Mental Health and Service Use of Migrants in Contact with the Public Psychiatry System in Paris
Abstract
:1. Introduction
The Public Mental Health Care System in France
2. Materials and Methods
2.1. The “Santé Mentale et Logement” (Mental Health and Housing) Survey
2.2. Migrants without Stable Housing Seen at the Reception and Guidance Psychiatric (Centre Psychiatrique d’Orientation et d’Accueil—CPOA)
2.3. Asylum Seekers
3. Results
3.1. Mental Health Care Use among Migrants in the Parisian Public Psychiatric Facilities
3.2. Migrants without Stable Housing
3.3. Asylum Seekers
4. Discussion
4.1. Limitations
4.2. Clinical Considerations and Perspectives
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
- Bhugra, D. Migration and mental health. Acta Psychiatr. Scand. 2004, 109, 243–258. [Google Scholar] [CrossRef] [PubMed]
- Fazel, M.; Wheeler, J.; Danesh, J. Prevalence of serious mental disorder in 7000 refugees resettled in western countries: A systematic review. Lancet 2005, 365, 1309–1314. [Google Scholar] [CrossRef]
- Steel, Z.; Chey, T.; Silove, D.; Marnane, C.; Bryant, R.A.; van Ommeren, M. Association of torture and other potentially traumatic events with mental health outcomes among populations exposed to mass conflict and displacement: A systematic review and meta-analysis. JAMA 2009, 302, 537–549. [Google Scholar] [CrossRef] [PubMed]
- Schoretsanitis, G.; Bhugra, D.; Eisenhardt, S.; Ricklin, M.E.; Srivastava, D.; Exadaktylos, A.K.; Walther, S. Upon Rejection: Psychiatric Emergencies of Failed Asylum Seekers. Int. J. Environ. Res. Public Health 2018, 15, 1498. [Google Scholar] [CrossRef] [Green Version]
- Satinsky, E.; Fuhr, D.C.; Woodward, A.; Sondorp, E.; Roberts, B. Mental health care utilisation and access among refugees and asylum seekers in Europe: A systematic review. Health Policy 2019, 123, 851–863. [Google Scholar] [CrossRef]
- Suphanchaimat, R.; Kantamaturapoj, K.; Putthasri, W.; Prakongsai, P. Challenges in the provision of healthcare services for migrants: A systematic review through providers’ lens. BMC Health Serv. Res. 2015, 15, 1–14. [Google Scholar] [CrossRef] [Green Version]
- Sandhu, S.; Bjerre, N.V.; Dauvrin, M.; Dias, S.; Gaddini, A.; Greacen, T.; Ioannidis, E.; Kluge, U.; Jensen, N.K.; Lamkaddem, M.; et al. Experiences with treating immigrants: A qualitative study in mental health services across 16 European countries. Soc. Psychiatry Psychiatr. Epidemiol. 2013, 48, 105–116. [Google Scholar] [CrossRef]
- Hacker, K.; Anies, M.E.; Folb, B.L.; Zallman, L. Barriers to health care for undocumented immigrants: A literature review. Risk Manag. Healthc Policy 2015, 8, 175–183. [Google Scholar] [CrossRef] [Green Version]
- De Vries, L.A.; Guild, E. Seeking refuge in Europe: Spaces of transit and the violence of migration management. J. Ethn. Migr. Stud. 2018, 45, 2156–2166. [Google Scholar] [CrossRef] [Green Version]
- Abbott, A. The mental-health crisis among migrants. Nat. Cell Biol. 2016, 538, 158–160. [Google Scholar] [CrossRef] [Green Version]
- Trovato, A.; Reid, A.; Takarinda, K.C.; Montaldo, C.; DeCroo, T.; Owiti, P.; Bongiorno, F.; Di Carlo, S. Dangerous crossing: Demographic and clinical features of rescued sea migrants seen in 2014 at an outpatient clinic at Augusta Harbor, Italy. Confl. Health 2016, 10, 1–11. [Google Scholar] [CrossRef] [Green Version]
- Akik, C.; Hoteit, R.; Mesmar, S.; Rabkin, M.; El-Sadr, W.M.; Fouad, F.M. Host country responses to non-communicable diseases amongst Syrian refugees: A review. Confl. Health 2019, 13, 1–13. [Google Scholar] [CrossRef] [PubMed]
- Brutel, C. La localisation Géographique des Immigrés. Une Forte Concentration dans l’aire Urbaine de Paris; Insee Première: Paris, France, 2016. [Google Scholar]
- Daly, G. Migrants and gate keepers: The links between immigration and homelessness in Western Europe. Cities 1996, 13, 11–23. [Google Scholar] [CrossRef]
- Pleace, N. Immigration and Homelessness. Available online: https://www.researchgate.net/profile/Nicholas_Pleace/publication/266068306_Immigration_and_Homelessness/links/54f6f2750cf28d6dec9b734d.pdf (accessed on 14 December 2020).
