Fassaert Thijs, de Wit Matty A S, Tuinebreijer Wilco C, Verhoeff Arnoud P, Beekman Aartjan T F, Dekker Jack
Dept. of Epidemiology, Documentation and Health Promotion, Amsterdam Municipal Health Service, Amsterdam, The Netherlands.
Soc Psychiatry Psychiatr Epidemiol. 2009 Mar;44(3):208-16. doi: 10.1007/s00127-008-0418-x. Epub 2008 Sep 11.
There is a supposed higher prevalence of common mental disorders among many migrant groups. At the same time, problems are reported regarding underutilisation of mental health services by migrants. Since perceived need for care is a powerful predictor of actual care utilisation, we aimed to study the hypothesis that, given the same level of mental morbidity, non-Western migrants would perceive less need for mental health care than ethnic Dutch residents. Additionally, we studied the extent to which needs are met in both groups, as well as several possible barriers to care.
A cross-sectional study with data from the 2004/2005 Amsterdam Health Monitor. Data were complete from 626 ethnic Dutch and non-Western (Turkish and Moroccan) labour migrants. Respondents participated in a structured interview in their own language, which included the perceived need for care questionnaire (PNCQ) and the composite international diagnostic interview (CIDI) version 2.1 for anxiety and depressive disorders.
Perceived need was much higher among Turkish migrants. Among Moroccans the perceived need was comparable to ethnic Dutch. Turkish migrants also reported that needs were met less often than ethnic Dutch. Differences were explained by a higher prevalence of common mental disorders and higher symptom levels among Turkish. When differences in mental morbidity were taken into account, Moroccans perceived less need for information, drugs, referral to specialised mental health care, or for counselling. The most important barrier to care in all ethnic groups was the preference to solve the problem on one's own.
In case of similar mental morbidity, perceived need for care was lower than among ethnic Dutch. The results did not support the hypothesis that in case of similar mental distress, needs of migrants were less often met than needs of ethnic Dutch.
许多移民群体中常见精神障碍的患病率据推测较高。与此同时,有报告称移民存在心理健康服务利用不足的问题。鉴于感知到的护理需求是实际护理利用的有力预测因素,我们旨在研究这样一个假设:在精神疾病发病率相同的情况下,非西方移民比荷兰族裔居民感知到的心理健康护理需求更少。此外,我们研究了两组人群的需求满足程度以及一些可能的护理障碍。
一项横断面研究,数据来自2004/2005年阿姆斯特丹健康监测。数据完整的有626名荷兰族裔和非西方(土耳其和摩洛哥)劳务移民。受访者用自己的语言参加了一次结构化访谈,其中包括感知护理需求问卷(PNCQ)和用于焦虑症和抑郁症的综合国际诊断访谈(CIDI)2.1版。
土耳其移民感知到的需求要高得多。摩洛哥人的感知需求与荷兰族裔相当。土耳其移民还报告说,他们的需求得到满足的频率低于荷兰族裔。差异的原因是土耳其人中常见精神障碍的患病率较高且症状水平较高。考虑到精神疾病发病率的差异后,摩洛哥人对信息、药物、转介至专门心理健康护理或咨询的需求感知较少。所有族裔群体中最重要的护理障碍是倾向于自行解决问题。
在精神疾病发病率相似的情况下,感知到的护理需求低于荷兰族裔。结果不支持这样的假设,即在精神痛苦相似的情况下,移民的需求比荷兰族裔更难得到满足。