1
|
Billian J, Imfeld L, Roth CB, Moeller J, Lang UE, Huber CG. Treatment-seeking threshold and accessibility of psychiatric outpatient services in Switzerland: the relationship with stigma and self-esteem. Front Psychiatry 2024; 15:1377971. [PMID: 38680786 PMCID: PMC11045997 DOI: 10.3389/fpsyt.2024.1377971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Accepted: 03/19/2024] [Indexed: 05/01/2024] Open
Abstract
Perceived stigmatization and low self-esteem are linked to poorer mental health outcomes, but their impact on treatment-seeking thresholds and the importance of outpatient service location remain unclear. The study included 525 outpatients of the University Psychiatric Clinic (UPK) Basel, Switzerland, of whom 346 were treated at inner city services and 179 at services located on the main site of the UPK at the outer city limits. Perceived discrimination and devaluation (PDD), self-esteem (SE), treatment-seeking threshold (TST), and accessibility were measured via a self-reported questionnaire. The PDD consisted of 12 items evaluating beliefs about the level of stigma towards individuals with mental illness in the general population on a 5-point Likert scale. SE, TST and accessibility were assessed through single-item 7-point Likert scales. PDD and SE were positively correlated (p < 0.001), suggesting that lower perceived stigma was linked to higher self-esteem, and were not associated with TST. The relationship between PDD and SE remained consistent after controlling for age, gender, and nationality. Age was negatively correlated with TST (p = 0.022), while gender did not significantly influence any of the variables. There was little variation regarding PDD, with emergencies at the site of the psychiatric clinic and substance use disorder (SUD) patients reporting higher levels of stigmatization. Emergency patients and those with SUD and personality disorder reported the lowest SE ratings. TST showed a broad range and was highest for emergency services and transcultural psychiatry patients. Differences in accessibility were mainly linked to the location, with outpatient service users in the inner city reporting better accessibility (p < 0.001) and higher SE (p = 0.009). In comparison to patients using services with planned contacts only, patients in emergency settings differed by higher TST (p = 0.018) and better ratings of accessibility (p = 0.004). In conclusion, there was a relevant amount of stigmatization, impaired self-esteem, and, for some outpatient services, high thresholds to seek treatment. Future research should explore other factors influencing TST. The findings highlight the need to address stigmatization and accessibility when planning mental health services.
Collapse
Affiliation(s)
- Janina Billian
- Universitäre Psychiatrische Kliniken (UPK) Basel, Klinik für Erwachsene, University of Basel, Basel, Switzerland
- Faculty of Psychology, Division of Clinical Psychology and Epidemiology, University of Basel, Basel, Switzerland
| | - Lukas Imfeld
- Universitäre Psychiatrische Kliniken (UPK) Basel, Klinik für Erwachsene, University of Basel, Basel, Switzerland
- Institute for Evaluation Research, Universitäre Psychiatrische Kliniken (UPK) Basel, University of Basel, Basel, Switzerland
| | - Carl B. Roth
- Universitäre Psychiatrische Kliniken (UPK) Basel, Klinik für Erwachsene, University of Basel, Basel, Switzerland
| | - Julian Moeller
- Universitäre Psychiatrische Kliniken (UPK) Basel, Klinik für Erwachsene, University of Basel, Basel, Switzerland
- Faculty of Psychology, Division of Clinical Psychology and Epidemiology, University of Basel, Basel, Switzerland
| | - Undine E. Lang
- Universitäre Psychiatrische Kliniken (UPK) Basel, Klinik für Erwachsene, University of Basel, Basel, Switzerland
| | - Christian G. Huber
- Universitäre Psychiatrische Kliniken (UPK) Basel, Klinik für Erwachsene, University of Basel, Basel, Switzerland
| |
Collapse
|
2
|
Smith ML, Seegulam V, Szentkúti P, Horváth-Puhó E, Galea S, Lash TL, Rosellini AJ, Schnurr PP, Sørensen HT, Gradus JL. Risk of psychopathology following traumatic events among immigrants and native-born persons in Denmark. Soc Psychiatry Psychiatr Epidemiol 2023; 58:1305-1316. [PMID: 36449069 DOI: 10.1007/s00127-022-02391-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 11/14/2022] [Indexed: 12/02/2022]
Abstract