- Defendeurs des Droits. Exiles and Fundamental Rights: The Situation in the Territory of Calais. 2015. Available online: https://defenseurdesdroits.fr/sites/default/files/atoms/files/20151006-rapport_calais_en.pdf (accessed on 20 August 2015).
- Yaouancq, F.; Duée, M. Les Sans-Domicile en 2012: Une Grande Diversité de Situations. France, Portrait Social 2014. Available online: https://www.insee.fr/fr/statistiques/1288519?sommaire=1288529 (accessed on 19 November 2014).
- Amad, A.; Guardia, D.; Salleron, J.; Thomas, P.; Roelandt, J.-L.; Vaiva, G. Increased prevalence of psychotic disorders among third-generation migrants: Results from the French Mental Health in General Population survey. Schizophr. Res. 2013, 147, 193–195. [Google Scholar] [CrossRef] [PubMed]
- Pignon, B.; Geoffroy, P.A.; Thomas, P.; Roelandt, J.-L.; Rolland, B.; Morgan, C.; Vaiva, G.; Amad, A. Prevalence and clinical severity of mood disorders among first-, second- and third-generation migrants. J. Affect. Disord. 2017, 210, 174–180. [Google Scholar] [CrossRef]
- Vandentorren, S.; Le Méner, E.; Oppenchaim, N.; Arnaud, A.; Jangal, C.; Caum, C.; Vuillermoz, C.; Martin-Fernandez, J.; Lioret, S.; Roze, M.; et al. Characteristics and health of homeless families: The ENFAMS survey in the Paris region, France 2013. Eur. J. Public Health 2016, 26, 71–76. [Google Scholar] [CrossRef] [Green Version]
- Roze, M.; Vandentorren, S.; Vuillermoz, C.; Chauvin, P.; Melchior, M. Emotional and behavioral difficulties in children growing up homeless in Paris. Results of the ENFAMS survey. Eur. Psychiatry 2016, 38, 51–60. [Google Scholar] [CrossRef] [Green Version]
- Laporte, A.; Vandentorren, S.; Détrez, M.-A.; Douay, C.; Le Strat, Y.; Le Méner, E.; Chauvin, P. The Samenta Research Group Prevalence of Mental Disorders and Addictions among Homeless People in the Greater Paris Area, France. Int. J. Environ. Res. Public Health 2018, 15, 241. [Google Scholar] [CrossRef] [Green Version]
- Berchet, C.; Jusot, F. État de santé et recours aux soins des immigrés en France: Une revue de la littérature. Available online: https://www.santepubliquefrance.fr/revues/beh/bulletin-epidemiologique-hebdomadaire (accessed on 14 December 2020).
- Guisao, A.; Queré, M.; Riou, F. Profil Socio-Sanitaire et Besoins de Suivi Sanitaire des Personnes Accueillies dans les Structures d’Ile-de-France Hébergeant des Migrants Évacues de Campements de Fortune Parisiens; Observatoire du Samusocial: Paris, France, 2017. [Google Scholar]
- Verdoux, H. The current state of adult mental health care in France. Eur. Arch. Psychiatry Clin. Neurosci. 2006, 257, 64–70. [Google Scholar] [CrossRef]
- Gouriou, F. Psychopathologie et Migration: Repérage Historique et Épistémologique dans le Contexte Français. Ph.D. Thesis, Université Rennes 2, Rennes, France, 2008. [Google Scholar]
- Jolivet, A.; Cadot, E.; Florence, S.; Lesieur, S.; LeBas, J.; Chauvin, P. Migrant health in French Guiana: Are undocumented immigrants more vulnerable? BMC Public Health 2012, 12, 53. [Google Scholar] [CrossRef]
- Roser, M.; Ritchie, H. Burden of Disease. Available online: https://ourworldindata.org/burden-of-disease (accessed on 14 December 2020).
