Arwidson Charlotta van Eggermont, Holmgren Jessica, Gottberg Kristina, Tinghög Petter
Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
Department of Health Sciences, Swedish Red Cross University, Huddinge, Sweden.
PLOS Glob Public Health. 2025 May 28;5(5):e0003987. doi: 10.1371/journal.pgph.0003987. eCollection 2025.
Refugees and asylum seekers face an increased risk of poor mental health, and evidence shows that housing in the post-migration context plays a crucial role in shaping their mental well-being. Research also suggests that institutional accommodations during the asylum process might be more detrimental to their mental health compared to private accommodations. We aimed to prospectively estimate the associations between housing type during the asylum process (institutional or self-organized accommodations) and healthcare utilization for common mental disorders (CMDs) after being granted a residence permit as a refugee in Sweden. This register-based cohort study includes all asylum seekers aged 18-60 who were granted residence permits in Sweden between 2010 and 2012, totaling 20,396 individuals, of whom 11,694 resided in self-organized housing (EBO) and 8,702 in accommodation centers (ABO). Using a generalized estimating equation (GEE), we estimated the associations between housing type (ABO or EBO) and prescriptions for antidepressants or anxiolytic medication, as well as specialized in- and outpatient visits with a diagnosis of CMDs, over a five-year follow-up period after being granted a residence permit. The adjusted odds ratio (controlled for sociodemographic factors) showed that those who had lived in ABO, compared with EBO, had a greater risk of any antidepressant or anxiolytic prescriptions (OR = 1.32, [1.21-1.44]) as well as any specialized in- or outpatient visits with a CMD diagnosis (OR = 1.41 [1.27-1.52]). Our results demonstrate that former asylum seekers who have lived in institutional housing use more mental healthcare services than those who have lived in self-organized housing, even when potential sociodemographic confounders and mediators are adjusted for. These associations persisted for up to five years after they had received a residence permit, highlighting that when asylum seekers live in institutional housing it is especially important to discuss how health can be promoted during the asylum-seeking period.
难民和寻求庇护者面临心理健康状况不佳的风险增加，有证据表明，移民后的住房状况对他们的心理健康起着至关重要的作用。研究还表明，与私人住房相比，庇护程序期间的机构收容可能对他们的心理健康更有害。我们旨在前瞻性地估计庇护程序期间的住房类型（机构收容或自行安排的住房）与在瑞典获得难民居留许可后常见精神障碍（CMD）的医疗保健利用之间的关联。这项基于登记的队列研究包括2010年至2012年期间在瑞典获得居留许可的所有18至60岁的寻求庇护者，共计20396人，其中11694人居住在自行安排的住房（EBO）中，8702人居住在收容中心（ABO）。我们使用广义估计方程（GEE），估计了住房类型（ABO或EBO）与获得居留许可后的五年随访期内抗抑郁药或抗焦虑药处方以及诊断为CMD的专科门诊和门诊就诊之间的关联。调整后的优势比（控制社会人口因素）显示，与EBO相比，居住在ABO的人开具任何抗抑郁药或抗焦虑药处方的风险更高（OR = 1.32，[1.21 - 1.44]）以及任何诊断为CMD的专科门诊或门诊就诊的风险更高（OR = 1.41 [1.27 - 1.52]）。我们的结果表明，曾居住在机构住房中的前寻求庇护者比居住在自行安排住房中的人使用更多的精神卫生保健服务，即使对潜在的社会人口混杂因素和中介因素进行了调整也是如此。这些关联在他们获得居留许可后持续了长达五年，这突出表明，当寻求庇护者居住在机构住房中时，讨论在寻求庇护期间如何促进健康尤为重要。