PURPOSE Immigrants may have increased risk of mental disorders compared with native-born persons. We aimed to expand the limited research on immigrants' posttraumatic psychopathology related to traumatic experiences in their country of resettlement. METHODS We obtained data from a cohort of Danish residents with ≥ 1 traumatic event recorded in health and administrative national registries during 1994-2016. We calculated risks of posttraumatic stress disorder (PTSD), depression, and substance use disorders (SUD) within 5 years post-trauma among native-born Danes and immigrants who had been in Denmark for ≥ 10 years at the time of their index trauma (including immigrants overall and immigrants from specific regions). Risks were compared via age- and sex-standardized risk ratios (SRR) with 95% confidence intervals (CI). We restricted to persons with no record of the disorder under investigation in the 10 years pre-trauma, and stratified by non-interpersonal (e.g., transport accidents) versus interpersonal trauma (e.g., assaults). RESULTS Following non-interpersonal trauma, immigrants were more likely than native-born Danes to be diagnosed with PTSD (SRR = 5.2, 95% CI 4.6, 5.9), about as likely to be diagnosed with depression (SRR = 0.98, 95% CI 0.92, 1.1), and less likely to be diagnosed with SUD (SRR = 0.89, 95% CI 0.82, 0.95). Results were similar following interpersonal trauma, except the SRR for PTSD was reduced in magnitude (SRR = 3.0, 95% CI 1.7, 5.4). There were differences by region of birth. CONCLUSION Immigrants to Denmark have higher risk of PTSD following traumatic experiences than do native-born Danes, possibly due to the combined influence of adverse pre-, peri-, and/or post-migration experiences.
Collapse
Affiliation(s)
- Meghan L Smith
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Vijaya Seegulam
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Péter Szentkúti
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
| | | | - Sandro Galea
- School of Public Health, Boston University, 715 Albany St., Boston, MA, 02118, USA
| | - Timothy L Lash
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Anthony J Rosellini
- Center for Anxiety and Related Disorders, Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA
| | - Paula P Schnurr
- National Center for PTSD Executive Division, White River Junction, VT, USA
- Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - Henrik Toft Sørensen
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
| | - Jaimie L Gradus
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA.
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.
- Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA.
| |
Collapse
|
3
|
Perceiving refugees as threats may backfire on one’s health: Relations with intercultural antecedents and psychological distress among Germans. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-03167-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
AbstractIn the recent years, research on the conditions, under which members of the host countries such as Germany perceive refugees as threatening and respond with negative attitudes, has increased. However, little attention has been given to the implications that subjective perceptions of threat among the host community may have for their own psychological health. Using integrated threat theory, the current study examined the relationships between perceived threats, person-centered antecedents in intercultural settings, and psychological distress among Germans, who reflected on incoming refugees. Using a survey company, a sample (N = 1000) was recruited, which matched the German census regarding central demographics. Participants completed a cross-sectional online survey with validated self-report measures. Assessments covered four perceived threat types (intergroup anxiety, symbolic and realistic threat, negative stereotypes), person-related antecedents (social identity as German, quantity and quality of prior intercultural contact), and psychological distress. Applying structural equation modeling, we found that high social identification as German was related to greater perceptions of symbolic/realistic threat, stronger negative stereotypes and to more intergroup anxiety. Vice versa, high quality of prior intercultural contact experiences was associated with a decrease of all threat types. The quantity of prior intercultural contact showed almost no relations to perceived threats. In terms of indirect effects, greater quality of contact predicted less distress, and greater identity as German predicted more distress, both via symbolic/realistic threat and intergroup anxiety. Taken together, perceiving refugees as a threatening outgroup may signify a self-harming risk, while high quality of intercultural relations may indirectly enhance health.
