Fakhoury Julien, Burton-Jeangros Claudine, Consoli Liala, Duvoisin Aline, Courvoisier Delphine, Jackson Yves
Swiss NCCR "LIVES - Overcoming Vulnerability: Life Course Perspectives", University of Geneva, Geneva, Switzerland.
Center for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, Geneva, Switzerland.
BMC Psychiatry. 2021 Apr 1;21(1):175. doi: 10.1186/s12888-021-03149-7.
Undocumented migrants live and work in precarious conditions. Few studies have explored the mental health consequences of such environment. The objective of this study is to describe the mental health of migrants at different stages of a regularization program.
This cross-sectional study included migrants undocumented or in the process of regularization. We screened for symptoms of anxiety, depression and sleep disturbance using validated tools. We created a composite outcome of altered mental health including these components plus self-report of a recent diagnosis of mental health condition by a health professional.
We enrolled 456 participants of whom 246 (53.9%) were undocumented. They were predominantly women (71.9%) with a median age of 43.3 (interquartile range: 15.5) years, from Latin America (63.6%) or Asia (20.2%) who had lived in Switzerland for 12 (IQR: 7) years. Overall, 57.2% presented symptoms of altered mental health. Prevalence of symptoms of anxiety, depression and sleep disturbance were 36% (95% confidence interval: 31.6-40.6%), 45.4% (95% CI: 40.8-50.1%) and 23% (95% CI: 19.2-27.2), respectively. Younger age (adjusted odd ratio: 0.7; 95% CI: 0.5-0.9 for each additional decade), social isolation (aOR: 2.4; 95% CI: 1.4-4.2), exposure to abuse (aOR: 1.9; 95% CI: 1.1-3.5), financial instability (aOR: 2.2; 95% CI: 1.4-3.7) and multi-morbidity (aOR: 3.2; 95% CI: 1.7-6.5) were associated with increased risk of having altered mental health while being in the early stages of the process of regularization had no effect (aOR: 1.3: 95% CI: 0.8-2.2).
This study highlights the need for multi-pronged social and health interventions addressing the various domains of undocumented migrants living difficulties as complement to legal status regularization policies. Protection against unfair working conditions and abuse, access to adequate housing, promoting social integration and preventive interventions to tackle the early occurrence of chronic diseases may all contribute to reduce the burden of altered mental health in this group. More research is needed to assess the long-term impact of legal status regularization on mental health.
无证移民生活和工作条件不稳定。很少有研究探讨这种环境对心理健康的影响。本研究的目的是描述处于合法化进程不同阶段的移民的心理健康状况。
这项横断面研究纳入了无证或正在办理合法化手续的移民。我们使用经过验证的工具筛查焦虑、抑郁和睡眠障碍症状。我们创建了一个心理健康改变的综合结果，包括这些组成部分以及卫生专业人员最近诊断为心理健康状况的自我报告。
我们招募了456名参与者，其中246名（53.9%）为无证移民。他们主要为女性（71.9%），中位年龄为43.3岁（四分位间距：15.5），来自拉丁美洲（63.6%）或亚洲（20.2%），已在瑞士生活12年（四分位间距：7）。总体而言，57.2%的人表现出心理健康改变的症状。焦虑、抑郁和睡眠障碍症状的患病率分别为36%（95%置信区间：31.6 - 40.6%）、45.4%（95%置信区间：40.8 - 50.1%）和23%（95%置信区间：19.2 - 27.2%）。年龄较小（调整后的优势比：0.7；每增加十岁95%置信区间：0.5 - 0.9）、社会隔离（调整后的优势比：2.4；95%置信区间：1.4 - 4.2）、遭受虐待（调整后的优势比：1.9；95%置信区间：1.1 - 3.5）、经济不稳定（调整后的优势比：2.2；95%置信区间：1.4 - 3.7）和多种疾病并存（调整后的优势比：3.2；95%置信区间：1.7 - 6.5）与心理健康改变风险增加相关，而处于合法化进程早期阶段则没有影响（调整后的优势比：1.3：95%置信区间：0.8 - 2.2）。
本研究强调需要采取多方面的社会和健康干预措施，解决无证移民生活困难的各个领域，作为法律身份合法化政策的补充。防止不公平的工作条件和虐待、提供适当住房、促进社会融合以及采取预防性干预措施以应对慢性病的早期发生，都可能有助于减轻该群体心理健康改变的负担。需要更多研究来评估法律身份合法化对心理健康的长期影响。