- Dardennes, R.; Chidiac, N.; Mercuel, A. Nonsectorized Psychiatry in France. Int. J. Ment. Health 2009, 38, 56–62. [Google Scholar] [CrossRef]
- Hansen, M.; Andersen, T.E.; Armour, C.; Elklit, A.; Palic, S.; Mackrill, T. PTSD-8: A Short PTSD Inventory. Clin. Pr. Epidemiol. Ment. Health 2010, 6, 101–108. [Google Scholar] [CrossRef] [PubMed]
- Tarricone, I.; Atti, A.R.; Salvatori, F.; Braca, M.; Ferrari, S.; Malmusi, D.; Berardi, D. Psychotic Symptoms and General Health in a Socially Disadvantaged Migrant Community in Bologna. Int. J. Soc. Psychiatry 2009, 55, 203–213. [Google Scholar] [CrossRef] [PubMed]
- Nilsson, S.F.; Hjorthøj, C.R.; Erlangsen, A.; Nordentoft, M. Psychiatric disorders and mortality among people in homeless shelters in Denmark: A nationwide register-based cohort study. Lancet 2011, 377, 2205–2214. [Google Scholar] [CrossRef]
- Lay, B.; Lauber, C.; Rössler, W. Are immigrants at a disadvantage in psychiatric in-patient care? Acta Psychiatr. Scand. 2005, 111, 358–366. [Google Scholar] [CrossRef] [PubMed]
- Hynie, M. The Social Determinants of Refugee Mental Health in the Post-Migration Context: A Critical Review. Can. J. Psychiatry 2017, 63, 297–303. [Google Scholar] [CrossRef]
- Campion, J.; Bhugra, D.; Bailey, S.; Marmot, M. Inequality and mental disorders: Opportunities for action. Lancet 2013, 382, 183–184. [Google Scholar] [CrossRef]
- Fazel, S.; Geddes, J.R.; Kushel, M. The health of homeless people in high-income countries: Descriptive epidemiology, health consequences, and clinical and policy recommendations. Lancet 2014, 384, 1529–1540. [Google Scholar] [CrossRef] [Green Version]
- Oduola, S.; Craig, T.K.J.; Morgan, C. Ethnic variations in duration of untreated psychosis: Report from the CRIS-FEP study. Soc. Psychiatry Psychiatr. Epidemiol. 2020, 1–11. [Google Scholar] [CrossRef]
- Schmoll, S.; Boyer, L.; Henry, J.-M.; Belzeaux, R. Patients récurrents aux urgences psychiatriques: Analyse démographique et clinique. L’Encephale 2015, 41, 123–129. [Google Scholar] [CrossRef]
- Morel, S. Inequality and discrimination in access to urgent care in France Ethnographies of three healthcare structures and their audiences. Soc. Sci. Med. 2019, 232, 25–32. [Google Scholar] [CrossRef] [PubMed]
- Wetzke, M.; Happle, C.; Vakilzadeh, A.; Ernst, D.; Sogkas, G.; Schmidt, R.E.; Behrens, G.M.N.; Dopfer, C.; Jablonka, A. Healthcare Utilization in a Large Cohort of Asylum Seekers Entering Western Europe in 2015. Int. J. Environ. Res. Public Health 2018, 15, 2163. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Nikendei, C.; Kindermann, D.; Brandenburg-Ceynowa, H.; Derreza-Greeven, C.; Zeyher, V.; Junne, F.; Friederich, H.-C.; Bozorgmehr, K. Asylum seekers’ mental health and treatment utilization in a three months follow-up study after transfer from a state registration-and reception-center in Germany. Health Policy 2019, 123, 864–872. [Google Scholar] [CrossRef] [PubMed]
- Tortelli, A.; Morgan, C.; Szöke, A.; Nascimento, A.; Skurnik, N.; De Caussade, E.M.; Fain-Donabedian, E.; Fridja, F.; Henry, M.; Ezembe, F.; et al. Different rates of first admissions for psychosis in migrant groups in Paris. Soc. Psychiatry Psychiatr. Epidemiol. 2013, 49, 1103–1109. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Bourque, F.; Van Der Ven, E.; Malla, A. A meta-analysis of the risk for psychotic disorders among first- and second-generation immigrants. Psychol. Med. 2011, 41, 897–910. [Google Scholar] [CrossRef] [PubMed]
