In many European health systems, general practitioners (GPs) serve as the first point of contact and as gatekeepers to specialist services. While gatekeeping is often framed as promoting equity, less is known about how such systems are experienced by newly arrived refugees who enter with expectations shaped by different healthcare fields. This study investigates Ukrainian refugees' experiences of (dis)engagement in encounters with primary care services in the Greater Copenhagen area and how they responded to these encounters. Data were generated through one participatory workshop and 15 semi-structured interviews with adult Ukrainian refugees living in Denmark (June-October 2023). Analysis followed reflexive thematic analysis and was informed by Bourdieu's concepts of habitus and field, and relational care. Participants frequently experienced initial GP encounters as surprising, frustrating, and alienating, particularly in relation to time-limited consultations, "wait-and-see" approaches, reluctance to prescribe medication, and the need to justify health concerns. These interactions were interpreted as dismissal, indifference, or conditional inclusion in the welfare state. When care felt unresponsive, participants sought alternative pathways, including informal networks and transnational strategies such as consulting Ukrainian doctors online or traveling for tests and medicines. Over time, some adapted to the Danish system's rules, particularly following encounters where GPs offered explanations, listened, or flexibly connected concerns across domains. Participants also emphasized the importance of brokers, such as municipal staff, volunteers, and peers, who helped make the system intelligible and accessible. The study shows that universal entitlements and rapid integration into mainstream healthcare do not automatically produce equitable care. Equity depends on relational work that supports navigation, translates system logics, and enables recognition within time-pressured primary care encounters.

AIMS:Over 41,000 Ukrainian refugees are now living in Denmark. Targeted initiatives have been taken by Danish health authorities; however, it is unknown whether their health needs are met. This descriptive study explores Ukrainian refugees' experiences with Danish healthcare. METHODS:Adult Ukrainian refugees were invited to participate in an online survey through temporary housing units and language schools. The survey was developed and tested in collaboration with Ukrainian refugees, based on existing questionnaires. In May-August 2023, 803 individuals filled out the questionnaire, with 540 being fully completed. We described and measured associations between exposures (sociodemographic characteristics, language skills and war trauma experiences) and outcomes (experiences with the Danish healthcare system). RESULTS:A minority (17%) felt knowledgeable about the Danish healthcare system. A third (36%) had needed but not received medical care within the past 12 months. This was associated with a language barrier (odds ratio (OR): 2.05; 95% confidence interval (CI): 1.08-1.88) and having > 2 traumatic war exposures (OR: 8.57; 95% CI: 1.10-66.5). Thirty-seven per cent had contacted a Ukrainian doctor and 72% received medicine from Ukraine. A minority had been offered assessment at primary care for vaccination (22%), mental health (7%), infectious diseases (12%) or chronic disease (19%). Being offered an assessment was associated with being male for mental health (OR: 2.63; 95% CI: 1.02-6.79) and being older (>70 years) for vaccinations (OR: 13.72; 95% CI: 3.83-49.12). CONCLUSIONS:Our results stress the need for interpreters and targeted interventions about healthcare in host countries from arrival, and in collaboration with refugees. Moreover, public health policies and guidelines must be supported by structural frameworks.

