Utilisation of psychiatrists and psychologists in private practice among non-Western labour immigrants, immigrants from refugee-generating countries and ethnic Danes: the role of mental health status

TY - JOUR

T1 - Utilisation of psychiatrists and psychologists in private practice among non-Western labour immigrants, immigrants from refugee-generating countries and ethnic Danes

T2 - the role of mental health status

AU - Nielsen, Signe Smith

AU - Jensen, Natasja Koitzsch

AU - Kreiner, Svend

AU - Nørredam, Marie Louise

AU - Krasnik, Allan

PY - 2015/1/1

Y1 - 2015/1/1

N2 - Purpose: The stressful migration process has been associated with higher vulnerability for mental health problems, implying a greater need for mental healthcare among immigrants compared with native-born. Our objective was to investigate whether potential differences in the use of psychiatrists and psychologists in labour immigrants, immigrants from refugee-generating countries (RGC), and ethnic Danes could be fully explained by mental health status. Methods: We conducted a nationwide survey in 2007 with 3,573 individuals aged 18–66 comprising ethnic Danes, labour immigrants (Pakistan and Turkey), and immigrants from RGC (Iran, Iraq, Lebanon, and Somalia). Survey data was linked to healthcare utilisation registries. Using Poisson regression, contacts with private practising psychiatrists and psychologists were estimated. Analyses were adjusted for socioeconomic factors and mental health status. Results: Overall, 2.2 % among ethnic Danes, 1.4 % among labour immigrants and 6.5 % among immigrants from RGC consulted a psychiatrist or psychologist. In adjusted analyses, for psychiatrists, compared with ethnic Danes, labour-immigrant women (multiplicative effect = 1.78), and immigrant women from RGC (multiplicative effect = 2.49) had increased use, while labour-immigrant men had decreased use (multiplicative effect = 0.03). For psychologists, immigrant men from RGC had increased use (multiplicative effect = 2.96), while labour-immigrant women had decreased use (multiplicative effect = 0.27) compared with ethnic Danes. Conclusions: Mental health status had a somewhat explanatory effect on the use of psychiatrists and psychologists. These selected parts of the Danish mental healthcare system seem responsive to health needs across different population groups, particularly for immigrants from RGC. Yet more attention should be given to non-Western labour immigrants to meet their mental health needs.

AB - Purpose: The stressful migration process has been associated with higher vulnerability for mental health problems, implying a greater need for mental healthcare among immigrants compared with native-born. Our objective was to investigate whether potential differences in the use of psychiatrists and psychologists in labour immigrants, immigrants from refugee-generating countries (RGC), and ethnic Danes could be fully explained by mental health status. Methods: We conducted a nationwide survey in 2007 with 3,573 individuals aged 18–66 comprising ethnic Danes, labour immigrants (Pakistan and Turkey), and immigrants from RGC (Iran, Iraq, Lebanon, and Somalia). Survey data was linked to healthcare utilisation registries. Using Poisson regression, contacts with private practising psychiatrists and psychologists were estimated. Analyses were adjusted for socioeconomic factors and mental health status. Results: Overall, 2.2 % among ethnic Danes, 1.4 % among labour immigrants and 6.5 % among immigrants from RGC consulted a psychiatrist or psychologist. In adjusted analyses, for psychiatrists, compared with ethnic Danes, labour-immigrant women (multiplicative effect = 1.78), and immigrant women from RGC (multiplicative effect = 2.49) had increased use, while labour-immigrant men had decreased use (multiplicative effect = 0.03). For psychologists, immigrant men from RGC had increased use (multiplicative effect = 2.96), while labour-immigrant women had decreased use (multiplicative effect = 0.27) compared with ethnic Danes. Conclusions: Mental health status had a somewhat explanatory effect on the use of psychiatrists and psychologists. These selected parts of the Danish mental healthcare system seem responsive to health needs across different population groups, particularly for immigrants from RGC. Yet more attention should be given to non-Western labour immigrants to meet their mental health needs.

KW - Faculty of Health and Medical Sciences

KW - Mental Health

KW - Mental Health Services

KW - psychologist

KW - psychiatrist

KW - utilization

KW - healthcare use

KW - immigrants

KW - refugees

KW - labour migrants

U2 - 10.1007/s00127-014-0916-y

DO - 10.1007/s00127-014-0916-y

M3 - Journal article

C2 - 24976522

SN - 0933-7954

VL - 50

SP - 67

EP - 76

JO - Social Psychiatry and Psychiatric Epidemiology

JF - Social Psychiatry and Psychiatric Epidemiology

IS - 1

ER -