Year: 2017
Type: article
Study design: Observational Study
Abstract: Background Migrants are subject to excess risk factors for psychiatric disorders. However, utilization of psychiatric services among migrants in host countries is often distinct from native populations. This project explores differences in utilization of psychiatric care between Swedish born and migrants, here defined as those born abroad who moved to and settled in Sweden. Methods Study design: Population based cohort study. Setting: Linked data of 4756076 people from Swedish health and population-registers. Study participants: Persons born 1944 to 1993, Swedish born and foreign born who arrived in Sweden prior to 2001, resident in Sweden 2001 to 2011; and foreign born who arrived after 2001, resident in Sweden 2010 and 2011. Statistics: Cox logistic regression. Outcome measures: Inpatient/outpatient psychiatric care, prescribed psychotropic medication. Results Population included 3890176 Swedish born and 865900 foreign born, of which 560428 arrived in Sweden prior to 2001, and 305,472 arrived 2001 to 2010. Foreign born individuals who arrived before 2001, compared to Swedish born, used psychiatric care to a higher extent, Hazard Ratio (HR) 1.34, 95% Confidence Interval (CI) 1.34-1.35. Those who arrived before 2001 had higher likelihood of inpatient care (HR 1.36, CI 1.34-1.37), outpatient care (HR 1.42, CI 1.41-1.43) and receipt of prescribed medication (HR 1.34, 1.33-1.34). In contrast, compared to Swedish born, those who migrated post 2001 had lower likelihood of total psychiatric care (HR 0.65, CI 0.64-0.65), lower inpatient (HR 0.47, CI 0.46-0.49), outpatient (HR 0.56, CI 0.55-0.57) and prescribed medication (HR 0.67, CI 0.66-0.67). Conclusions Migrants demonstrate a distinct profile of psychiatric care utilization compared to Swedish born, and care use varies between migrant groups by time in host country. This may be due to differing conceptions of mental illness, levels of health literacy, or may represent systematic barriers to psychiatric care for migrants. Key messages: Migrants have distinct profiles of psychiatric care utilization compared to Swedish born. A deeper understanding of migrants’ pathways to care is needed to ensure equitable provision of services.
Authors: E Mackay, AC Hollander, C Dalman, J Kirkbride, S Bäärnhielm
Institutions: Karolinska Institutet, University College London
Language: English
Topic: Migration, Health and Trauma
Subfield: Clinical Psychology
Field: Psychology
Domain: Social Sciences
Open Access status: bronze
OpenAlex ID: W2765505689