Collapse
|
4
|
Kobel F, Erim Y, Morawa E. Predictors for successful psychotherapy: Does migration status matter? PLoS One 2021; 16:e0257387. [PMID: 34529716 PMCID: PMC8445403 DOI: 10.1371/journal.pone.0257387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 09/01/2021] [Indexed: 11/24/2022] Open
Abstract
Background We investigated, if migration status, and additional sociodemographic and clinical factors, are associated with somatization and depressiveness at admission and with remission after inpatient psychotherapy. Methods Multiple linear and binary logistic regression analyses were used to identify predictors for severity of somatoform and depressive symptoms at admission of inpatient psychotherapy (T0), and for remission after inpatient psychotherapy (T1). We tested the association between symptoms concerning somatization (PHQ-15: Patient-Health-Questionnaire Somatization Module) and depression (PHQ-9: Patient-Health-Questionnaire Depression Module) and several sociodemographic and clinical factors in 263 patients at admission. For remission after treatment, we additionally included severity of symptoms at admission, number of diagnoses and duration of treatment in the regression models. Remission after treatment was defined as response plus a post value of less than 10 points in the respective questionnaire. Clinical relevance was interpreted using effect sizes (regression coefficients, Odds Ratio (OR)) and Confidence Intervals (CI). Findings Significant and clinically relevant predictors for high symptom severity at T0 were lower education (β = -0.13, p = 0.04), pretreatment(s) (β = 0.205, p = 0.002) and migration status (β = 0.139, p = 0.023) for somatization, and potential clinically relevant predictors (|β|>0.1) for depression were living alone (β = -0.116, p = 0.083), pretreatment(s) (β = 0.118, p = 0.071) and migration status (β = 0.113, p = 0.069). At T1 patients with pretreatment(s) (OR = 0.284 [95% CI: 0.144, 0.560], p<0.001) and multiple diagnoses (OR = 0.678 [95% CI: 0.472, 0.973], p = 0.035) were significantly and clinically relevant less likely to show a remission of depressive symptoms. In addition, a potentially clinically meaningful effect of migration status on remission of depressive symptoms (OR = 0.562 [95% CI: 0.264, 1.198], p = 0.136) cannot be ruled out. For somatoform symptoms pretreatment(s) (OR = 0.403, [95% CI: 0.156, 1.041], p = 0.061) and education (OR = 1.603, [95% CI: 0.670, 3.839], p = 0.289) may be regarded as clinically relevant predictors for remission. Conclusion The results of our study suggest that migration status has a clinically relevant influence on severity of somatoform and depressive symptoms at admission. Clinical relevance of migration status can also be assumed regarding the remission of depression. Migration status and further factors affecting the effectiveness of the treatment should be analyzed in future research among larger samples with sufficient power to replicate these findings.
Collapse
Affiliation(s)
- Friederike Kobel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Yesim Erim
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Eva Morawa
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
- * E-mail:
| |
Collapse
|
5
|
Kostareva U, Albright CL, Berens EM, Levin-Zamir D, Aringazina A, Lopatina M, Ivanov LL, Sentell TL. International Perspective on Health Literacy and Health Equity: Factors That Influence the Former Soviet Union Immigrants. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E2155. [PMID: 32213891 PMCID: PMC7142703 DOI: 10.3390/ijerph17062155] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 03/07/2020] [Accepted: 03/16/2020] [Indexed: 12/19/2022]
Abstract
Among the world's 272 million international migrants, more than 25 million are from the former Soviet Union (FSU), yet there is a paucity of literature available about FSU immigrants' health literacy. Besides linguistic and cultural differences, FSU immigrants often come from a distinct healthcare system affecting their ability to find, evaluate, process, and use health information in the host countries. In this scoping review and commentary, we describe the health literacy issues of FSU immigrants and provide an overview of FSU immigrants' health literacy based on the integrated health literacy model. We purposefully consider the three most common locations where FSU immigrants have settled: the USA, Germany, and Israel. For context, we describe the healthcare systems of the three host countries and the two post-Soviet countries to illustrate the contribution of system-level factors on FSU immigrants' health literacy. We identify research gaps and set a future research agenda to help understand FSU immigrants' health literacy across countries. Amidst the ongoing global population changes related to international migration, this article contributes to a broad-scope understanding of health literacy among FSU immigrants related to the system-level factors that may also apply to other immigrants, migrants, and refugees.