BackgroundPostpartum depression (PPD) is a major public health concern. Despite advancements in treatment, many barriers to accessing care remain. There has been a growing interest in digital interventions for the prevention and treatment of PPD. However, for mothers with mild and moderate symptoms of depression, there is a limited offer of self-guided internet-based interventions developed with user input and with considerations on how to integrate the intervention into stepped care models for PPD. ObjectiveThe aim of this study was (1) to describe the process of the design and development of iCARE, a self-guided digital psychological intervention for mothers with mild and moderate symptoms of PPD in Denmark, (2) present the program’s theory illustrated by a logic model, and (3) explore its initial usability and prospective acceptability. MethodsApplying user-centered design methods, the intervention development followed six steps: (1) a literature review to identify evidence‑based therapeutic components of self‑guided interventions for PPD, (2) interviews with women with lived experience of PPD and group discussions with mental health experts and home‑visiting providers to identify user needs, (3) iterative design and content development with stakeholder feedback in collaboration with the Department of Digital Psychiatry, (4) prototype testing using think‑aloud usability sessions and interviews with 5 mothers, (5) a group cognitive walkthrough with mental health experts, and (6) final refinement and implementation of the iCARE program with developers and designers. ResultsInitial interviews with mothers and maternal health care providers emphasized the importance of a digital intervention offering timely psychoeducation, coping strategies, and pathways to in-person care while addressing the diversity of expressions of PPD symptoms. Stakeholders recommended a flexible program, multimodal content, and integration into maternal care systems with community health nurses supporting engagement and participation. The prototype was designed to be user-centered, engaging, and with multiple interactive features. It included components on psychoeducation, cognitive exercises grounded in cognitive behavioral therapy, acceptance and commitment principles, and mood-monitoring. The prototype was designed to be user-centered and engaging, with interactive features and components on psychoeducation, cognitive exercises grounded in cognitive behavioral and acceptance and commitment principles, and mood-monitoring. Prototype testing indicated high prospective acceptability and led to refinements across 6 themes: appropriateness of content; motivation and engagement; inclusivity and gender representation; clarity of instructions and data use; understanding of therapeutic method; and usability, layout, and navigation. ConclusionsiCARE is a self-guided internet-based psychological intervention for mothers with mild and moderate symptoms of PPD in Denmark. It was developed with user input by using qualitative methods, user-centered design, and psychological theory. Further research is needed to evaluate the feasibility and effectiveness of the program in a randomized controlled trial and its integration into maternal health care models such as universal PPD screening and home-visiting.

Migrant women across the European region face persistent barriers to equitable maternity care, including exclusion from service design, language barriers, racism, and a lack of culturally responsive care. These inequities can contribute to poorer maternal and infant outcomes. This workshop aims to explore practical, effective, and sustainable methods for meaningfully involving migrant women in the co-design and implementation of maternity care interventions across the European region. It seeks to challenge existing research practices, encourage more inclusive, participatory approaches, and promote responsiveness in maternal health care services. Using a roundtable format, this 60-minute session will be co-facilitated by a migrant woman with lived experience and an academic researcher. Five discussants will present brief case examples, including intervention research from the UK, Germany, and Denmark, alongside findings from a systematic review and qualitative study. A ‘Creative Thinking’ framework will guide participant engagement through mind mapping, live polling, and facilitated discussion to stimulate new ideas and capture diverse perspectives. Participants will:

Millions of adolescents have entered the US as ‘unaccompanied’ minors by crossing overland from Latin America. Although several studies have examined their emotional health once settled in the US, or while temporarily resettled in Mexico, few examine time in transit. We propose to examine narratives of journey experiences while transiting from South/Central America through Mexico to understand coping strategies under duress. In the mixed methods CAMINANDO study of unaccompanied minors recently resettled in New York, youth were invited to share their journey. Using an inductive approach, we examined the journey narratives of 15 youth who migrated at ages 15-17 from Latin America. Youth’s northbound transit narratives emphasized tactics and social navigation to maneuver around obstacles in order to continue on their trips. For some youth these strategies appeared a source of pride, while others’ accounts were more pragmatic. Narratives juxtaposed descriptions of details of familiar objects such as types of trees that served as unofficial landmarks delineating crossroads in their journeys, with descriptions of decision making and calculated risk-taking to allow their journeys to proceed. Youth described interactions with other youth, (migrants, as well as host country origin) which highlighted strategies they had used to circumvent restrictions and seemingly insurmountable obstacles, evidencing ways in which they rationalized their possibilities for achieving their goal of continuing their journey. Vignettes shared by youth also described their positionality vis-a-vis other migrants whom they saw as especially vulnerable (e.g. pregnant women) and for whom they appeared willing to prioritize limited resources. Narratives simultaneously reflected childlike optimism, and pragmatic resourcefulness in problem solving when survival was at risk. Examination of trajectory narratives reveal tactics and social navigation used under duress and can serve as an informative lens through which to observe evolving decision making skills, resilience and agency in these adolescents.

