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Epidemiological evidence suggests that regular physical activity (PA) positively impacts individuals' mental health (MH). The PA-MH relationship may be critical among immigrants owing to psycho-social-cultural influences. This scoping review of 61 studies employed a holistic bio-psycho-socio-cultural framework to thoroughly investigate the complex relationship between PA (across life domains) and immigrants' MH in Western countries. A systematic search of five electronic databases (Medline, PubMed, Embase, PsycINFO and Anthropology Plus) was conducted to locate relevant articles. No limitations were applied to study design, age, gender, home country, MH condition or PA type. A bio-psycho-socio-cultural-informed conceptual model guided the analysis of the multi-domain PA-MH relationship. Immigrant PA-MH studies were conducted and reported most commonly in the USA (38%), Australia (18%), and Canada (11%). Overall, PA was positively related to MH. Each domain-specific PA appeared to be associated with unique MH-promoting pathways/mechanisms. Leisure-related PA may support MH by enhancing self-agency and minimizing risky behaviors, whilst travel- and domestic-related PA may promote self-accomplishment and physical engagement. Ethnic sports appeared to enhance resilience. Occupational-related PA was associated with either positive or negative MH, depending on the type of occupation. A bio-psycho-socio-cultural-informed model is required to gain an encompassing and integrated understanding of immigrants' health. The first iteration of such a model is presented here, along with an illustration of how the model may be used to deepen analysis and understanding of the multi-domain PA-MH relationship among immigrants and inform public health planners and practitioners. [ABSTRACT FROM AUTHOR]

Objectives: The present paper aims to: (i) describe how the Mental Health Commission in New Zealand works and has contributed to the substantial enhancement of mental health resources and services; (ii) determine whether mental health reform policies will ever be implemented properly without an independent monitor with official influence at the highest levels of government; and (iii) demonstrate how variants on this model work in other Western countries and how it can be adapted to the Federated system in Australia.Conclusions: It is recommended that the Australian National Mental Health Plan 2003-2008 should be complemented by a long-standing national mental health commission (or similarly constituted body), which is also able to report independently from and to the government, with direct access to the Prime Minister, Premiers and Australian Health Ministers. Its aims would be to monitor service effectiveness and identify gaps in service provision, training and performance of the work force, management and government. It would be informed by consumer, carer and provider experience, and by reviews of evidence-based research regarding health needs and cost-effective services. It should accurately cost such service gaps, and advise government on a strategy for implementing them. It could also promote and advise formally on enhancing community awareness, decreasing stigma and discrimination and improving workforce recruitment and retention. [ABSTRACT FROM AUTHOR]

Background: Disparities in access to primary care (PC) have been demonstrated within and between health systems. However, few studies have assessed the factors associated with multiple barriers to access occurring along the care-seeking process in different healthcare systems. Methods: In this secondary analysis of the 2016 Commonwealth Fund International Health Policy Survey of Adults, access was represented through participant responses to questions relating to access barriers either before or after reaching the PC practice in 11 countries (Australia, Canada, France, Germany, Norway, the Netherlands, New Zealand, Sweden, Switzerland, the United Kingdom, and United States). The number of respondents in each country ranged from 1000 to 7000 and the response rates ranged from 11% to 47%. We used multivariable logistic regression models within each of eleven countries to identify disparities in response to the access barriers by age, sex, immigrant status, income and the presence of chronic conditions. Results: Overall, one in five adults (21%) experienced multiple barriers before reaching PC practices. After reaching care, an average of 16% of adults had two or more barriers. There was a sixfold difference between nations in the experience of these barriers to access. Vulnerable groups experiencing multiple barriers were relatively consistent across countries. People with lower income were more likely to experience multiple barriers, particularly before reaching primary care practices. Respondents with mental health problems and those born outside the country displayed substantial vulnerability in terms of barriers after reaching care. Conclusion: A greater understanding of the multiple barriers to access to PC across the stages of the care-seeking process may help to inform planning and performance monitoring of disparities in access. Variation across countries may reveal organisational and system drivers of access, and inform efforts to improve access to PC for vulnerable groups. The cumulative nature of these barriers remains to be assessed. [ABSTRACT FROM AUTHOR]