Collapse
Affiliation(s)
- Uliana Kostareva
- School of Nursing and Dental Hygiene, University of Hawai’i at Mānoa, Honolulu, HI 96822, USA;
| | - Cheryl L. Albright
- School of Nursing and Dental Hygiene, University of Hawai’i at Mānoa, Honolulu, HI 96822, USA;
| | - Eva-Maria Berens
- Interdisciplinary Center for Health Literacy Research, Bielefeld University, 33699 Bielefeld, Germany;
| | - Diane Levin-Zamir
- Department of Health Education and Promotion, Clalit Health Services, School of Public Health, University of Haifa, Haifa 31000, Israel;
| | - Altyn Aringazina
- Kazakhstan School of Public Health, Medical University, Almaty 050000, Kazakhstan;
| | - Maria Lopatina
- National Medical Research Center for Therapy and Preventive Medicine of the Ministry of Health of the Russian Federation, 101000 Moscow, Russia;
| | - Luba L. Ivanov
- Chamberlain College of Nursing, Chamberlain University, Downers Grove, 60515 IL, USA;
| | - Tetine L. Sentell
- Office of Public Health Studies, University of Hawai’i at Mānoa, Honolulu, HI 96822, USA;
| |
Collapse
|
6
|
Does Labor Market Position Explain the Differences in Self-Rated Health between Employed Immigrants and Native Swedes: a Population-Based Study from Southern Sweden. JOURNAL OF INTERNATIONAL MIGRATION AND INTEGRATION 2019. [DOI: 10.1007/s12134-018-0620-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
7
|
Schubert CC, Punamäki RL, Suvisaari J, Koponen P, Castaneda A. Trauma, Psychosocial Factors, and Help-Seeking in Three Immigrant Groups in Finland. J Behav Health Serv Res 2018; 46:80-98. [DOI: 10.1007/s11414-018-9587-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
8
|
Engelman M, Kestenbaum BM, Zuelsdorff ML, Mehta NK, Lauderdale DS. Work Disability Among Native-born and Foreign-born Americans: On Origins, Health, and Social Safety Nets. Demography 2017; 54:2273-2300. [PMID: 28975558 PMCID: PMC5705426 DOI: 10.1007/s13524-017-0617-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Public debates about both immigration policy and social safety net programs are increasingly contentious. However, little research has explored differences in health within America's diverse population of foreign-born workers, and the effect of these workers on public benefit programs is not well understood. We investigate differences in work disability by nativity and origins and describe the mix of health problems associated with receiving Social Security Disability Insurance benefits. Our analysis draws on two large national data sources-the American Community Survey and comprehensive administrative records from the Social Security Administration-to determine the prevalence and incidence of work disability between 2001 and 2010. In sharp contrast to prior research, we find that foreign-born adults are substantially less likely than native-born Americans to report work disability, to be insured for work disability benefits, and to apply for those benefits. Overall and across origins, the foreign-born also have a lower incidence of disability benefit award. Persons from Africa, Northern Europe, Canada, and parts of Asia have the lowest work disability benefit prevalence rates among the foreign-born; persons from Southern Europe, Western Europe, the former Soviet Union, and the Caribbean have the highest rates.
Collapse
Affiliation(s)
- Michal Engelman
- Department of Sociology and Center for Demography and Ecology, University of Wisconsin-Madison, 1180 Observatory Drive, Madison, WI, 53704, USA.
