Nielsen Signe Smith, Jensen Natasja Koitzsch, Kreiner Svend, Norredam Marie, Krasnik Allan
Danish Research Centre for Migration, Ethnicity, and Health, Section for Health Services Research, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5A, 1014, Copenhagen K, Denmark,
Soc Psychiatry Psychiatr Epidemiol. 2015 Jan;50(1):67-76. doi: 10.1007/s00127-014-0916-y. Epub 2014 Jul 1.
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.
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.
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.
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.
压力重重的移民过程与心理健康问题的更高易感性相关，这意味着与本土出生的人相比，移民对心理保健的需求更大。我们的目标是调查劳动力移民、来自难民产生国（RGC）的移民和丹麦族裔在使用精神科医生和心理学家方面的潜在差异是否能完全由心理健康状况来解释。
2007年，我们对3573名年龄在18 - 66岁之间的个人进行了一项全国性调查，这些人包括丹麦族裔、劳动力移民（巴基斯坦和土耳其）以及来自RGC的移民（伊朗、伊拉克、黎巴嫩和索马里）。调查数据与医疗保健利用登记处相关联。使用泊松回归估计与私人执业精神科医生和心理学家的接触情况。分析对社会经济因素和心理健康状况进行了调整。
总体而言，丹麦族裔中有2.2%、劳动力移民中有1.4%以及来自RGC的移民中有6.5%咨询过精神科医生或心理学家。在调整后的分析中，对于精神科医生，与丹麦族裔相比，劳动力移民女性（相乘效应 = 1.78）和来自RGC的移民女性（相乘效应 = 2.49）的使用增加，而劳动力移民男性的使用减少（相乘效应 = 0.03）。对于心理学家，与丹麦族裔相比，来自RGC的移民男性使用增加（相乘效应 = 2.96），而劳动力移民女性的使用减少（相乘效应 = 0.27）。
心理健康状况对精神科医生和心理学家的使用有一定的解释作用。丹麦心理保健系统的这些特定部分似乎对不同人群的健康需求有反应，特别是对来自RGC的移民。然而，应该更加关注非西方劳动力移民以满足他们的心理健康需求。
