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Patterns of inpatient care for immigrants in Switzerland

A case control study

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Abstract

Background

Migration has become a major political and social concern in West European societies.

Methods

A case–control method was used to analyse the utilisation of inpatient mental health services by immigrants from a catchment area in Switzerland over a 7-year period.

Results

Compared to natives, immigrants had fewer psychiatric hospitalisations, but more emergency and compulsory admissions. During inpatient treatment, they received less psycho-, ergo- and physiotherapy. Other therapies as well as compulsory measures were at comparable rates, as was the frequency of irregular discharge. They spent shorter periods as inpatients and the rate of psychiatric readmissions was significantly lower. Comparison of different countries of origin revealed that only patients from West and North Europe were comparable to natives regarding type of referral, inpatient treatment, and longitudinal measures of service utilisation. Even after accounting for effects of social class, immigrants from South Europe, former Yugoslavia, Turkey, East Europe and more distant countries spent significantly shorter time in inpatient treatment, compared to Swiss control patients.

Conclusions

Results of this study clearly point to an underutilisation of inpatient facilities among immigrants with mental disorders, and to disadvantages in psychiatric inpatient care. This, however, does not pertain to all foreign patients to the same extent: inequalities of mental health service use are particularly pronounced in immigrants from more distant countries.

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References

  1. Freeman GP (1997) Immigration as a source of political discontent and frustration in Western democracies. Stud Comp Int Dev 32:42–64

    CAS  PubMed  Google Scholar 

  2. Hutchinson G, Haasen C (2004) Migration and schizophrenia: the challenges for European psychiatry and implications for the future. Soc Psychiatry Psychiatr Epidemiol 39:350–357

    Article  PubMed  Google Scholar 

  3. Swiss Federal Statistical Office (2005) http://www.bfs.admin.ch/bfs/portal/de/index/themen/bevoelkerung/uebersicht/blank/wichtigste_kennzahlen.html. 19–09–2005

  4. Ødegård O (1932) Emigration and insanity: a study of mental disease among Norwegian born population in Minnesota. Acta Psychiatr Neurol 7:1–206

    Google Scholar 

  5. Cantor-Graae E, Pedersen CB, McNeil TF, Mortensen PB (2003) Migration as a risk factor for schizophrenia: a Danish population-based cohort study. Br J Psychiatry 182:117–122

    Article  PubMed  Google Scholar 

  6. Vollebergh WA, ten Have M, Dekovic M, Oosterwegel A, Pels T, Veenstra R, et al. (2005) Mental health in immigrant children in the Netherlands. Soc Psychiatry Psychiatr Epidemiol 40:489–496

    Article  PubMed  Google Scholar 

  7. Bhugra D (2002) Ethnic factors and service utilization. Curr Opin Psychiatry 15:201–204

    Article  Google Scholar 

  8. Steel Z, Silove D, Chey T, Bauman A, Phan T, Phan T (2005) Mental disorders, disability and health service use amongst Vietnamese refugees and the host Australian population. Acta Psychiatr Scand 111:300–309

    Article  CAS  PubMed  Google Scholar 

  9. McCrone P, Bhui K, Craig T, Mohamud S, Warfa N, Stansfeld SA, et al. (2005) Mental health needs, service use and costs among Somali refugees in the UK. Acta Psychiatr Scand 111:351–357

    Article  CAS  PubMed  Google Scholar 

  10. Lorant V, Kampfl D, Seghers A, Deliege D, Closon MC, Ansseau M (2003) Socio-economic differences in psychiatric in-patient care. Acta Psychiatr Scand 107:170–177

    Article  CAS  PubMed  Google Scholar 

  11. Drukker M, Driessen G, Krabbendam L, van Os J (2004) The wider social environment and mental health service use. Acta Psychiatr Scand 110:119–129

    Article  CAS  PubMed  Google Scholar 

  12. Gotor L, Gonzalez-Juarez C (2004) Psychiatric hospitalization and continuity of care in immigrants treated in Madrid (Spain). Soc Psychiatry Psychiatr Epidemiol 39(7):560–568

    Article  PubMed  Google Scholar 

  13. Have M, Oldehinkel A, Vollebergh W, Ormel J (2003) Does educational background explain inequalities in care service use for mental health problems in the Dutch general population? Acta Psychiatr Scand 107:178–187

    Article  PubMed  Google Scholar 

  14. Commander MJ, Odell S, Sashidharan SP, Surtees PG (1999) Psychiatric morbidity in people born in Ireland. Soc Psychiatry Psychiatr Epidemiol 34:565–569

    CAS  PubMed  Google Scholar 

  15. Fossion P, Ledoux Y, Valente F, Servais L, Staner L, Pelc I, et al. (2002) Psychiatric disorders and social characteristics among second-generation Moroccan migrants in Belgium: an age-and gender-controlled study conducted in a psychiatric emergency department. Eur Psychiatry 17:443–450

    Article  CAS  PubMed  Google Scholar 

  16. Fossion P, Servais L, Rejas MC, Ledoux Y, Pelc I, Minner P (2004) Psychosis, migration and social environment: an age- and gender-controlled study. Eur Psychiatry 19:338–343

    Article  CAS  PubMed  Google Scholar 

  17. Haasen C, Yagdiran O, Mass R, Krausz M (2001) Schizophrenic disorders among Turkish migrants in Germany. A controlled clinical study. Psychopathology 34:203–208

    Article  CAS  PubMed  Google Scholar 

  18. Schrier AC, van de Wetering BJ, Mulder PG, Selten JP (2001) Point prevalence of schizophrenia in immigrant groups in Rotterdam: data from outpatient facilities. Eur Psychiatry 16:162–166