| | - Bert M Kestenbaum
- Office of the Chief Actuary, Social Security Administration, Baltimore, MD, USA
| | - Megan L Zuelsdorff
- Center for Demography of Health and Aging, University of Wisconsin-Madison, Madison, WI, USA
| | - Neil K Mehta
- Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Diane S Lauderdale
- Department of Public Health Sciences, University of Chicago, Chicago, IL, USA
| |
Collapse
|
9
|
Smith KM, Chesin MS, Jeglic EL. Minority College Student Mental Health: Does Majority Status Matter? Implications for College Counseling Services. JOURNAL OF MULTICULTURAL COUNSELING AND DEVELOPMENT 2014. [DOI: 10.1002/j.2161-1912.2014.00046.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Kellie M. Smith
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, and VA Greater Los Angeles Healthcare System
| | - Megan S. Chesin
- Department of Psychology, John Jay College of Criminal Justice, City University of New York
- Now at Department of Psychiatry, Molecular Imaging and Neuropathology Division, Columbia University, New York State Psychiatric Institute
| | - Elizabeth L. Jeglic
- Department of Psychology, John Jay College of Criminal Justice, City University of New York
| |
Collapse
|
10
|
[Mental health of Polish immigrants compared to that of the Polish and German populations]. ZEITSCHRIFT FUR PSYCHOSOMATISCHE MEDIZIN UND PSYCHOTHERAPIE 2013; 59:209-17. [PMID: 23775558 DOI: 10.13109/zptm.2013.59.2.209] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES This survey examines the mental health of immigrants of Polish origin compared to samples from the Polish and German populations. METHODS In a sample of 513 subjects (261 persons with Polish migration background and 252 autochthone Poles) depression (BDI), anxiety (BAI), and somatic complaints (GBB-24) were measured. RESULTS Immigrants of Polish origin showed a significantly higher level of anxiety as well as somatic complaints but only a tendency toward higher depressiveness than the German normvalue, but not than that of the native Poles. Female immigrants showed an overall higher number of symptoms in the three domains in question compared to German women and - except for depressiveness - also compared to male immigrants. CONCLUSIONS Persons with a Polish migration background present levels of mental distress higher than the general German population, but similar to the population of their country of origin. Further research is needed to clarify the special structure of the mental morbidity in Polish immigrants.
Collapse
|
11
|
Dunlavy AC, Rostila M. Health inequalities among workers with a foreign background in Sweden: do working conditions matter? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2013; 10:2871-87. [PMID: 23846669 PMCID: PMC3734464 DOI: 10.3390/ijerph10072871] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/03/2013] [Revised: 07/01/2013] [Accepted: 07/01/2013] [Indexed: 01/22/2023]
Abstract
Employment and working conditions are key social determinants of health, yet current information is lacking regarding relationships between foreign background status, working conditions and health among workers in Sweden. This study utilized cross-sectional data from the 2010 Swedish Level of Living Survey (LNU) and the Level of Living Survey for Foreign Born Persons and their Children (LNU-UFB) to assess whether or not health inequalities exist between native Swedish and foreign background workers and if exposure to adverse psychosocial and physical working conditions contributes to the risk for poor health among foreign background workers. A sub-sample of 4,021 employed individuals aged 18-65 was analyzed using logistic regression. Eastern European, Latin American and Other Non-Western workers had an increased risk of both poor self-rated health and mental distress compared to native Swedish workers. Exposure to adverse working conditions only minimally influenced the risk of poor health. Further research should examine workers who are less integrated or who have less secure labor market attachments and also investigate how additional working conditions may influence associations between health and foreign background status.
Collapse
Affiliation(s)
- Andrea C Dunlavy
- Centre for Health Equity Studies, Stockholm University/Karolinska Institute, SE-106 91 Stockholm, Sweden.
| | | |
Collapse
|
12
|
Missinne S, Bracke P. Depressive symptoms among immigrants and ethnic minorities: a population based study in 23 European countries. Soc Psychiatry Psychiatr Epidemiol 2012; 47:97-109. [PMID: 21110000 DOI: 10.1007/s00127-010-0321-0] [Citation(s) in RCA: 125] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2010] [Accepted: 11/04/2010] [Indexed: 11/30/2022]
Abstract
PURPOSE European studies about ethnic inequalities in depressive symptoms are scarce, show inconclusive results and are complicated by the discussion of what constitute (im)migrant and ethnic minority groups. Moreover, comparisons across countries are hampered by a lack of comparable measures of depressive symptoms. This study aims to assess the prevalence and determinants of depressive symptoms among immigrants, ethnic minorities and natives in 23 European countries. METHODS Multilevel analyses are performed using data from the third wave of the European Social Survey (ESS-3). This dataset comprises information about 36,970 respondents, aged 21 years or older, of whom 13.3% immigrants and 6.2% ethnic minorities. Depressive symptoms were assessed with an 8-item version of the Center for Epidemiologic Studies-Depression scale. Main determinants are immigrant status, socio-economic conditions and the experience of ethnic discrimination in the host country. RESULTS The results show that immigrants and ethnic minorities do experience more depressive symptoms than natives in an essential part of the countries. Moreover, socio-economic conditions and the experience of ethnic discrimination are important risk factors. Immigrant status seems irrelevant, once the other risk factors are accounted for. Finally, immigrant and ethnic minority groups do not consist of the same individuals and therefore have different prevalence rates of depressive symptoms. CONCLUSIONS The prevalence rates of depressive symptoms are higher for immigrant and ethnic minority groups in a substantial part of the European countries. A clear definition is indispensable for developing policies that address the right-targeted population.