- Soosay, I.; Silove, D.; Bateman-Steel, C.R.; Steel, Z.; Bebbington, P.E.; Jones, P.B.; Chey, T.; Ivancic, L.; Marnane, C. Trauma exposure, PTSD and psychotic-like symptoms in post-conflict Timor Leste: An epidemiological survey. BMC Psychiatry 2012, 12, 229. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Alsawy, S.; Wood, L.; Taylor, P.J.; Morrison, A.P. Psychotic experiences and PTSD: Exploring associations in a population survey. Psychol. Med. 2015, 45, 2849–2859. [Google Scholar] [CrossRef]
- Laban, C.J.; Gernaat, H.B.P.E.; Komproe, I.H.; De Jong, J.T.V.M. Prevalence and predictors of health service use among Iraqi asylum seekers in the Netherlands. Soc. Psychiatry Psychiatr. Epidemiol. 2007, 42, 837–844. [Google Scholar] [CrossRef] [Green Version]
- Le Courant, S. Le poids de la menace. L’évaluation quotidienne du risque d’expulsion par les étrangers en situation irrégulière. Ethnol. Fr. 2015, 45, 123–133. [Google Scholar] [CrossRef] [Green Version]
- Laban, C.J.; Gernaat, H.B.P.E.; Komproe, I.H.; Van Der Tweel, I.; De Jong, J.T.V.M. Postmigration Living Problems and Common Psychiatric Disorders in Iraqi Asylum Seekers in the Netherlands. J. Nerv. Ment. Dis. 2005, 193, 825–832. [Google Scholar] [CrossRef]
- Schweitzer, R.D.; Melville, F.; Steel, Z.; Lacherez, P. Trauma, Post-Migration Living Difficulties, and Social Support as Predictors of Psychological Adjustment in Resettled Sudanese Refugees. Aust. N. Z. J. Psychiatry 2006, 40, 179–187. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Bogic, M.; Njoku, A.; Priebe, S. Long-term mental health of war-refugees: A systematic literature review. BMC Int. Health Hum. Rights 2015, 15, 1–41. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Puchner, K.P.; Karamagioli, E.; Pikouli, A.; Tsiamis, C.; Kalogeropoulos, A.; Kakalou, E.; Pavlidou, E.; Pikoulis, E. Time to Rethink Refugee and Migrant Health in Europe: Moving from Emergency Response to Integrated and Individualized Health Care Provision for Migrants and Refugees. Int. J. Environ. Res. Public Health 2018, 15, 1100. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Bhugra, D.; Gupta, S.; Bhui, K.; Craig, T.; Dogra, N.; Ingleby, J.D.; Kirkbride, J.; Moussaoui, D.; Nazroo, J.; Qureshi, A.; et al. WPA guidance on mental health and mental health care in migrants. World Psychiatry 2011, 10, 2–10. [Google Scholar] [CrossRef]
- Nathan, T. L’influence Qui Guérit; Odile Jacob: Paris, France, 1994. [Google Scholar]
- Fassin, D. La psyché africaine, des colonies africaines aux banlieues parisiennes. L’Homme 2000, 153, 231–250. [Google Scholar]
- Chambon, N.; Le Goff, G. Enjeux et controverses de la prise en charge des migrants précaires en psychiatrie. Rev. Fr. Aff. Soc. 2016, 1, 123–140. [Google Scholar] [CrossRef]
- Tortelli, A.; Sauzé, D.; Skurnik, N. Capital Social, Santé Mentale et Immigration, Annales Médico-Psychologiques, Revue Psychiatrique; Elsevier: Amsterdam, The Netherlands, 2017; pp. 573–576. [Google Scholar]
- Purić, D.; Marković, M.V. Development and validation of the Stressful Experiences in Transit Questionnaire (SET-Q) and its Short Form (SET-SF). Eur. J. Psychotraumatol. 2019, 10, 1611091. [Google Scholar] [CrossRef] [Green Version]
- Rousseau, C.; Foxen, P. Le mythe du réfugié menteur: Un mensonge indispensable? L’évolution Psychiatrique 2006, 71, 505–520. [Google Scholar] [CrossRef]
