Migrants Are Underrepresented in Mental Health and Rehabilitation Services—Survey and Register-Based Findings of Russian, Somali, and Kurdish Origin Adults in Finland
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Context in Finland
2.2. Study Design, Procedure, and Participants
2.3. Comparison Group of the General Population
2.4. Register-Based Data and Measurements
2.5. Survey Measurements
2.6. Analyses of the Register-Based and Survey-Based Variables
2.7. Statistical Analysis
2.8. Ethical Approval
3. Results
4. Discussion
Strengths and Limitations
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Total | Men | Women | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Russian | Somali | Kurdish | General population | Russian | Somali | Kurdish | General population | Russian | Somali | Kurdish | General population | |
Participants by variables, n | ||||||||||||
Register-based variables | 1998 | 1963 | 1948 | 2275 | 767 | 942 | 1129 | 1112 | 1231 | 1021 | 819 | 1163 |
Affective symptoms (HSCL) * | 465 | 377 | 509 | 870 | 167 | 155 | 274 | 373 | 298 | 222 | 235 | 497 |
Self-reported mental health-related use of health services ** | 689 | 478 | 613 | 932 | 252 | 216 | 235 | 409 | 437 | 262 | 288 | 523 |
Self-reported mental health-related need for health services *** | 524 | 331 | 508 | 1081 | 186 | 151 | 278 | 451 | 338 | 180 | 230 | 630 |
Gender, % (95% CI) **** | ||||||||||||
Men | 37.8 (35.6–40.0) | 48.0 (46.3–49.7) | 57.9 (56.7–59.1) | 48.8 (46.7–50.8) | ||||||||
p-value ***** | <0.001 | 0.544 | <0.001 | |||||||||
Age, % (95% CI) **** | ||||||||||||
18–29 | 28.7 (26.7–30.8) | 40.1 (38.4–41.7) | 42.2 (41.0–43.3) | 30.4 (28.5–32.3) | 32.7 (29.3–36.2) | 40.2 (37.8–42.6) | 43.8 (42.3–45.4) | 31.0 (28.3–33.8) | 26.2 (23.8–28.9) | 40.0 (37.7–42.3) | 39.9 (38.1–41.7) | 29.8 (27.2–32.5) |
30–44 | 33.0 (30.9–35.2) | 40.0 (38.3–41.7) | 37.3 (36.2–38.4) | 30.1 (28.2–32.0) | 32.1 (288–35.6) | 39.9 (37.4–42.3) | 35.5 (34.0–37.0) | 30.0 (27.4–32.8) | 33.5 (30.8–36.3) | 40.2 (37.9–42.5) | 39.7 (37.9–41.5) | 30.2 (27.6–32.9) |
45–64 | 38.3 (36.1–40.6) | 19.9 (18.6–21.3) | 20.6 (19.6–21.5) | 39.5 (37.5–41.5) | 35.2 (31.8–38.8) | 20.0 (18.0–22.1) | 20.7 (19.4–21.9) | 39.0 (36.1–41.9) | 40.3 (37.4–43.1) | 19.9 (18.0–21.8) | 20.4 (19.0–21.9) | 40.0 (37.3–42.9) |
p-value ***** | 0.104 | <0.001 | <0.001 | 0.151 | <0.001 | <0.001 | 0.31 | <0.001 | <0.001 |
Total * | |||||||
---|---|---|---|---|---|---|---|
Russian (Rus) | p-Value, Rus vs. Gen | Somali (Som) | p-Value, Som vs. Gen | Kurdish (Kur) | p-Value, Kur vs. Gen | General Population (Gen) | |
Visits to hospital in-/outpatient care with a psychiatric diagnosis (2009–2012) | 4.2 (3.4–5.3) | <0.001 | 3.4 (2.8–4.1) | <0.001 | 8.3 (7.6–8.9) | 0.043 | 6.9 (6.0–8.1) |