Introduction Migrant populations, especially women, are often more susceptible to poor mental health and they face healthcare access barriers. This study aims to develop and evaluate a community-based mental health intervention through a participative research process to promote mental health and prevent psychiatric disorders among migrant women in Barcelona city. The intervention is built upon two evidence-based guidelines: Group Problem Management Plus (Group PM+) and Self-Help Plus (SH+). Methods “Self-Care Among Women” is a mixed-methods process evaluation study for the development of a community-based psychological pilot intervention. A participatory approach will be employed to adapt the content agenda of the community mental health intervention. Process indicators on context, implementation and mechanisms of change will be assessed through an intersectionality lens to explore the way in which the intervention is developed and implemented. The contextual fit, acceptability and feasibility of the proposed psychological intervention will be examined through participants' and facilitators' perceptions of the intervention. Further, women's clinical mental health condition and wellbeing will be assessed before and after the intervention, through standardized and culturally-validated instruments. Ethics and dissemination Ethical approval of the research protocol has been obtained by the Research Ethics Committees of Hospital Clínic, Fundació Institut Universitari per a la recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol) and Parc Sanitari Sant Joan de Déu. Written informed consent will be requested from all research participants for inclusion in the study. The study results will be published in peer-reviewed journals and communicated to congresses.

INTRODUCTION:More than 31,000 Ukrainian refugees have been resettled in Denmark. To mitigate related health challenges, the Danish Health Authority issued Guidelines for Healthcare Professionals on Displaced Ukrainians in 2022, stating that general practitioners (GPs) should conduct a health assessment at one of the first contacts with a Ukrainian refugee. We aimed to explore how GPs had implemented this health policy into practice. METHODS:From 11 May to 22 June 2023, we distributed a self-administered online questionnaire to 3,284 GPs through the newsletter of the Danish Organisation of General Practitioners (PLO). Analyses included frequencies and statistical logistic regression analyses. RESULTS:A total of 55 GP responded. Those who were knowledgeable about the guidelines were significantly more likely to ask adults (OR = 4.0; 95% confidence interval (CI): 2.1-7.9) and children (odds ratio (OR) = 4.7; 95% CI: 1.4-16.1) about vaccination status and infectious diseases (OR = 5.0; 95% CI: 3.6-19.3) as part of a general health assessment. GPs experienced language barriers and a lack of knowledge about refugee health as obstacles to implementing the guidelines. GPs also found that Ukrainian refugees had a high need for interpreters and lacked the competencies needed to navigate healthcare services. Lastly, GPs expressed that intersectoral cooperation and referral possibilities were lacking. CONCLUSIONS:Our study highlights the importance of providing structural support and evaluation to ensure that migrant health policies effectively impact the target groups in practice. FUNDING:None. TRIAL REGISTRATION:Regional Data Protection Centre (P-504-0406/23-5000).

