Mental Health
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Contents |
Overview
Migration and its accompanying stressors have been associated with a number of mental health problems, such as depression, anxiety, post-traumatic stress and schizophrenia. At the same time, the use of mental health services by ethnic minorities often differs from that of the majority and questions have arisen on the cultural validity of diagnoses.
Migration, acculturation and mental health
Migration and its accompanying stressors affect migrating individuals and their families. Migration has been associated with depression and psychiatric problems for many years and in order to understand the impact of migration on mental health adjustment it is important to look at types of mental stresses, psychological mechanisms which are adapted and the kinds of resources that are utilised, and the outcomes of mental health based on individual processes of adjustment.
Bhugra (2004) regards migration as not just a phase, but a series of events, which are influenced by a number of factors over a prolonged period of time and these phases in return are influenced by other factors at social and individual levels. In his article, he provides a comprehensive graph of risk and protective factors during the process of migration.
More information on Bhugra (2004)
Bhugra D (2004). Migration and Mental Health. Acta Psychiatrica Scandinavica. 109.243-258. Abstract
Culture, ethnicity and mental health
Culture influences the definitions of mental illness in populations by defining the norms of behaviour and by indicating under which conditions apparently abnormal behaviour is culturally sanctioned. Culture is also related to coping behaviours, such as prayer, alcohol consumption and help-seeking. Culture also influences appraisals of distress. Lloyd (2006) identified the following factors that might explain the ethnic differences found in common mental health disorders:
- True ethnic differences
- Differences in idioms of distress i.e. symptom patterns of mental illness, expression of mental illness and cultural meaning of mental illness
- Problems with the research as in the culturally inappropriate instruments used, the different response rates in different ethnic groups and the few community-based studies that rely on service contact
- Other factors such as differences in socioeconomic status, differences in acculturation and differences in language
- Access to services-factors such as the stigma of mental illness, discrimination, perceptions of mental illness and detection by health professionals
Bhui, K., Stansfeld, S., Hull, S. e.a. (2003). Ethnic variations in pathways to and use of specialist mental health services in the UK: systematic review. British Journal of Psychiatry, 182, p. 105-116. Download article
Lloyd K (2006). Common Mental Health Disorders among Black and Minority Ethnic Groups in the UK. Psychiatry. 5(11). 388-391. Abstract
Suresh K and Bhui K (2006). Ethnic Minority Patients' Access to Mental Health Services. Psychiatry. 5. 413-416. Abstract & full text
Prevalence of Mental Health Disorders among Black and Minority Ethnic groups in the UK
When looking at the prevalence of mental health disorders in migrants and minorities, the above factors identified by Lloyd (2006) should all be taken into consideration. In the research on common mental health disorders in migrants and minorities the following focus has often been on the following mental health disorders:
- Depressive disorders
- Anxiety disorders
- Post-traumatic disorder (particularly in refugees and asylum seekers)
- Schizophrenia and psychosis
- Self-harm (especially in South Asian young women)
Bhugra D (2004). Migration and Mental Health. Acta Psychiatrica Scandinavica. 109.243-258. Abstract
Lloyd K (2006). Common Mental Health Disorders among Black and Minority Ethnic Groups in the UK. Psychiatry. 5(11). 388-391. Abstract
Reports on BME mental health
S. P. Sashidharan (2003) INSIDE/OUTSIDE: Improving Mental Health Services for Black and Minority Ethnic Communities in England. London: Department of Health. Download here
"The report, launched by Health Minister Jacqui Smith on 10 March 2003, signals an important step forward to support the reform of mental health services for people from black and minority ethnic communities in this country. It was prepared by a group of experts under the chairmanship of Professor Sashi Sashidharan, Medical Director of North Birmingham Mental Health Trust on behalf of the Mental Health Taskforce. In the report, Prof. Sashidharan sets out three key objectives and recommendations for change to improve the overall mental health of black and minority ethnic people living in England:
- To reduce and eliminate ethnic inequalities in mental health service experience and outcome.
- To develop the cultural capability of mental health services
- To engage the community and build capacity through community development workers."
Racism and mental health
Karlsen S, Nazroo JY, McKenzie K, Bhui K, Weich S (2005). Racism, psychosis and common mental disorder among ethnic minority groups in England. Psychol Med, 35(12), p. 1795-803. Abstract
See also Racism and Health
Specific topics
Access to Mental Health Services
Depression, Self-harm and Suicide
Post-traumatic stress disorder
Substance Abuse and Related Illnesses (including Alcoholism and Drug Abuse)
Employment of people with mental health problems
Specific groups
Mental health of refugees and asylum seekers
Mental health of children and young people
Mental health of refugee children and unaccompanied minors
