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  1. Home
  2. Books
  3. Migration and Mental Health
  • Cited by 30
Publisher:
Cambridge University Press
Online publication date:
February 2011
Print publication year:
2010
Online ISBN:
9780511760990
DOI:
https://doi.org/10.1017/CBO9780511760990
Subjects:
Psychiatry and Clinical Psychology, Medicine, Psychiatry
Information

Book description

Human migration is a global phenomenon and is on the increase. It occurs as a result of 'push' factors (asylum, natural disaster), or as a result of 'pull' factors (seeking economic or educational improvement). Whatever the cause of the relocation, the outcome requires individuals to adjust to their new surroundings and cope with the stresses involved, and as a result, there is considerable potential for disruption to mental health. This volume explores all aspects of migration, on all scales, and its effect on mental health. It covers migration in the widest sense and does not limit itself to refugee studies. It covers issues specific to the elderly and the young, as well as providing practical tips for clinicians on how to improve their own cultural competence in the work setting. The book will be of interest to all mental health professionals and those involved in establishing health and social policy.

Reviews

'Readers and instructors interested in a broad introduction to issues concerning mental healthcare for migrant and ethnic minority populations will find this a useful volume.'

Source: Psychological Medicine

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Contents

Page 1 of 2

Contents
  • Chapter 7 - Risk and protective factors in mental health among migrants
    pp 98-106
  • View abstract

    Summary

    People have migrated from one place to another since the start of human existence, for all kinds of reasons and varying durations. The process of migration can be divided into three stages: pre-migration, migration and post-migration. The impact of migration on an individual's mental health is multifaceted and affects different aspects of the individual, whether it is biological, social or psychological. Migration involves a series of losses, such as the family and the familiar society; both emotional and structural losses are experienced. The relationship between social inequalities and mental health is well known and it is inevitable that if migrants suffer from social and economic inequalities they are also likely to suffer from mental ill-health, though the mediating factors may well vary. In cultures where Cartesian mind-body dualism is not a prevalent model, the interaction between somatic symptoms and psychological distress will be significant.
  • Chapter 8 - Psychosis, migration and ethnic minority status:
    pp 107-116
  • a story of inequality, rejection and discrimination
  • View abstract

    Summary

    This chapter focuses on the epidemiological study of major psychiatric illnesses among migrant groups and their offspring. The main focus is on psychotic disorders, for which there is most evidence of elevated rates in immigrant groups and their offspring. However, the evidence with regard to other psychiatric outcomes, such as common mental disorders, suicide and post-traumatic stress disorder (PTSD), is also considered. Potential policy recommendations are proposed to address the excess morbidity of mental illness in some immigrant and black and minority ethnic (BME) groups in the UK. Several hypotheses have been raised to explain elevated rates of psychotic disorders in immigrant groups and their offspring. The chapter reviews each hypothesis. Pathways to care for BME populations have been observed to differ from those of the white British group. The risk of suicide in BME groups appears to vary by sex and ethnicity.
  • Chapter 10 - Identity, idioms and inequalities:
    pp 128-138
  • providing psychotherapies for South Asian women
  • View abstract

    Summary

    Epidemiological studies related to the field of migration have demonstrated that rates of psychotic disorders among some migrant groups are higher than expected. This chapter explores the factors related to returning migrants and internal migration. One of the major aspects of social changes following rapid globalisation from the second half of the last century is migration. Most studies used a cross-sectional design and assessed short-term and/or long-term effects of migration on mental health retrospectively. The time of investigation is a key issue in assessing the impact of migration on mental health. Earlier studies among immigrants suggested a negative migration effect on people who were in the early incipient stage of illness, notably schizophrenia, prior to migration. Influenced by both biological and psychological factors, cultural and social changes arising from migration may put vulnerable migrants at risk for developing mental problems.
  • Chapter 11 - Cultural bereavement, culture shock and culture conflict:
    pp 139-148
  • adjustments and reactions
  • View abstract

    Summary

    This chapter argues that the processes of globalization influence market, political and social forces. It suggests that various manifestations of globalisation include rapid communication, cheap modes of travel, increasing deregulation in economic matters and international political organisations. Economic factors add to the likelihood of developing psychiatric disorders and these are likely to be caused by industrialisation and urbanization. Studies over the past century have repeatedly identified migration as an important factor in the development of mental disorders in migrant communities. Rex draws a distinction between colonial societies and advanced metropolitan industrial societies which have lesser coercive sanctions. Colonial societies rely on these coercive sanctions and also have higher levels of racism and racialism. Another interesting and useful notion of the rise of the therapeutic culture of the self linked with more general political transformation has been described by Rose.
  • Chapter 12 - Collective trauma
    pp 149-158
  • View abstract