Visits to hospital in-/outpatient care in psychiatry (2009–2012) | 3.7 (3.0–4.7) | <0.001 | 2.8 (2.3–3.5) | <0.001 | 9.7 (9.0–10.5) | <0.001 | 6.5 (5.5–7.6) |
Purchase of psychotropic medication (2009–2011) | 15.1 (13.6–16.7) | <0.001 | 11.9 (10.8–13.1) | <0.001 | 22.4 (21.3–23.4) | 0.081 | 20.6 (19.0–22.3) |
Reimbursement of psychotropic medication at a special rate (2009–2011) | 1.0 (0.6–1.6) | 0.573 | 1.4 (1.1–1.9) | 0.525 | 1.3 (1.1–1.6) | 0.702 | 1.2 (0.8–1.8) |
>10 days of sick leave due to a psychiatric diagnosis (2009–2011) | 0.9 (0.6–1.4) | <0.001 | 0.4 (0.2–0.6) | <0.001 | 3.7 (3.2–4.2) | 0.004 | 2.4 (1.8–3.1) |
Psychotherapeutic rehabilitation (2009–2012) | 0.2 (NA) *** | 0 (NA) *** | 0 (NA) *** | 1.1 (0.8–1.7) | |||
Any register-based record on mental health-related use of health services **** | 16.3 (14.8–18.1) | <0.001 | 13.7 (12.5–14.9) | <0.001 | 25.6 (24.5–26.7) | 0.004 | 22.6 (20.9–24.3) |
General rehabilitation (2009–2012) | 0.8 (0.5–1.3) | <0.001 | 0.9 (0.6–1.2) | <0.001 | 1.4 (1.1–1.7) | <0.001 | 3.0 (2.4–3.8) |
Men ** | |||||||
Visits to hospital in-/outpatient care with a psychiatric diagnosis (2009–2012) | 3.9 (2.7–5.6) | 0.059 | 3.8 (2.9–5.0) | 0.017 | 7.2 (6.5–8.1) | 0.117 | 5.9 (4.7–7.4) |
Visits to hospital in-/outpatient care in psychiatry (2009–2012) | 3.3 (2.2–4.9) | 0.067 | 3.3 (2.5–4.4) | 0.027 | 7.4 (6.7–8.3) | 0.008 | 5.1 (3.9–6.6) |
Purchase of psychotropic medication (2009–2011) | 11.3 (9.2–13.7) | 0.002 | 12.0 (10.4–13.8) | 0.002 | 18.5 (17.2–19.8) | 0.084 | 16.2 (14.3–18.4) |
Entitlement to reimbursement of psychotropic medication at a special rate (2009–2011) | 1.1 (0.6–2.1) | 0.835 | 2.0 (1.4–2.9) | 0.140 | 1.5 (1.2–1.9) | 0.394 | 1.2 (0.7–2.0) |
>10 days of sick leave due to a psychiatric diagnosis (2009–2011) | 0.2 (NA) *** | 0.5 (0.3–0.9) | 0.018 | 2.0 (1.6–2.4) | 0.157 | 1.3 (0.8–2.2) | |
Psychotherapeutic rehabilitation (2009–2012) | 0 (NA) *** | 0 (NA) *** | 0 (NA) *** | 0.3 (NA) *** | |||
Any register-based record on mental health-related use of health services **** | 12.5 (10.3–15.1) | 0.002 | 13.9 (12.2–15.8) | 0.006 | 21.4 (20.1–22.8) | 0.009 | 17.9 (15.8–20.2) |
General rehabilitation (2009–2012) | 0.4 (NA) *** | 1.1 (0.7–1.8) | 0.794 | 1.2 (0.9–1.6) | 0.920 | 1.2 (0.7–2.1) | |
Women ** | |||||||
Visits to hospital in-/outpatient care with a psychiatric diagnosis (2009–2012) | 4.6 (3.5–6.0) | 0.002 | 3.0 (2.4–3.8) | <0.001 | 9.3 (8.4–10.4) | 0.146 | 7.9 (6.5–9.6) |
Visits to hospital in-/outpatient care in psychiatry (2009–2012) | 4.2 (3.1–5.5) | <0.001 | 2.4 (1.8–3.2) | <0.001 | 12.2 (11.1–13.4) | <0.001 | 7.7 (6.3–9.5) |
Purchase of psychotropic medication (2009–2011) | 18.4 (16.2–20.7) | <0.001 | 11.8 (10.4–13.4) | <0.001 | 26.1 (24.5–27.8) | 0.346 | 24.7 (22.3–27.2) |
