Psychiatric admissions of Asian Canadians to an adolescent inpatient unit

Mental health service use by Chinese immigrants with severe and persistent mental illness

OBJECTIVE

To investigate whether recent Chinese immigrants in British Columbia diagnosed with severe and persistent mental illness used mental health services at a lower rate than a similar group of nonimmigrants and longer-term immigrants.

METHOD

Subjects were selected from linked immigration and health administrative databases. Their health service use records for the years 1992 to 2001 were extracted. Rates and rate ratios of use for severe psychiatric disorders for Chinese immigrants and the comparison group were calculated for 4 types of health services: mental health visits to general practitioners (GPs), visits to psychiatrists, psychiatric hospitalizations, and use of psychiatric medications. Rates and rate ratios of use for any mental health condition were calculated for the above 4 types of services, plus community mental health service and nonmental health visits to GPs.

RESULTS

The Chinese immigrants (n = 786) and comparison subjects (n = 3962) having severe and persistent mental illness were identified. For serious mental disorders, Chinese immigrants were more likely to visit psychiatrists (RR = 1.36) but less likely to use the other types of services, with rate ratios ranging from 0.51 to 0.81. Including all mental health conditions, Chinese immigrants were less likely to use all 6 types of services, with rate ratios ranging from 0.41 to 0.90.

CONCLUSIONS

Except for psychiatric visits for serious disorders, recent Chinese immigrants diagnosed with severe and persistent mental illness used fewer mental health services than subjects from the comparison group. Seriously ill Chinese immigrants may experience problems with access to mental health services.

Psychopathology and mental health service utilization by immigrants' children and their families

To investigate the psychopathology of immigrants' children and psychiatric service utilization by the immigrant families, data were collected from the files of all 35 immigrant children seen over a 3-year period at the Community Mental Health Centre of the Athens University Psychiatric Department. Immigrant children were matched by age, gender and intake date with 70 Greek children. Data concerned information about the child's place of birth, current living conditions, parents' country of origin, social and economic situation, occupations and educational status, social insurance, psychiatric history, referral source, diagnostic and therapeutic services rendered, number of sessions and outcome. Utilization of services was assessed 6 months after intake. No significant differences were found regarding family's structure and parents' psychopathology. However, immigrant families had significantly worse economic situations, lower status jobs, worse housing and were usually uninsured. No significant differences were observed regarding service utilization parameters, except concerning 'cooperation with other services' No differences were found regarding frequency or type of psychiatric diagnosis. However, 91% of the immigrant group received a psychosocial diagnosis as opposed to 49% of the Greek group. Immigrant children did not present more serious or diverse psychopathology than did Greek children. Immigrant families had equal levels of service utilization as Greek families. However, it was apparent that immigrant families did not apply for help as readily as their Greek counterparts.

Neighbourhood recent immigration and hospitalization in Toronto, Canada

Recent immigrants to Canada tend to initially settle in low-income urban core areas. The relationships among immigration, neighbourhood effects and health are poorly understood. This study explored the risk of hospitalization in high recent-immigration areas in Toronto compared to other Toronto neighbourhoods. The study used 1996 hospitalization and census data. Regression was used to examine the effects of recent immigration on neighbourhood hospitalization rates. Most hospitalization categories showed significantly higher rates of admission as the proportion of recent immigrants increased. Income was also significantly associated with all categories of hospitalization except surgical admissions. Average household income was almost 60% lower (dollar 36,122) in the highest versus the lowest immigration areas (dollar 82,641) suggesting that, at the neighbourhood level, the effects of immigration and income may be difficult to disentangle. These findings have important implications for health care planning, delivery, and policy.