This study aims to assess the contextual fit, acceptability and feasibility of the “Self-Care Among Women” community-based group psychological intervention, inspired by Group Problem Management Plus, targeting migrant women in Barcelona, Spain. A mixed-methods process evaluation study was conducted from November 2023 to December 2024 to evaluate the pilot implementation of the intervention. Eligibility for participation was assessed through GHQ-12, WHODAS 2.0 and clinical observations. Process outcome measures were collected through structured observation and logsheets, as well as focus group discussions with women and interviews with facilitators – community psychologists and intercultural mediators. Clinical outcomes were measured at three time points. A grounded theory approach was employed to analyse the qualitative data. A total of 30 migrant women participated in four multicultural intervention groups, with a retention of 90%. Our results showed that the intervention addressed the diverse needs of migrant women through an intersectional lens, providing resources to cope with adversity while genuinely promoting social ties among women with diverse cultural backgrounds. Clinical outcomes showed a considerable improvement. Mechanisms of change suggested the need for integrating intercultural mediators in the facilitation of such interventions to bridge communication and cultural perspectives, and generate bonds. However, this requires strong institutional commitment to ensure their presence at public services. Further, established community-based referral networks can facilitate migrant women’s navigation through relevant resources. In a highly culturally diverse urban context, community-based mental health can enhance reachability. Such approaches can amplify migrants’ perspectives of wellbeing while breaking stereotypes around women’s position in certain communities. Within the framework of prevention of psychiatric disorders and?mental health promotion, “Self-Care among Women” proposes mechanisms of innovative change in migrant mental health.

Migration is increasingly feminized, with women comprising 48% of global migrants. Forcibly displaced pregnant women and new mothers face heightened risks of poor physical and mental health due to migration-related adversities and disruptions in care, leading to under-documented intergenerational impacts. Multisectoral strategies to improve maternal and infant care for forcibly displaced migrant (FDM) women remain scarce, especially in low- and middle-income countries and transit regions. This workshop highlights the need to rethink maternal and child health services, drawing from a scoping review and three qualitative pilot studies engaging FDM women and stakeholders across transitory destinations in Colombia, Tunisia, and Spain. This 60-minute workshop will present qualitative data from three pilot studies in northern Colombia, Tunisia, and the Canary Islands, alongside findings from a scoping review of maternal health guidelines. Each case will focus on migrant mothers, offering different perspectives on their experiences, which will be integrated into the discussion. The session will invite participants to discuss research gaps, intervention strategies, and how adopting a Feminist Ethics of Care approach that emphasizes communities of care and mutual responsibility among care actors can help us reimagine maternal healthcare for migrants in transitory destinations. Participants will:

Late adolescence includes self-discovery and continued emotional, cognitive and physiologic development. For millions of teens, this life stage transpires during irregular migration, where they confront unexpected opportunities, negotiate agency, and transect boundaries. Both unaccompanied and accompanied adolescent migrants navigate unsettling uncertainty during transit/ temporary resettlement, often expressing resilience through interactions with other migrants, age-peers, or post-hoc family-like units. Researchers working with adolescent migrants face ethical and logistical complexities that benefit from community collaboration. to explore how community partnerships facilitate and inform research with adolescent migrants through formal and informal co-creation. We draw on 3 examples of research with adolescent migrants carried out in partnership with service providers, shelters, and migrant youth organizations in three different global regions to highlighting the unique complexities of migrant youth research based in community settings. Key themes that emerged from our combined work include challenges surrounding: consent and assent; institutional policies on working with ‘minors’; selection of teen-friendly approaches, language, and assessment settings and structures to accommodate the heterogeneity within adolescence; societal othering/ xenophobia; and intricacies of including siblings within studies. Youth transiting through Mexico demonstrate engaging in practices of solidarity in transient communities defined by shared experiences. An adult-centric view on the part of service providers, IRBs and researchers may obscure adolescents’ agency. In Türkiye, participatory-based research with forcibly displaced adolescents supports outreach, co-design of health initiatives, and youth empowerment, especially when local youth are included. In resettlement contexts in the US, embedding health research within legal service provision settings facilitates access and enriches results but also implies balancing competing priorities, and trust building across disciplines. Health-related research with migrant or refugee adolescents, whether emancipated, ‘disconnected’, or residing within family units is uniquely informed and challenged when carried out in partnership with community based providers.

