Work

Determinants of Mental Illness Among Humanitarian Migrants: Longitudinal Analysis of Findings From the First Three Waves of a Large Cohort Study

Year: 2018

Type: article

Abstract: Background: As refugee numbers grow worldwide, understanding prevalence and determinants of mental illness in this population becomes increasingly important. We used longitudinal data to examine the initial years of resettlement in Australian refugees with a focus on ethnic-like social support. Methods: Three annual waves from a longitudinal, nationally representative cohort of 2399 humanitarian migrants recently resettled in Australia were examined for two mental illness outcomes: Posttraumatic Stress Disorder indicated by positive PTSD-8 screen; and 'High risk of Severe Mental Illness' (HR-SMI) by Kessler Psychological Distress Scale (K6) ≥19. Generalised linear mixed models examined demographic and resettlement factors. Findings: Contrary to predictions, high prevalence of mental illness persisted over 3 years. At baseline, 30·3% (95%CI 28·5-32·2) screened positive for PTSD and 15·4% (95%CI 14·0-16·9) had HR-SMI. Over the 3-years, 52·2% met screening criteria for mental illness. PTSD was associated with older age, females, Middle Eastern birthplace, increasing traumatic events, more financial hardships, having a chronic health condition and poor self-rated health. HR-SMI was associated with females, Middle Eastern birthplace, unstable housing, more financial hardships, having a chronic health condition, poor self-rated health, and discrimination. Also contrary to predictions like-ethnic social support was positively associated with PTSD (OR: 1.51, 95%CI 1·10-2·09). Interpretation: There is high prevalence of mental illness throughout initial years of resettlement for refugees migrating to Australia. Our unexpected finding regarding like-ethnic social support raises future avenues for research. Predictors of mental illness in the post-migration context represent tangible opportunities for intervention and are likely relevant to similar resettlement settings globally. Funding Statement: Funding source for access to data was Monash University. Funding for the original BNLA questionaire design and data collection was provided by the Department of Human Services (Australian Government), from whom the authors are independent.Declaration of Interests: Dr. Enticott has nothing to disclose. Mr. Cooper has nothing to disclose. Dr. Meadows has nothing to disclose. Dr. Shawyer has nothing to disclose.Ethics Approval Statement: The study was deemed as exempt from review by the Chairs of the Monash University Human Research Ethics Committee (MUHREC). The Committee did not consider this to require a submission to MUHREC for ethical clearance, as the study accessed and analysed a dataset that was designed for sharing.

Source: Frontiers in Psychiatry

DOI: 10.2139/ssrn.3271431

Authors: Sam Cooper, Joanne Enticott, Frances Shawyer, Graham Meadows

Institutions: Monash University, The University of Melbourne, Monash Health

Language: English

Topic: Migration, Health and Trauma

Subfield: Clinical Psychology

Field: Psychology

Domain: Social Sciences

SDGs: Good health and well-being, Reduced inequalities

Open Access status: gold

Estimated APC paid: $3,801