- Jedwab, N.; Nguyen-Lamouri, C. Management of acute psychotic states among migrants: A specific case of isolated minor psychiatric emergencies. L’Information Psychiatrique 2015, 91, 29–37. [Google Scholar]
- Lindencrona, F.; Ekblad, S.; Hauff, E. Mental health of recently resettled refugees from the Middle East in Sweden: The impact of pre-resettlement trauma, resettlement stress and capacity to handle stress. Soc. Psychiatry Psychiatr. Epidemiol. 2008, 43, 121–131. [Google Scholar] [CrossRef]
- Fazel, M.; Reed, R.V.; Panter-Brick, C.; Stein, A. Mental health of displaced and refugee children resettled in high-income countries: Risk and protective factors. Lancet 2012, 379, 266–282. [Google Scholar] [CrossRef]
- Kirmayer, L.J.; Narasiah, L.; Munoz, M.; Rashid, M.; Ryder, A.G.; Guzder, J.; Hassan, G.; Rousseau, C.; Pottie, K. Canadian Collaboration for Immigrant and Refugee Health (CCIRH) Common mental health problems in immigrants and refugees: General approach in primary care. Can. Med Assoc. J. 2011, 183, E959–E967. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Nadeau, L.; Measham, T. Immigrants and mental health services: Increasing collaboration with other service providers. Can. Child Adolesc. Psychiatry Rev. 2005, 14, 73. [Google Scholar]
- Tortelli, A.; Wolmark, L. Meeting Mental Health Care Needs of Asylum Seekers: Collaboration between Service Providers. In Proceedings of the XXXVIth International Congress on Law and Mental Health, Rome, Italy, 21–26 July 2018. [Google Scholar]
- Nickerson, A.; Bryant, R.A.; Silove, D.; Steel, Z. A critical review of psychological treatments of posttraumatic stress disorder in refugees. Clin. Psychol. Rev. 2011, 31, 399–417. [Google Scholar] [CrossRef]
- Turrini, G.; Purgato, M.; Acarturk, C.; Anttila, M.; Au, T.; Ballette, F.; Bird, M.; Carswell, K.; Churchill, R.; Cuijpers, P.; et al. Efficacy and acceptability of psychosocial interventions in asylum seekers and refugees: Systematic review and meta-analysis. Epidemiol. Psychiatr. Sci. 2019, 28, 376–388. [Google Scholar] [CrossRef] [Green Version]
- Davydov, D.M.; Stewart, R.; Ritchie, K.; Chaudieu, I. Resilience and mental health. Clin. Psychol. Rev. 2010, 30, 479–495. [Google Scholar] [CrossRef] [Green Version]
- Sijbrandij, M.; Acarturk, C.; Bird, M.; Bryant, R.A.; Burchert, S.; Carswell, K.; De Jong, J.; Dinesen, C.; Dawson, K.S.; El Chammay, R.; et al. Strengthening mental health care systems for Syrian refugees in Europe and the Middle East: Integrating scalable psychological interventions in eight countries. Eur. J. Psychotraumatol. 2017, 8, 1388102. [Google Scholar] [CrossRef] [Green Version]
- Dawson, K.S.; Bryant, R.A.; Harper, M.; Tay, A.K.; Rahman, A.; Schafer, A.; Van Ommeren, M. Problem Management Plus (PM+): A WHO transdiagnostic psychological intervention for common mental health problems. World Psychiatry 2015, 14, 354–357. [Google Scholar] [CrossRef]
- Mothersill, O.; Donohoe, G. Neural effects of social environmental stress—An activation likelihood estimation meta-analysis. Psychol. Med. 2016, 46, 2015–2023. [Google Scholar] [CrossRef]
- Gandubert, C.; Scali, J.; Ancelin, M.-L.; Carrière, I.; Dupuy, A.M.; Bagnolini, G.; Ritchie, K.; Sebbane, M.; Martrille, L.; Baccino, E.; et al. Biological and psychological predictors of posttraumatic stress disorder onset and chronicity. A one-year prospective study. Neurobiol. Stress 2016, 3, 61–67. [Google Scholar] [CrossRef] [Green Version]