    Article  CAS  PubMed  Google Scholar 

  19. Lay B, Lauber C, Rossler W (2005) Are immigrants at a disadvantage in psychiatric in-patient care? Acta Psychiatr Scand 111:358–366

    Article  CAS  PubMed  Google Scholar 

  20. Christen S, Christen L, Meyer PC, Eichenberger A (2003) Length of inpatient stay in psychiatric hospitals – record linkage. Research Report of the Psychiatric University Hospital Zurich 8[1] ISBN-Nr. 3-907620-32-1

  21. World Health Organisation (1993) The International Statistical Classification of Diseases and Related Health Problems, 10th revision. Chapter V (F). German Version. Huber, Bern Göttingen, Toronto, Seattle

  22. Brown H, Prescott R (2000) Applied mixed models in medicine. Wiley, Chichester

    Google Scholar 

  23. Zolkowska K, Cantor-Graae E, McNeil TF (2001) Increased rates of psychosis among immigrants to Sweden: is migration a risk factor for psychosis? Psychol Med 31:669–678

    Article  CAS  PubMed  Google Scholar 

  24. Gupta S (1991) Psychosis in migrants from the Indian subcontinent and English-born controls. A preliminary study on the use of psychiatric services. Br J Psychiatry 159:222–225

    CAS  PubMed  Google Scholar 

  25. Phan T (2000) Investigating the use of services for Vietnamese with mental illness. J Community Health 25:411–425

    Article  CAS  PubMed  Google Scholar 

  26. Smaje C, Grand JL (1997) Ethnicity, equity and the use of health services in the British NHS. Soc Sci Med 45:485–496

    Article  CAS  PubMed  Google Scholar 

  27. Stronks K, Ravelli AC, Reijneveld SA (2001) Immigrants in the Netherlands: equal access for equal needs? J Epidemiol Community Health 55:701–707

    CAS  PubMed  Google Scholar 

  28. Weiss MG, Yilmaz AT (2001) Euro-international perspectives. In: Yilmaz AT, Weiss MG, Riecher-Rössler A (eds) Cultural psychiatry: Euro-international perspectives. Basel, Karger, pp1–10

    Google Scholar 

  29. Iversen VC, Morken G (2003) Acute admissions among immigrants and asylum seekers to a psychiatric hospital in Norway. Soc Psychiatry Psychiatr Epidemiol 38:515–519

    PubMed  Google Scholar 

  30. Klimidis S, McKenzie DP, Lewis J, Minas IH (2000) Continuity of contact with psychiatric services: immigrant and Australian-born patients. Soc Psychiatry Psychiatr Epidemiol 35:554–563

    Article  CAS  PubMed  Google Scholar 

  31. Bruxner G, Burvill P, Fazio S, Febbo S (1997) Aspects of psychiatric admissions of migrants to hospitals in Perth, Western Australia. Aust NZ J Psychiatry 31:532–542

    CAS  Google Scholar 

  32. Cochrane R, Bal SS (1989) Mental hospital admission rates of immigrants to England: a comparison of 1971 and 1981. Soc Psychiatry Psychiatr Epidemiol 24:2–11

    Article  CAS  PubMed  Google Scholar 

  33. Shaikh A (1985) Cross-cultural comparison: psychiatric admission of Asian and indigenous patients in Leicestershire. Int J Soc Psychiatry 31:3–11

    CAS  PubMed  Google Scholar 

  34. Wijesinghe CP, Clancy DJ (1991) Schizophrenia in migrants living in the western region of Melbourne. Aust NZ J Psychiatry 25:350–357

    CAS  Google Scholar 

  35. Trauer T (1995) Ethnic differences in the utilisation of public psychiatric services in an area of suburban Melbourne. Aust NZ J Psychiatry 29:615–623

    CAS  Google Scholar 

  36. Bhugra D (2004) Migration and mental health. Acta Psychiatr Scand 109:243–258

    Article  CAS  PubMed  Google Scholar 

  37. OECD Health Data (2005) http://www.oecd.org/dataoecd/3/62/31938359.pdf http://www.oecd.org/dataoecd/10/20/2789777.pdf

  38. Burnett R, Mallett R, Bhugra D, Hutchinson G, Der G, Leff J (1999) The first contact of patients with schizophrenia with psychiatric services: social factors and pathways to care in a multi-ethnic population. Psychol Med 29:475–483

    Article  CAS  PubMed  Google Scholar 

  39. Cole E, Leavey G, King M, Johnson-Sabine E, Hoar A (1995) Pathways to care for patients with a first episode of psychosis. A comparison of ethnic groups. Br J Psychiatry 167:770–776

    CAS  PubMed  Google Scholar 

  40. Davies S, Thornicroft G, Leese M, Higgingbotham A, Phelan M (1996) Ethnic differences in risk of compulsory psychiatric admission among representative cases of psychosis in London. BMJ 312:533–537

    CAS  PubMed  Google Scholar 

  41. Parkman S, Davies S, Leese M, Phelan M, Thornicroft G (1997) Ethnic differences in satisfaction with mental health services among representative people with psychosis in south London: PRiSM study 4. Br J Psychiatry 171:260–264

    CAS  PubMed  Google Scholar 

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Correspondence to Barbara Lay.

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Lay, B., Lauber, C., Nordt, C. et al. Patterns of inpatient care for immigrants in Switzerland. Soc Psychiat Epidemiol 41, 199–207 (2006). https://doi.org/10.1007/s00127-005-0014-2

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