Barriers to access, pathways to equity: clinicians’ perspectives on mental health service delivery

TL;DR

This study explores how mental health clinicians in Canada perceive barriers to care for immigrant, refugee, and ethnically diverse populations and suggests ways to improve access and equity.

Contribution

The study provides new insights into clinicians' perspectives on systemic and cultural barriers to mental health care for diverse populations in Canada.

Findings

Logistical and cultural barriers, such as long wait times and stigma, hinder access to mental health care for diverse populations.

Clinicians face institutional challenges like limited training in culturally responsive care.

Recommendations include system-level changes and increased education to reduce inequities in mental health service delivery.

Abstract

This study explored clinicians’ perceptions of the barriers that immigrant, refugee, and ethnically diverse populations face in accessing mental health (MH) care in Canada, the challenges clinicians encounter in service delivery, and their recommendations for improving access and quality of care.

Guided by a practice-based research approach, a qualitative descriptive approach was used, employing semi-structured interviews and thematic analysis. The study was conducted across community-based MH organizations in multiple Canadian provinces within primary and community care settings. Nineteen MH clinicians, including social workers, psychotherapists, and counselors were purposively sampled. Eligible participants were currently employed in MH roles and had direct experience working with diverse populations; there were no formal exclusion criteria.

Clinicians identified two overarching categories of barriers: logistical challenges (such as long wait times, cost, and limited access to multilingual services) and cultural/social barriers (including stigma, cultural mismatch, and mistrust of Western MH models). Clinicians also reported institutional challenges, such as limited training and resources for culturally responsive care. Recommendations focused on enhancing cultural responsiveness, increasing clinician education, and implementing system-level changes to reduce structural inequities.

Clinician insights highlight the need for more accessible, equitable, and culturally responsive MH services for diverse populations in Canada. These findings have implications for future research, clinician training, and policy reform.

The online version contains supplementary material available at 10.1186/s12913-025-13948-3.