Postpartum depression (PPD) affects 10–15% of women globally. Women with migrant backgrounds have twice the risk of developing PPD yet face significant barriers to participate in screening programs and accessing treatment services. Over the past decade, there has been a surge in digital mental health interventions (DMHIs) for the treatment and prevention of PPD. However, these have overlooked the needs and realities of migrant women, highlighting the importance of engaging end users in the development of DMHIs to promote accessibility, acceptability and equity. This study uses iCARE, a DMHI to reduce PPD symptoms in Denmark, as a case study to explore the sociocultural and linguistic adaptation of a self-guided DMHI for women with Arabic-speaking migrant backgrounds experiencing postpartum distress such as depression and anxiety. The adaptation process followed Heim and Kohrt’s conceptual framework for the sociocultural adaptation of scalable psychological interventions. Using a participatory and human-centered design approach, civil society, migrant women and stakeholders were engaged in an iterative process of adaptation and prototype testing. Adaptations are made to three key areas of the intervention: Cultural concepts of distress – understanding the explanatory models and idioms of postpartum distress among Arabic-speaking women with migrant backgrounds; treatment components – adjustments to intervention content to align with beliefs, norms, and preferences; and treatment delivery – modifications to ensure accessibility and usability for Arabic-speaking women. This study describes the sociocultural and linguistic adaptation process of a DMHI for postpartum distress, detailing what components were adapted and why. Through an equity lens, we critically discuss the potentials and limitations of self-guided DMHIs in supporting the maternal mental health needs of women with migrant backgrounds. Digital mental health interventions, sociocultural adaptation, mental health, postpartum depression (PPD), migration, qualitative research, participatory methods

Background:Migrant women who are pregnant or postpartum and their infants are often at increased risk of poorer perinatal outcomes compared to host country populations. This review aimed to identify public health, policy, and clinical interventions to improve maternity care for migrant women and their infants in high-income countries (HICs). Methods:In this systematic review we searched EMBASE, EMCARE, MEDLINE and PsycINFO, CENTRAL, Scopus, CINAHL Plus, Web of Science, and grey literature from inception to 13th March 2024, with no language or date restrictions (PROSPERO: CRD42022380678). Interventional and observational studies assessing the effectiveness of any intervention to improve perinatal care for migrant women and their infants in HICs delivered in the pregnancy, peripartum, or postpartum period (up to one year after birth) were included. Quantitative outcomes were extracted. Qualitative studies were excluded. The main outcomes of interest were preterm birth, birthweight, and appointment attendance. Quantitative synthesis was conducted using Harvest plots and binomial exact calculations. Findings:15,689 records were retrieved, 29 studies comprising data from 16,763,837 women were included. 22 studies (75.9%) included multiple interventions. Five interventions had strong evidence of effectiveness. Two clinical interventions: 100.0% of studies including specialist multidisciplinary teams improved one or more of the main outcomes of interest, namely preterm birth, birthweight, and appointment attendance (95% confidence interval 73.5-100.0%; p < 0.001); and 90.9% of studies including specialist in-person interpreting improved one or more of the main outcomes of interest (58.7-100.0%; p = 0.012). Three public health or policy interventions: 100.0% of social welfare interventions (75.3%-100.0%; p < 0.001) improved one or more of the main outcomes of interest; 100.0% of maternal education interventions (71.5-100.0%. p < 0.001), and 83.3% of studies assessing access to free healthcare (51.6-97.9%; p = 0.039). Interpretation:The findings suggest that multicomponent interventions comprising multidisciplinary teams, in-person interpreting, maternal education, and social welfare support can improve perinatal outcomes for migrant women and their infants. Removing financial barriers to care may improve perinatal outcomes and be cost saving to healthcare systems. However, these findings should be interpreted with caution given that most included studies were of poor quality and that sensitivity analysis restricting to interventional studies only did not demonstrate any effect on the main outcomes of interest. Funding:KS is supported by a National Institute for Health Research (NIHR) Doctoral Fellowship (NIHR302577). HRJ is supported by an NIHR Advanced Fellowship (NIHR303183). HRJ is supported by NIHR Applied Research Collaboration (ARC) South London. MM is supported by a Medical Research Council Clinical Research Training Fellowship (Grant number MR/W01498X/1). GF is supported by a Nuffield Department of Population Health Clinical Research Fellowship. MK is an NIHR Senior Investigator (NIHR303806). The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care.