Collapse
Affiliation(s)
- Sarah Missinne
- Department of Sociology, Ghent University, Korte Meer 5, 9000 Ghent, Belgium.
| | | |
Collapse
|
13
|
Huang C, Mehta NK, Elo IT, Cunningham SA, Stephenson R, Williamson DF, Venkat Narayan KM. Region of Birth and Disability Among Recent U.S. Immigrants: Evidence from the 2000 Census. POPULATION RESEARCH AND POLICY REVIEW 2011; 30:399-418. [PMID: 21666828 PMCID: PMC3110007 DOI: 10.1007/s11113-010-9194-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
This study aimed to test the "healthy immigrant" hypothesis and assess health heterogeneity among newly arrived working-age immigrants (18-64 years) from various regions of origin. Using the 5% sample of the 2000 U.S. Census (PUMS), we found that, compared with their native-born counterparts, immigrants from all regions of the world were less likely to report mental disability and physical disability. Immigrants from selected regions of origin were, however, more likely to report work disability. Significant heterogeneity in disabilities exists among immigrants: Those from Eastern Europe and Southeast Asia reported the highest risk of mental and physical disability, and those from East Asia reported the lowest risk of physical disability. Furthermore, Mexican immigrants reported the lowest risk of mental disability, and Canadian immigrants reported the lowest risk of work disability. Socioeconomic status and English proficiency partially explained these differences. The health advantage of immigrants decreased with longer U.S. residence.
Collapse
Affiliation(s)
- Cheng Huang
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, 1599 Clifton Road, NE., Room 6404, Atlanta, GA 30322, USA
| | - Neil K. Mehta
- School of Public Health, University of Michigan, Ann Arbor, USA
| | - Irma T. Elo
- Population Studies Center, University of Pennsylvania, Philadelphia, USA
| | - Solveig A. Cunningham
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, 1599 Clifton Road, NE., Room 6404, Atlanta, GA 30322, USA
| | - Rob Stephenson
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, 1599 Clifton Road, NE., Room 6404, Atlanta, GA 30322, USA
| | - David F. Williamson
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, 1599 Clifton Road, NE., Room 6404, Atlanta, GA 30322, USA
| | - K. M. Venkat Narayan
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, 1599 Clifton Road, NE., Room 6404, Atlanta, GA 30322, USA
| |
Collapse
|
14
|
Wrapson W, Mewse AJ. Does the doctor or the patient control sick leave certification? A qualitative study interpreting patients' interview dialogue. Fam Pract 2011; 28:202-9. [PMID: 20978243 DOI: 10.1093/fampra/cmq088] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Sickness certification poses challenges and problems for the GP. Patient factors may influence the sick leave period. OBJECTIVE To explore how sickness certification occurred based on patients' reports of medical consultations for a new episode of low back pain. METHODS A qualitative study using semi-structured interviews with 16 employees who were currently or had recently been off work with an episode of low back pain. RESULTS We present a preliminary typology of sickness certification responses by medical practitioners comprising four response types: 'process', 'cued', 'consultative' and 'laissez-faire'. All but the process response allows the patient some influence in the sickness certification decision. It is possible that certain types of response may occur at specific stages of recovery. CONCLUSIONS Doctors may allow patients input into the sickness certification process for a number of reasons. As yet, we do not know if this helps or hinders the return to work process.