- Zorn, J.V.; Schür, R.R.; Boks, M.; Kahn, R.S.; Joëls, M.; Vinkers, C.H. Cortisol stress reactivity across psychiatric disorders: A systematic review and meta-analysis. Psychoneuroendocrinology 2017, 77, 25–36. [Google Scholar] [CrossRef] [PubMed]
Sociodemographic Characteristics | Migrant Status | Odds Ratio (95% CI) | ||||
---|---|---|---|---|---|---|
Migrants N = 1055 | Natives N = 2923 | |||||
N | % | N | % | |||
Sex | ||||||
Male | 609 | 57.7 | 1538 | 52.6 | 1.23 | (1.06–1.42) |
Age | ||||||
<30 | 127 | 12.0 | 495 | 16.9 | 0.66 | (0.53–0.82) |
≥60 | 239 | 22.7 | 572 | 19.6 | 1.20 | (1.01–1.43) |
Mean (sd) | 47.8 (14.6) | 45.9 (14.9) | ||||
Living conditions | ||||||
Single | 682 | 64.6 | 2276 | 77.9 | 0.51 | (0.44–0.60) |
Homelessness | 74 | 7 | 44 | 1.5 | 4.93 | (3.32–7.39) |
Social accommodation | 99 | 9.4 | 103 | 3.5 | 2.83 | (2.10–3.81) |
No income | 130 | 12.3 | 108 | 3.7 | 3.66 | (2.78–4.82) |
Migrant Status | ||||||
---|---|---|---|---|---|---|
Migrants N = 1055 | Natives N = 2923 | |||||
N | % | N | % | Odds Ratio | ||
(95% CI) | ||||||
Psychiatric disorders | ||||||
Psychosis | 617 | 58.5 | 1537 | 52.6 | 1.27 | (1.09–1.46) |
Mood disorders | 173 | 16.4 | 536 | 18.3 | 0.87 | (0.72–1.05) |
Drug abuse | 29 | 2.7 | 103 | 3.5 | 0.77 | (0.49–1.19) |
Type of service | ||||||
Inpatient facilities | 343 | 32.5 | 836 | 28.6 | 1.20 | (1.03–1.40) |
Specialized consultation | 37 | 3.5 | 177 | 6.1 | 0.56 | (0.38–0.81) |
Outpatient facilities | 550 | 52.1 | 1482 | 50.7 | 1.05 | (0.91–1.22) |
Mandatory admissions | 84 | 7.9 | 174 | 5.9 | 1.36 | (1.02–1.80) |
Medical care | ||||||
No general practitioner | 320 | 30.3 | 520 | 17.8 | 2.01 | (1.70–2.37) |
No medical insurance | 43 | 4.1 | 14 | 0.5 | 8.82 | (4.71–17.53) |
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. |
© 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
Share and Cite
Tortelli, A.; Perquier, F.; Melchior, M.; Lair, F.; Encatassamy, F.; Masson, C.; K’ourio, H.; Gourevitch, R.; Mercuel, A. Mental Health and Service Use of Migrants in Contact with the Public Psychiatry System in Paris. Int. J. Environ. Res. Public Health 2020, 17, 9397. https://doi.org/10.3390/ijerph17249397
Tortelli A, Perquier F, Melchior M, Lair F, Encatassamy F, Masson C, K’ourio H, Gourevitch R, Mercuel A. Mental Health and Service Use of Migrants in Contact with the Public Psychiatry System in Paris. International Journal of Environmental Research and Public Health. 2020; 17(24):9397. https://doi.org/10.3390/ijerph17249397
Chicago/Turabian StyleTortelli, Andrea, Florence Perquier, Maria Melchior, François Lair, Fabien Encatassamy, Chloé Masson, Hélène K’ourio, Raphaël Gourevitch, and Alain Mercuel. 2020. "Mental Health and Service Use of Migrants in Contact with the Public Psychiatry System in Paris" International Journal of Environmental Research and Public Health 17, no. 24: 9397. https://doi.org/10.3390/ijerph17249397
APA StyleTortelli, A., Perquier, F., Melchior, M., Lair, F., Encatassamy, F., Masson, C., K’ourio, H., Gourevitch, R., & Mercuel, A. (2020). Mental Health and Service Use of Migrants in Contact with the Public Psychiatry System in Paris. International Journal of Environmental Research and Public Health, 17(24), 9397. https://doi.org/10.3390/ijerph17249397