PurposeTo explore the experiences of refugee mothers and community health nurses participating in a nurse home visiting program in Denmark, focusing on the program's effects on the psychosocial well-being of refugee mothers during the transition to motherhood.MethodsThe nurse home visiting program was an add-on the public care offered to all families, with extra training of the community health nurses and more time to engage with the families with immigrant and refugee backgrounds. Community health nurses (12) and participating women (9) participated in qualitative interviews between September and December 2020, following the program's conclusion.ResultsUtilizing the Resource-Based Model of refugee adaptation as a theoretical framework, we identified four main themes: (i) negotiating parenting norms and gaining confidence through parenting resources; (ii) finding emotional support to cope with integration pressures; (iii) expanding social resources, (iv) building bridges with welfare state services. These themes captured the resources gained by mothers through the home visiting program, positively influencing their psychosocial well-being, while also acknowledging the impact of the socio-political context on community health nurses' work and mothers' daily lives.ConclusionFindings offer insights about the potential and limitations of tailored nurse home visiting programs for refugee families, emphasizing the positive impact on mental health. However, challenges such as assimilation pressures, unwelcoming immigration policies, and discrimination may hinder program effectiveness.

seeking asylum and their families, write

IntroductionSkill-based curricula supplementing Head Start programming have shown great promise as early interventions improving school readiness of children from socioeconomically under-resourced families. The Getting Ready for School (GRS) intervention builds on such research by providing a supplemental skill-based curriculum targeting three core school readiness domains—language/literacy, math, and self-regulation—using learning activities aligned across the classroom and home contexts. The goal of this study was to examine the effects of the GRS intervention on school readiness skills in children in Head Start programs.MethodsParticipants were 3- to 4-year-olds (N = 463, 46% male, 81% Hispanic/Latine). Classrooms were non-randomly assigned to the GRS intervention (n = 20) or Head-Start-as-usual comparison group (n = 17). At pretest and posttest, children completed assessments of early language/literacy, math, and self-regulation. Multilevel modeling was used to examine the group-by-time interaction in prediction of children's school readiness skills.ResultsSignificant group-by-time interactions were found for early language/literacy (vocabulary, print knowledge) and math skills. Children in the intervention group demonstrated significantly greater gains over time in these skills compared to children in the comparison group. At posttest, children in the intervention group had significantly higher vocabulary than children in the comparison group (effect size = 0.34). Intervention effects were not found for self-regulation.DiscussionThe GRS intervention may support early language/literacy and math skills in preschool children from socioeconomically under-resourced families. Future studies focused on a modified version of the intervention could demonstrate larger effect sizes and improvements in self-regulation.

Abstract Background The ADVANCE project aims to address mental health disparities among people in a situation of vulnerability in Europe. Through a co-creation approach, workshops were conducted to devise stigma prevention strategies during the implementation of mental health promotion interventions for migrant populations in Italy and Denmark. Methods The methodology involved two rounds of scenario-based workshops, a participatory method that elicit expert opinions to solve local problems and anticipate future ones. Round 1 included two separate workshops with (1) end-users and umbrella organizations, and (2) healthcare practitioners and decision-makers, to ensure diverse perspectives and minimize the impact of power imbalances. Participants brainstormed strategies to minimize stigma and optimize the intervention scenario. In Round 2, a mixed-group workshop was held to refine the strategies. Workshops occurred in Copenhagen and Verona in March 2024. Content analysis of the data was carried out. Results In Denmark, discussions emphasized tailored presentation of the intervention promoting shared experiences and normalizing mental health challenges, language sensitivity, participation through self-identification, and attention to relational aspects in intervention delivery to combat stigma effectively and enhance acceptability and engagement with the intervention. In Italy, proposed strategies included group exercises to raise awareness and promote open dialogue about cultural differences, language barriers, and discrimination. Discussions also considered the intersectionality of stigma, including factors like gender, socioeconomic status, and sexual orientation. Common themes included language sensitivity, facilitator training, and inclusive and safe spaces. Conclusions Scenario-based workshops can be a valuable tool to facilitate the co-creation of stigma-prevention strategies while involving all stakeholders in promoting effective mental health interventions. Key messages • Co-creation approach fostered stakeholder collaboration, yielding tailored strategies that promote inclusivity, acceptability and engagement with mental health interventions for migrant populations. • Context-specific approaches that emphasize trust, confidentiality and cultural sensitivity were prioritised to tackle stigma when implementing interventions and promoting mental health equity.

