Year: 2018
Type: article
Study design: Observational Study
Abstract: Background: Migrants are subject to excess risk factors for psychiatric disorders. However, use of psychiatric services among migrants in host countries is often distinct from native populations. This project explores differences in use 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 4,756,076 people from Swedish health and population-registers. Study participants: Persons born 1944 to 1993, Swedish born and foreign born who arrived in Sweden before 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: The population included 3,890,176 Swedish born and 865,900 foreign born, of whom 560,428 arrived in Sweden before 2001, and 305,472 arrived 2001 to 2010. Foreign born individuals who arrived before 2001, compared to Swedish born, used psychiatric care to a greater extent (Hazard Ratio (HR) 1.34, 95% Confidence Interval (CI) 1.34-1.35. Those who arrived before 2001 had a 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 the Swedish born, those who migrated post 2001 had a lower likelihood of total psychiatric care (HR 0.65, CI 0.64-0.65), lower inpatient care (HR 0.47, CI 0.46-0.49), outpatient care (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 in their use of psychiatric care compared to Swedish born, and care use varies between migrant groups by the length of time in the host country. This may reflect systematic barriers to psychiatric care for migrants. Main messages: Migrants to Sweden achieve worse profiles of psychiatric care than Swedish born. This may indicate exclusion from health systems.
Authors: E Mackay, A Hollander, S Bäärnhielm, J Kirkbride, C Dalman
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: W2802266137