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Language mediation in psychotherapeutic healthcare for refugees in Germany – shunting responsibility between levels and actors

Renate Reiter (Department of Political Sciences, Faculty of Cultural and Social Sciences, FernUniversitat in Hagen, Hagen, Germany)
Lisa Walter (Deutsches Zentrum für Integrations- und Migrationsforschung, Berlin, Germany)

International Journal of Migration, Health and Social Care

ISSN: 1747-9894

Article publication date: 19 December 2022

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Abstract

Purpose

Refugees’ access to psychotherapeutic care is insufficient in Germany. One factor particularly contributing to hindering their access to adequate therapeutic care is a lack of provision of language mediation. This paper aims to explore the institutional system in which the financing of language mediation in the context of the medical treatment of asylum seekers in Germany is located. It examines why the language barrier problem resulting from a lack of financing is not being solved, even though it has been well known for years as a structural problem of day-patient health care to refugees and migrants in Germany.

Design/methodology/approach

The financing of language mediation is analysed against the background of theories of the so-called “shunting yard”, in which public responsibilities for the assumption of costs are shifted from one level and actor to the other, thus preventing sustainable solutions being achieved. A mix of qualitative methods including the evaluation of official documents, reports and secondary literature, and of 23 expert interviews was used.

Findings

The financing of language mediation is a perfect example of the “shunting yard” phenomenon, with responsibilities being shifted between federal government, health insurance bodies and the municipalities in Germany. This paper argues that the specific financing structure in the German federal system can be viewed as a reason for the non-solution of the language barrier that hinders refugees’ access to health care.

Originality/value

The problem of the financing of language mediation in the context of health care has been rarely treated from a social sciences perspective. This paper contributes to addressing this gap.

Keywords

Acknowledgements

This study was supported by Federal Ministry of Education and Research (BMBF) Germany (01UM1815BY).

Citation

Reiter, R. and Walter, L. (2022), "Language mediation in psychotherapeutic healthcare for refugees in Germany – shunting responsibility between levels and actors", International Journal of Migration, Health and Social Care, Vol. ahead-of-print No. ahead-of-print. https://doi.org/10.1108/IJMHSC-05-2022-0053

Publisher

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Emerald Publishing Limited

Copyright © 2022, Emerald Publishing Limited

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