Entitlement to reimbursement of psychotropic medication at a special rate (2009–2011) | 0.9 (0.5–1.7) | 0.500 | 0.9 (0.5–1.5) | 0.429 | 1.1 (0.8–1.6) | 0.720 | 1.2 (0.7–2.1) |
>10 days of sick leave due to a psychiatric diagnosis (2009–2011) | 1.4 (0.9–2.2) | 0.001 | 0.2 (NA) *** | 5.3 (4.5–6.1) | 0.011 | 3.4 (2.5–4.6) | |
Psychotherapeutic rehabilitation (2009–2012) | 0.3 (NA) *** | 0 (NA) *** | 0.1 (NA) *** | 2.0 (1.3–3.0) | |||
Any register-based record on mental health-related use of health services **** | 19.7 (17.5–22.1) | <0.001 | 13.4 (11.9–15.0) | <0.001 | 29.5 (27.9–31.3) | 0.099 | 26.9 (24.4–29.5) |
General rehabilitation (2009–2012) | 1.2 (0.7–1.9) | <0.001 | 0.6 (0.4–1.0) | <0.001 | 1.4 (1.0–1.9) | <0.001 | 4.6 (3.6–6.0) |
Total * | |||||||
---|---|---|---|---|---|---|---|
Russian (Rus) | p-Value, Rus vs. Gen | Somali (Som) | p-Value, Som vs. Gen | Kurdish (Kur) | p-Value, Kur vs. Gen | General Population (Gen) | |
Visits to hospital in-/outpatient care with a psychiatric diagnosis (2009–2012) | 10.7 (4.8–22.3) | 0.002 | 14.7 (6.5–29.9) | 0.028 | 17.8 (12.9–23.9) | 0.008 | 41.8 (24.5–61.3) |
Visits to hospital in-/outpatient care in psychiatry (2009–2012) | 11.2 (5.5–21.5) | 0.001 | 11.6 (4.6–26.3) | 0.012 | 23.1 (17.7–29.6) | 0.040 | 42.6 (25.2–62.0) |
Purchase of prescribed psychotropic medication (2009–2011) | 36.9 (25.3–50.3) | 0.013 | 23.3 (10.9–42.9) | 0.003 | 42.2 (35.6–49.1) | 0.018 | 66.0 (47.0–81.0) |
Any register-based record on mental health-related use of health services ***** | 39.8 (28.0–52.9) | 0.023 | 30.5 (16.4–49.6) | 0.012 | 46.9 (40.1–53.8) | 0.056 | 66.4 (47.1–81.3) |
General rehabilitation (2009–2012) | 2.4 (NA) *** | NA **** | 2.7 (1.2–6.0) | 0.021 | 10.8 (5.0–21.5) | ||
Men ** | |||||||
Visits to hospital in-/outpatient care with a psychiatric diagnosis (2009–2012) | 10.9 (1.7–46.8) | 0.137 | NA **** | 16.5 (9.5–27.3) | 0.101 | 38.5 (16.6–66.3) | |
Visits to hospital in-/outpatient care in psychiatry (2009–2012) | 16.5 (NA) *** | NA **** | 21.3 (13.3–32.3) | 0.246 | 37.7 (15.8–66.1) | ||
Purchase of prescribed psychotropic medication (2009–2011) | 58.6 (27.8–83.9) | 0.698 | NA **** | 39.0 (28.2–51.0) | 0.346 | 50.9 (30.1–71.4) | |
Any register-based record on mental health-related use of health services ***** | 58.7 (28.3–83.6) | 0.743 | NA **** | 43.9 (32.7–55.7) | 0.525 | 52.2 (30.6–73.0) | |
Women ** | |||||||
Visits to hospital in-/outpatient care with a psychiatric diagnosis (2009–2012) | 11.0 (4.5–24.4) | 0.008 | 14.2 (5.5–32.2) | 0.049 | 18.2 (12.5–25.7) | 0.023 | 43.8 (22.3–68.0) |
Visits to hospital in-/outpatient care in psychiatry (2009–2012) | 9.9 (NA) *** | 10.2 (NA) *** | 23.2 (16.7–31.2) | 0.034 | 48.5 (26.0–71.6) | ||