    Summary

    The migration process will be affected by personality characteristics and other factors such as education, socio-economic status, previous experience of migration and the social capital which people bring with them when they migrate. Several biological, psychological and social environmental and cultural factors interact and lead to the development of a bio-psycho-social model of aetiology and management. Individuals are born into a culture and not with a culture. Cultures are dynamic and keep changing as a result of coming into contact with other cultures, through direct or indirect contact. Social factors such as unemployment, poor housing, urbanisation, over-crowding and changes in family structure have been shown to be related to poor mental health. Poor educational background will influence pre- and post-migration experiences. After migration, the possibility of cultural bereavement, culture shock or cultural conflict will play a role in adjustment to the new culture.
  • Chapter 13 - Theimpact of acculturative stress on the mental health of migrants
    pp 159-172
  • View abstract

    Summary

    This chapter emphasises the role of social and economic inequalities in the production of both ethnic/racial differences in risk of mental illness, and in constructing the experience of ethnic/racial minorities in psychiatric care. It discusses the ethnic minority people's experiences of mental health services and the implications this has for healthcare provision and practice. Ethnic differences in risk of psychotic illnesses have been the primary focus of research in the mental health field, and most of this work has been based on studies of treatment rates. The chapter discusses non-health service-related factors: migration, genetics, culture, social and economic inequalities. One of the central problems with work on ethnicity and mental illness arises from the reliance of most work on data based on contact with treatment services. Generally, regardless of their ethnic background, people with mental health problems are critical of the services they receive.
  • Chapter 14 - Migration and mental health of older people
    pp 173-195
  • View abstract

    Summary

    This chapter points out that risk factors for deteriorating mental health among migrants are not only multiple but also multidimensional and interactive. Migration is a universal phenomenon and is inherent to the human condition. Since migration is not just one phenomenon, but a whole process involving a series of events, it will be influenced by a number of factors at social and individual levels. During this stage, risk factors can be divided into two categories: factors depending on personal characteristics of migrants and those linked to environmental factors. Age at migration plays an important role in the adaptation and adjustment to the new society and may represent a risk factor for psychological distress. Protective factors prevent psychological distress and mental illness among migrants. The process of migration and subsequent cultural and social adjustments play a key role in the mental health of migrants.
  • Chapter 15 - Migration and its effects on child mental health
    pp 196-208
  • View abstract

    Summary

    There is a growing consensus that the incidence of schizophrenia is increased among migrant populations. The aetiology and ethnicity in schizophrenia and other psychoses (AESOP) study was carried out in cities where migrants, their children and grandchildren have lived for many years. The hazard ratio for psychosis and depression for four increasingly urbanised areas was compared with the most rural/least urbanised area. In the AESOP study, the rates of schizophrenia and mania were elevated in South London compared to those in Nottingham and Bristol, and this difference persisted even when adjusting for differences in age and sex. One consequence of living in a deprived environment may be restricted access to resources, be these directly because of personal hardship, poverty or because of the lack of opportunity to access resources in the community. The association between ethnic identification and distress are mixed and complicated by contextual factors.
  • Chapter 16 - Mental health issues related to migration in women
    pp 209-219
  • View abstract

    Summary

    This chapter uses comparative data across Austria, Georgia, Ghana, Lithuania, Nigeria, Pakistan and Poland, and points out that paranoid schizophrenia was commoner in post-modern societies and migration status by itself had no impact on changing symptoms. Compared to the amount of literature concerning the high risk of certain migrant groups developing schizophrenia or bipolar disorder, little is known about the impact of migration on the psychopathology of psychoses. Schizophrenia subtypes are complex phenotypes with more or less typical symptoms which often differ not only in the cross-sectional psychopathology but also in prevalence, age at onset and outcome of disease. Within the migrants from traditional countries and the inhabitants of the modern countries, the distribution of most schizophrenia subtypes differed significantly. Differences were only seen in audible and visual hallucinations, in the so-called higher sensory perceptions. The data presented in the chapter highlights the impact of migration on symptoms of schizophrenia.
  • Chapter 18 - Adapting mental health services to the needs of migrants and ethnic minorities
    pp 231-244
  • View abstract

    Summary

    Identity is a multilayered and multifaceted concept. This chapter describes the link between culture and expression of symptoms and distress, and how culture influences help-seeking and affects recovery and health inequalities. Using clinical examples from South Asian women, the chapter illustrates clinical management issues and what clinicians may find useful in dealing with the problems with which patients present. The literature on the role of culture in the development of mental illness and the promotion of mental health makes use of numerous terms to denote specific cultural, religious, ethnic and racial groups. The early literature on South Asian women refers to a higher suicide rate among young women of Indian origin, and greater levels of self-harm amongst South Asian women. Somatic idioms of distress are common. This chapter predicates on the clinician/therapist being able to enquire about unusual beliefs and forms of identity with which they are unfamiliar.

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