The stressors of immigration detention and negative host country experiences make effective access to health care vital for migrant detainees, but little is known regarding the health experiences of this populations and the barriers to healthcare access. The present research investigates immigration detainees’ experiences of health-related help-seeking in the distressing and stigmatised environment of UK immigration removal centres (IRCs), as well as staff members’ experiences of providing help. Semi-structured interviews were conducted with 40 detainees and 21 staff and analysed using theoretical thematic analysis guided by the social identity approach. The findings indicate that the practical constraints on help provision (e.g. lack of time and resources, the unpredictable nature of detention) are exacerbated by the complex and conflictual intergroup relationships within which these helping transactions occur. These transactions are negatively affected by stigma, mutual distrust and reputation management concerns, as well as detainees’ feelings of powerlessness and confusion around eligibility to receive health care. Some detainees argued that the help ignores the systematic inequalities associated with their detainee status, thereby making it fundamentally inappropriate and ineffective. The intergroup context (of inequality and illegitimacy) shapes the quality of helping transactions, care experiences and health service engagement in groups experiencing chronic low status, distress and uncertainty.

中文翻译：

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移民搬迁中心内的医疗保健提供：信任、合法性和脱离的社会认同分析

移民拘留的压力源和东道国的负面经历使得有效获得医疗保健对移民被拘留者至关重要，但人们对这些人群的健康经历和获得医疗保健的障碍知之甚少。本研究调查了移民被拘留者在英国移民遣返中心 (IRC) 令人痛苦和污名化的环境中寻求健康相关帮助的经历，以及工作人员提供帮助的经历。对 40 名被拘留者和 21 名工作人员进行了半结构化访谈，并使用以社会认同方法为指导的理论主题分析进行了分析。调查结果表明，提供帮助的实际限制（例如缺乏时间和资源、拘留的不可预测性）因这些帮助交易发生的复杂和冲突的群体间关系而加剧。这些交易受到耻辱、相互不信任和声誉管理问题的负面影响，以及被拘留者对获得医疗保健资格的无能为力和困惑的感觉。一些被拘留者争辩说，这种帮助忽视了与他们被拘留者身份相关的系统性不平等，因此从根本上来说是不恰当和无效的。群体间环境（不平等和非法）塑造了处于长期低地位、痛苦和不确定性的群体的帮助交易、护理体验和医疗服务参与的质量。这些交易受到耻辱、相互不信任和声誉管理问题的负面影响，以及被拘留者对获得医疗保健资格的无能为力和困惑的感觉。一些被拘留者争辩说，这种帮助忽视了与他们被拘留者身份相关的系统性不平等，因此从根本上来说是不恰当和无效的。群体间环境（不平等和非法）塑造了处于长期低地位、痛苦和不确定性的群体的帮助交易、护理体验和医疗服务参与的质量。这些交易受到耻辱、相互不信任和声誉管理问题的负面影响，以及被拘留者对获得医疗保健资格的无能为力和困惑的感觉。一些被拘留者争辩说，这种帮助忽视了与他们被拘留者身份相关的系统性不平等，因此从根本上来说是不恰当和无效的。群体间环境（不平等和非法）塑造了处于长期低地位、痛苦和不确定性的群体的帮助交易、护理体验和医疗服务参与的质量。一些被拘留者争辩说，这种帮助忽视了与他们被拘留者身份相关的系统性不平等，因此从根本上来说是不恰当和无效的。群体间环境（不平等和非法）塑造了处于长期低地位、痛苦和不确定性的群体的帮助交易、护理体验和医疗服务参与的质量。一些被拘留者争辩说，这种帮助忽视了与他们被拘留者身份相关的系统性不平等，因此从根本上来说是不恰当和无效的。群体间环境（不平等和非法）塑造了处于长期低地位、痛苦和不确定性的群体的帮助交易、护理体验和医疗服务参与的质量。