Access and utilization of Portuguese mental healthcare services by migrant children and adolescents: perceptions and experiences of families

• Migrant families face barriers in accessing mental health services in Portugal. • Emergency departments are the main entry point for mental healthcare access. • Bureaucratic and economic challenges hinder healthcare utilization for migrants. • NGOs and schools play key roles in overcoming access barriers. • Policies promoting equity and cultural sensitivity can improve migrant healthcare. This study explores the perceptions and experiences of migrant families regarding access and utilization of mental health services for children and adolescents in Portugal, addressing a critical gap in national research. A qualitative, exploratory approach was adopted, involving focus groups (FG) with migrant families recruited through non-governmental organizations. Participants included parents or caregivers from diverse cultural and migratory backgrounds. Five FG were conducted, stratified by shared linguistic and cultural characteristics, with 4 to 8 participants per group. Discussions were audio-recorded, transcribed, and analyzed using thematic analysis to identify patterns of utilization, barriers to access, and sources of support. Results revealed that migrant families face significant barriers, including bureaucratic obstacles in obtaining healthcare user numbers, economic constraints, geographic challenges, and language barriers. Emergency departments were frequently used as the main entry point to mental health care due to difficulties accessing primary care. Despite these challenges, formal support from NGOs and schools, as well as informal networks and technological tools such as translation apps, were identified as key facilitators in overcoming barriers. Participants emphasized the need for more culturally sensitive practices and better dissemination of information about the healthcare system. The findings highlight the urgent need for systemic changes to improve access to mental health services for migrant children and adolescents. Addressing institutional barriers and integrating community support mechanisms are critical to promoting equity in healthcare and ensuring better outcomes for vulnerable migrant populations in Portugal.