized instruments to evaluate these treatment goals are still missing. We present results of analyses of the psychometric properties of the Hamburg Self-Care Questionnaire (HamSCQ). Besides r...

Die vergangenen zehn Jahre der Psychotherapieausbildung können in drei Phasen unterteilt werden: Adaptation, Stagnation und Transformation. In der Phase der Adaptation haben PiA der ersten Generation zusätzlichen Aufwand betreiben m¸ssen, um die zahlreichen Unklarheiten auszuräumen. In der Phase der Stagnation scheinen sich viele Akteure hinter den...

Studienergebnisse deuten auf eine erhohte psychosoziale Belastung von in Deutschland lebenden Menschen mit turkischem Migrationshintergrund. In der vorliegenden Studie wurde untersucht, ob sich ein solcher Belastungsunterschied auch zu Beginn einer stationar rehabilitativen Behandlung bei Patienten mit psychischen/psychosomatischen Storungen finden...