Access to psychotherapy for refugees, individuals with migration background, and non-migrants - A correspondence study of discrimination in mental health care in Germany

There is a high demand for psychotherapeutic care in Germany. However, resources in outpatient psychotherapeutic care are limited. Against this background, psychotherapists may act as gatekeepers in access to therapeutic care. Evidence indicates that decisions to accept help-seekers as patients to psychotherapy are influenced by psychotherapists’ attitudes toward specific groups of help-seekers. Research suggests that particularly refugees and individuals with a migration are underrepresented in mental health care. Nevertheless, discrimination in access to outpatient psychotherapy for individuals with refugee experience or a migration background has not been thoroughly investigated. Moreover, the role of help-seekers’ region of origin in potential discrimination processes remains unclear. Given the prevailing public attitudes, it is assumed that individuals from the Middle East in particular are subject to discrimination, while individuals from Ukraine are more likely to receive assistance. In this study, we use correspondence testing to examine access to outpatient psychotherapy for refugees, individuals with migration background, and non-migrants. In addition, we examine the differences in access to psychotherapy for help-seekers of Syrian and Ukrainian origin. Our study is conducted with a randomly selected, nationally representative sample of 1200 psychotherapists.