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Utilisation of psychiatrists and psychologists in private practice among non-Western labour immigrants, immigrants from refugee-generating countries and ethnic Danes: the role of mental health status

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Abstract

Purpose

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.

Methods

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.

Results

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.

Conclusions

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.

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Acknowledgments

We thank participants in the study “Ethnic minorities’ health”, Partnerskabet, in particular John Singhammer, for collaboration of data collection. Thanks to John Sahl Andersen and Frans Boch Waldorff for information on health registries, to Cecilie Dinesen for information on education variables and to Nana Folmann Hempler for commenting on the manuscript. Thanks too to Trygfonden for a grant for this study. This paper is a by-product of the EU-funded project Migrant and Ethnic Minority Health Observatory (MEHO) (http://www.meho.eu.com) from the work package “Healthcare utilization and self-perceived health”. We thank the project leader Marleen Foets, co-project leader Gerrit Koopmans, and former leader Semiha Denktaş (Erasmus Medical Centre, The Netherlands), as well as other participants: Laura Cacciani, Emanuela Forcella, and Aldo Rosano (Agenzia di Sanitá Pubblica della Regiona Lazio, Italy), Johan Mackenbach and Irina Stirbu (Erasmus Medical Centre, The Netherlands), Anton Kunst (University of Amsterdam), Raj Bhopal and Snorri Bjorn Rafnsson (University of Edinburgh, Scotland), Jacob Spallek, Oliver Razum, and Anna Reeske (University of Bielefeld, Germany), Alexander Krämer, Manas Akmatov (University of Bielefeld, Germany), Ralf Reintjes and Johann Popp (University of Hamburg, Germany), Kvetoslava Rimarova (University of Slovenia), and Dineke Zeegers (EUPHA). The study was supported by a grant from Trygfonden and DG Sanco, EU Commission.

Conflict of interest

The authors declare that there is no conflict of interest.

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Authors and Affiliations

  1. 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

    Signe Smith Nielsen, Natasja Koitzsch Jensen, Marie Norredam & Allan Krasnik

  2. Section for Biostatistics, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5A, 1014, Copenhagen K, Denmark

    Svend Kreiner

Authors
  1. Signe Smith Nielsen
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  2. Natasja Koitzsch Jensen
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  3. Svend Kreiner
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  4. Marie Norredam
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  5. Allan Krasnik
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Correspondence to Signe Smith Nielsen.

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Nielsen, S.S., Jensen, N.K., Kreiner, S. et al. Utilisation of psychiatrists and psychologists in private practice among non-Western labour immigrants, immigrants from refugee-generating countries and ethnic Danes: the role of mental health status. Soc Psychiatry Psychiatr Epidemiol 50, 67–76 (2015). https://doi.org/10.1007/s00127-014-0916-y

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  • DOI: https://doi.org/10.1007/s00127-014-0916-y

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