Purchase of prescribed psychotropic medication (2009–2011) | 31.8 (20.6–45.7) | 0.006 | 24.3 (10.2–47.6) | 0.006 | 43.8 (35.7–52.2) | 0.029 | 75.1 (47.4–90.9) |
Any register-based record on mental health-related use of health services ***** | 35.6 (23.9–49.4) | 0.012 | 34.5 (17.3–57.0) | 0.029 | 48.2 (39.8–56.7) | 0.065 | 75.0 (46.6–91.2) |
Total * | |||||||
---|---|---|---|---|---|---|---|
Russian (Rus) | p-Value, Rus vs. Gen | Somali (Som) | p-Value, Som vs. Gen | Kurdish (Kur) | p-Value, Kur vs. Gen | General Population (Gen) | |
Purchase of psychotropic medication (2009–2011) | 2.7 (1.5–4.9) | <0.001 | 3.2 (1.8–5.4) | <0.001 | 3.8 (3.0–4.9) | <0.001 | 10.1 (7.7–13.1) |
Any register-based record on mental health-related use of health services ***** | 3.4 (2.1–5.7) | <0.001 | 3.5 (2.2–5.7) | <0.001 | 3.7 (2.9–4.7) | <0.001 | 10.8 (8.5–13.8) |
Self-reported need of health services due to mental health problems | 2.5 (NA) *** | NA **** | 10.0 (5.1–18.8) | 0.006 | 27.3 (18.5–38.3) | ||
Men ** | |||||||
Purchase of psychotropic medication (2009–2011) | 1.8 (NA) *** | 4.9 (2.5–9.3) | 0.709 | 3.9 (2.8–5.5) | 0.291 | 5.8 (3.1–10.4) | |
Any register-based record on mental health-related use of health services ***** | 2.6 (NA) *** | 5.3 (2.8–9.5) | 0.965 | 3.6 (2.6–4.9) | 0.258 | 5.4 (2.9–9.6) | |
Women ** | |||||||
Purchase of psychotropic medication (2009–2011) | 3.2 (1.6–6.3) | <0.001 | 1.3 (0.6–2.8) | <0.001 | 3.4 (2.4–4.9) | <0.001 | 13.0 (9.6–17.4) |
Any register-based record on mental health-related use of health services ***** | 4.1 (2.3–7.1) | <0.001 | 1.7 (NA) *** | 3.5 (2.5–5.0) | <0.001 | 14.5 (11.1–18.8) |
Total * | |||||||
---|---|---|---|---|---|---|---|
Russian (Rus) | p-Value, Rus vs. Gen | Somali (Som) | p-Value, Som vs. Gen | Kurdish (Kur) | p-Value, Kur vs. Gen | General Population (Gen) | |
Out of those having purchased psychotropic medication | |||||||
Self-reported mental health-related use of health services | 22.9 (16.0–31.7) | 0.050 | 10.6 (5.2–20.4) | 0.001 | 40.1 (32.6–48.1) | 0.244 | 33.7 (27.1–41.0) |
Self-reported mental health-related need for health services | 29.8 (21.0–40.4) | 0.198 | NA *** | 36.8 (28.7–45.8) | 0.008 | 22.7 (17.4–29.0) | |
Out of those having any register-based record on mental health-related use of health services **** | |||||||
Self-reported mental health-related use of health services | 22.7 (16.1–31.1) | 0.059 | 10.5 (5.4–19.4) | <0.001 | 39.5 (32.4–46.9) | 0.204 | 32.8 (26.3–40.0) |
Self-reported mental health-related need for health services | 30.1 (21.5–40.3) | 0.190 | 6.7 (2.0–19.5) | 0.025 | 38.8 (30.9–47.3) | 0.002 | 23.0 (17.9–29.1) |
Men ** | |||||||
Out of those having purchased psychotropic medication | |||||||
Self-reported mental health-related use of health services | 21.1 (10.8–37.2) | 0.328 | NA *** | 30.3 (20.1–43.0) | >0.999 | 30.4 (19.8–43.5) | |