Collapse
Affiliation(s)
- Wendy Wrapson
- Centre of Methods and Policy Application in the Social Sciences, The University of Auckland, Auckland 1142, New Zealand.
| | | |
Collapse
|
15
|
Mewes R, Rief W, Martin A, Glaesmer H, Brähler E. Somatoforme Symptome, Angst und Depression bei Migranten aus der Türkei, aus Osteuropa und aus der ehemaligen Sowjetunion. ACTA ACUST UNITED AC 2010. [DOI: 10.1024/1661-4747.a000024] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Hintergrund: Gegenüberstellende epidemiologische Studien zur psychischen Gesundheit bei verschiedenen Migrantengruppen in Deutschland fehlen weitgehend. Sie sind jedoch von großer Wichtigkeit, um den Therapiebedarf für diese Gruppen zu bestimmen und Angebote entsprechend auszurichten. Die vorliegende Studie möchte die Ausprägung einer depressiven, somatoformen und angstbezogenen Symptomatik bei osteuropäischen, türkischen und Migranten aus der ehemaligen Sowjetunion in der Allgemeinbevölkerung miteinander vergleichen und untersuchen, ob es Unterschiede in der Bereitschaft gibt, für verschiedene Beschwerden einen Arzt aufzusuchen. Methode: 43 osteuropäische Migranten (beide Eltern in Polen, Rumänien, Slowakischer Republik, Tschechischer Republik oder Ungarn geboren), 49 Migranten aus der ehemaligen Sowjetunion (beide Eltern in Russland, Ukraine, Weißrussland oder Kasachstan geboren; Russlanddeutsche Personen fallen auch in diese Gruppe) und 42 Personen mit türkischem Migrationshintergrund wurden mit dem Patient-Health-Questionnaire auf depressive, somatoforme und angstbezogene Symptome untersucht und mit einem Fragebogen zu ihrer Bereitschaft befragt, für verschiedene Beschwerden einen Arzt aufzusuchen. Die Gruppen wurden mit Varianzanalysen unter Kontrolle möglicher konfundierender Variablen miteinander verglichen. Ergebnisse: Unter Kontrolle von Geschlecht, Alter, Partnerschaft und Erwerbstätigkeit zeigten sich keine signifikanten Unterschiede in depressiver, somatoformer und ängstlicher Symptomatik zwischen den drei Gruppen. Unter Kontrolle für Alter und Geschlecht zeigten sich ebenfalls keine Unterschiede in der Bereitschaft, für verschiedene Beschwerden einen Arzt aufzusuchen. Frauen berichteten mehr somatoforme Beschwerden als Männer und zeigten eine höhere Bereitschaft, einen Arzt zu konsultieren. Diskussion: Es lassen sich keine kulturellen Einflüsse in Bezug auf die psychische Gesundheit und den Umgang mit verschiedenen Beschwerden bei diesen eher gut integrierten Migranten feststellen. Weitere Studien zu dieser Fragestellung mit größeren Stichproben und unter Einbezug schlechter Deutsch sprechender Migranten wären wünschenswert.
Collapse
Affiliation(s)
- Ricarda Mewes
- Klinische Psychologie und Psychotherapie, Philipps-Universität Marburg
| | - Winfried Rief
- Klinische Psychologie und Psychotherapie, Philipps-Universität Marburg
| | - Alexandra Martin
- Abteilung für Psychosomatik: Psychotherapieforschung, Universitätsklinikum Erlangen, Universität Erlangen-Nürnberg
| | - Heide Glaesmer
- Medizinische Psychologie und Medizinische Soziologie, Universität Leipzig
| | - Elmar Brähler
- Medizinische Psychologie und Medizinische Soziologie, Universität Leipzig
| |
Collapse
|
16
|
Ponizovsky AM, Grinshpoon A. Mood and anxiety disorders and the use of services and psychotropic medication in an immigrant population: findings from the Israel National Health Survey. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2009; 54:409-19. [PMID: 19527561 DOI: 10.1177/070674370905400608] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Using the Israel National Health Survey (INHS), we compared immigrants' 12-month prevalence of mental disorders and the use of services and psychotropic drugs with that of the general population. METHODS A representative sample of noninstitutionalized residents, aged 21 years and older, was drawn from the National Population Register. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) disorders were assessed using a revised version of the Composite International Diagnostic Interview. Respondents were asked to report any health service and psychotropic drug use in the past 12 months. RESULTS During the 12 months preceding the INHS, immigrants and Israelis (that is, those born in Israel or those who emigrated to Israel before 1989) were equally likely to have a common mental disorder (OR 0.9; 95% CI 0.7 to 1.1) and to use health services (OR 0.9; 95% CI 0.7 to 1.2). However, among respondents who did not meet the DSM-IV criteria for a specific mental disorder, the immigrants reported markedly more use of psychotropic drugs than the Israelis, in particular more anxiolytics, mood stabilizers, and hypnotics. CONCLUSION The results suggest that the common mental disorders and mental health service use among the immigrants are no higher than that among their Israeli counterparts. The higher use of psychotropic drugs by immigrants may be an indirect indicator of a higher level of psychological distress symptoms, such as anxiety, depression, and sleep disorders.