Population Medicine considers the following types of articles:• Research Papers -reports of data from original research or secondary dataset analyses.• Review Papers -comprehensive, authoritative, reviews within the journal's scope.These include both systematic reviews and narrative reviews.• Short Reports -brief reports of data from original research.• Policy Case Studies -brief articles on policy development at a regional or national level.• Study Protocols -articles describing a research protocol of a study.• Methodology Papers -papers that present different methodological approaches that can be used to investigate problems in a relevant scientific field and to encourage innovation.• Methodology Papers -papers that present different methodological approaches that can be used to investigate problems in a relevant scientific field and to encourage innovation.

This study investigated the association between mothers' migration background and infant regulatory problems and analysed the mediating role of maternal mental health. We also explored whether the child's sex, parity and length of residence moderated the effect of a maternal migrant background. Child health surveillance data from the Danish home visiting programme were used. Community health nurses followed infants from birth to 12 months of age. The source population comprised 103 813 infants born between 1 January 2008 and 31 December 2018. The final sample comprised 62 964 infants, including 3.4% with a refugee background. A maternal migrant background was the primary exposure. The results are presented as risk ratios (RR) and 95% confidence intervals (CI). A maternal refugee background increased the risk of regulatory problems in offspring (RR 1.34, 95% CI: 1.18–1.51). The effect was partially mediated by maternal postpartum mental health concerns. The association between maternal refugee background and infant regulatory problems was more pronounced in first-time mothers (RR 1.80, 95% CI: 1.51–2.15). The risk of infant regulatory problems was higher in the first-born children of refugee mothers. First-time refugee parents may need tailored support to identify mental health needs and infants with regulatory problems.

AIMS The aim of this study was to examine the association between women's migrant status (majority, immigrant, descendant) and use of postpartum mental healthcare and investigate whether migration characteristics are associated with mental healthcare use. METHODS Retrospective cohort study. We included all mothers of children born between 2002 and 2018 in 34 municipalities of Denmark who had an identified mental health need as clinically assessed by a child health visitor (CHV) or by a score of 11 or more on the Edinburgh Postpartum Depression Scale (EPDS). Women were followed until the first mental healthcare received 2 years' postpartum, death or emigration. Using Cox regression models, we estimated the time to mental healthcare by migrant status and explored the role of migration characteristics. RESULTS A total of 29% of women (n = 45,573) had a mental health need identified by the CHV, and 7% (n = 4968) had an EPDS ⩾ 11. Immigrants accounted for 19.5%, and descendants for 4.7% of the sample. Immigrants were at lower risk of using mental healthcare than the majority group (CHV: hazard ratio adjusted (HRa) 0.75 (0.70-0.79), EPDS: HRa 0.67 (0.58-0.78)), as were descendants (CHV: HRa 0.77 (0.70-0.86), EPDS: HRa 0.69 (0.55-0.88)). Among migrants, those not refugees, newly arrived, whose partners were immigrants or descendants, and those originally from Africa showed a lower risk of using postpartum mental healthcare. CONCLUSIONS Our findings emphasize the need to strengthen access to mental healthcare for immigrants and descendants experiencing postpartum mental health concerns and consider migration characteristics as indicators of potential inequalities in access to maternal mental healthcare.