Self-reported mental health-related need for health services | 19.7 (8.7–38.9) | 0.760 | NA *** | 22.2 (12.6–35.9) | 0.512 | 17.0 (9.4–28.6) | |
Out of those having any register-based record on mental health-related use of health services **** | |||||||
Self-reported mental health-related use of health services | 20.9 (11.1–35.9) | 0.324 | NA *** | 28.6 (19.1–40.4) | 0.881 | 29.9 (19.3–43.1) | |
Self-reported mental health-related need for health services | 18.1 (8.0–36.0) | 0.817 | NA *** | 25.7 (15.9–38.7) | 0.218 | 16.2 (9.0–27.3) | |
Women ** | |||||||
Out of those having purchased psychotropic medication | |||||||
Self-reported mental health-related use of health services | 23.7 (15.4–34.7) | 0.078 | 10.3 (4.1–23.5) | 0.004 | 47.8 (37.8–57.9) | 0.074 | 35.6 (27.8–44.3) |
Self-reported mental health-related need for health services | 35.8 (24.3–49.3) | 0.150 | NA *** | 46.5 (35.3–58.1) | 0.003 | 25.5 (18.9–33.4) | |
Out of those having any register-based record on mental health-related use of health services **** | |||||||
Self-reported mental health-related use of health services | 23.5 (15.4–34.0) | 0.086 | 10.6 (4.7–22.4) | 0.003 | 47.5 (38.2–57.0) | 0.050 | 34.7 (26.9–43.4) |
Self-reported mental health-related need for health services | 36.5 (25.1–49.6) | 0.159 | NA *** | 46.7 (35.9–57.7) | 0.003 | 26.6 (20.2–34.2) |
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Castaneda, A.E.; Çilenti, K.; Rask, S.; Lilja, E.; Skogberg, N.; Kuusio, H.; Salama, E.; Lahti, J.; Elovainio, M.; Suvisaari, J.; et al. Migrants Are Underrepresented in Mental Health and Rehabilitation Services—Survey and Register-Based Findings of Russian, Somali, and Kurdish Origin Adults in Finland. Int. J. Environ. Res. Public Health 2020, 17, 6223. https://doi.org/10.3390/ijerph17176223
Castaneda AE, Çilenti K, Rask S, Lilja E, Skogberg N, Kuusio H, Salama E, Lahti J, Elovainio M, Suvisaari J, et al. Migrants Are Underrepresented in Mental Health and Rehabilitation Services—Survey and Register-Based Findings of Russian, Somali, and Kurdish Origin Adults in Finland. International Journal of Environmental Research and Public Health. 2020; 17(17):6223. https://doi.org/10.3390/ijerph17176223
Chicago/Turabian StyleCastaneda, Anu E., Katja Çilenti, Shadia Rask, Eero Lilja, Natalia Skogberg, Hannamaria Kuusio, Essi Salama, Jari Lahti, Marko Elovainio, Jaana Suvisaari, and et al. 2020. "Migrants Are Underrepresented in Mental Health and Rehabilitation Services—Survey and Register-Based Findings of Russian, Somali, and Kurdish Origin Adults in Finland" International Journal of Environmental Research and Public Health 17, no. 17: 6223. https://doi.org/10.3390/ijerph17176223