Collapse
|
17
|
Abstract
PURPOSE To explore the meaning of health among midlife Russian-speaking women from the former Soviet Union. DESIGN AND METHODOLOGY A hermeneutic phenomenological design was used. Study participants included 12 Russian-speaking women ages 40-61, who also spoke English and had migrated to the United States after 1991. FINDINGS These themes were identified: health as being highly valued, though less of a priority during immigration; being a stranger and seeking the familiar; grieving and loss and building a new life; experiencing changes and transitions; trusting self; and the importance of hope. CONCLUSIONS Although health was less of a priority during the immigration process, the women valued and were knowledgeable about health, participated in self-care practices, trusted their own abilities to make self-care decisions, and sought health-related information. This is a vulnerable population at risk for the onset of chronic medical conditions associated with the process of aging, past exposures, the tendency to avoid health screening, and current stressors related to immigration and family responsibilities. Implications include the need for interventions to build trust, assess self-care practices, and understand values and beliefs concerning health screening. Future research recommendations include replication with other samples within this population and exploring curative beliefs and practices more fully. Ultimately, this study design could be applied to other immigrant populations in Western cultures. CLINICAL RELEVANCE Midlife Russian speaking women from the former Soviet Union are a vulnerable group at risk for the onset of chronic medical conditions associated with aging, past exposures, the tendency to avoid health screening, and current stressors related to immigration and family responsibilities.
Collapse
|
18
|
Ekblad S. Mental health among recent immigrants to Sweden from Eastern Europe and the former Soviet Union. Int Psychiatry 2008; 5:55-57. [PMID: 31507944 PMCID: PMC6734830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/30/2022] Open
Abstract
Several European states such as Sweden have become transit countries for migrants, as well as reception countries for an increasing number of young migrants, not only asylum seekers and refugees from beyond Europe but also from the European Union's new members, after the dissolution of the Soviet bloc in 1989 and then the Soviet Union itself in 1991. Over 110 000 immigrants from Eastern Europe and the former Soviet Union resided in Sweden in 2002, although the exact figure is difficult to estimate because of the varied legal status of the migrants. International migration is not a new phenomenon in this part of the world, of course: people have always moved in the search of greater personal safety, among other reasons. However, new groups with new psychosocial needs and demands on the healthcare systems of the host countries will be a challenge. The aim of this article is to give an overview of three sets of empirical data: the prevalence of mental disorders among recent immigrants to Sweden from Eastern Europe and the former Soviet Uniontheir access to mental health and social care facilities arising from their legal statustheir utilisation of health and social services.
Collapse
Affiliation(s)
- Solvig Ekblad
- Associate Professor in Transcultural Psychology, Stress Research Institute, Stockholm University, email
| |
Collapse
|
19
|
Ekblad S. Mental health among recent immigrants to Sweden from Eastern Europe and the former Soviet Union. Int Psychiatry 2008. [DOI: 10.1192/s1749367600002058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Several European states such as Sweden have become transit countries for migrants, as well as reception countries for an increasing number of young migrants, not only asylum seekers and refugees from beyond Europe but also from the European Union's new members, after the dissolution of the Soviet bloc in 1989 and then the Soviet Union itself in 1991. Over 110000 immigrants from Eastern Europe and the former Soviet Union resided in Sweden in 2002, although the exact figure is difficult to estimate because of the varied legal status of the migrants. International migration is not a new phenomenon in this part of the world, of course: people have always moved in the search of greater personal safety, among other reasons. However, new groups with new psychosocial needs and demands on the healthcare systems of the host countries will be a challenge. The aim of this article is to give an overview of three sets of empirical data:
•the prevalence of mental disorders among recent immigrants to Sweden from Eastern Europe and the former Soviet Union•their access to mental health and social care facilities arising from their legal status•their utilisation of health and social services
Collapse
|