Retention factors affecting migrant psychiatrists from low- and middle-income countries

Abstract

A major barrier to the large treatment gap in mental healthcare in low- and middle-income countries is the shortage of psychiatrists, partly caused by a brain drain. This qualitative study aimed to gain an in-depth understanding of the motivations and experiences of migrant psychiatrists in order to address retention factors. We interviewed a convenience sample of 11 psychiatrists from Afghanistan, Iraq, South Asia and Africa. Interviews were semi-structured and based on questions about the participants' reasons for emigrating, their expectations and experiences of the move, their views of psychiatry as a profession in their country of origin and whether any incentives would persuade them to return. Prevention of emigration appears to be far more effective than encouraging expatriates to return; an improvement in training and job opportunities could have a drastic impact on retention. Almost all the psychiatrists interviewed intended to contribute to training and raising the profile of psychiatry in their country of origin, and therefore their emigration may have long-term benefits. It could potentially break the cycle between lack of understanding, lack of demand for mental health services and lack of training. It should therefore be an ethical obligation of UK employers to offer migrant psychiatrists time and support to facilitate these contributions.