Abstract
Purpose
As the immigrant population rises in Norway, it becomes ever more important to consider the responsiveness of health services to the specific needs of these immigrants. It has been questioned whether access to mental healthcare is adequate among all groups of immigrants. This study aims to examine the use of specialist mental healthcare services among ethnic Norwegians and specific immigrants groups.
Methods
Register data were used from the Norwegian Patient Registry and Statistics Norway. The sample (age 0–59) consisted of 3.3 million ethnic Norwegians and 200,000 immigrants from 11 countries. Poisson regression models were applied to examine variations in the use of specialist mental healthcare during 2008–2011 according to country of origin, age group, reason for immigration, and length of stay.
Results
Immigrant children and adolescents had overall significantly lower use of specialist mental healthcare than ethnic Norwegians of the same age. A distinct exception was the high utilization rate among children and youth from Iran. Among adult immigrants, utilization rates were generally lower than among ethnic Norwegians, particularly those from Poland, Somalia, Sri Lanka, and Vietnam. Adult immigrants from Iraq and Iran, however, had high utilization rates. Refugees had high utilization rates of specialist mental healthcare, while labour immigrants had low use.
Conclusion
Utilization rates of specialist mental healthcare are lower among immigrants than Norwegians. Immigrants from Poland, Somalia, Sri Lanka, and Vietnam, had generally quite low rates, while immigrants from Iran had high utilization rates. The findings suggest that specialist mental healthcare in Norway is underutilized among considerable parts of the immigrant population.
Similar content being viewed by others
References
Bhui K, Stansfeld S, Hull S, Priebe S, Mole F, Feder G (2003) Ethnic variations in pathways to and use of specialist mental health services in the UK systematic review. Br J Psychiatry 182(2):105–116
Chow JC-C, Jaffee K, Snowden L (2003) Racial/ethnic disparities in the use of mental health services in poverty areas. AJPH 93 (5):792–797
de Haan AM, Boon AE, Vermeiren RR, de Jong JT (2012) Ethnic differences in utilization of youth mental health care. Ethn Health 17 (1–2):105–110
Mulder CL, Koopmans GT, Selten J-P (2006) Emergency psychiatry, compulsory admissions and clinical presentation among immigrants to The Netherlands. Br J Psychiatry 188(4):386–391
Snowden LR, Cheung FK (1990) Use of inpatient mental health services by members of ethnic minority groups. Am Psychol 45 (3):347
Stuart G, Klimidis S, Minas I (1998) The treated prevalence of mental disorder amongst immigrants and the Australian-born: community and primary-care rates. Int J Soc Psychiatry 44(1):22–34
Ivert A-K, Merlo J, Svensson R, Levander MT (2013) How are immigrant background and gender associated with the utilisation of psychiatric care among adolescents? Soc Psychiatry Psychiatr Epidemiol 48(5):693–699
Manhica H, Almquist Y, Rostila M, Hjern A (2016) The use of psychiatric services by young adults who came to Sweden as teenage refugees: a national cohort study. Epidemiol Psychiatr Sci 1–9. doi:10.1017/S2045796016000445
Barghadouch A, Kristiansen M, Jervelund SS, Hjern A, Montgomery E, Norredam M (2016) Refugee children have fewer contacts to psychiatric healthcare services: an analysis of a subset of refugee children compared to Danish-born peers. Soc Psychiatry Psychiatr Epidemiol 51(8):1125–1136
Straiton M, Reneflot A, Diaz E (2014) Immigrants’ use of primary health care services for mental health problems. BMC Health Serv Res 14(1):341
Straiton ML, Reneflot A, Diaz E (2016) Mental health of refugees and non-refugees from war-conflict countries: data from primary healthcare services and the Norwegian prescription database. J Immigr Minor Health 1–8. doi:10.1007/s10903-016-0450-y
Nielsen SS, Jensen NK, Kreiner S, Norredam M, Krasnik A (2015) 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(1):67–76
Spallek J, Zeeb H, Razum O (2011) What do we have to know from migrants’ past exposures to understand their health status? a life course approach. Emerg Themes Epidemiol 8(1). doi:10.1186/1742-7622-8-6
Nørredam M, Krasnik A (2011) Migrants’ access to health services. In: Rechel B, Mladovsky P, Deville W, Rijks B, Petrova-Bendict R, Mckee M (eds) Migration and health in the European Union. McGraw-Hill, Open University Press, Maidenhead, pp 67–80
Bhugra D (2004) Migration and mental health. Acta Psychiatr Scand 109(4):243–258
Lindert J, Schinina G (2011) Mental health of refugees and asylum-seekers. In: Rechel B, Mladovsky P, Deville W, Rijks B, Petrova-Bendict R, Mckee M (eds) Migration and health in the European Union. McGraw-Hill, Open University Press, Maidenhead, pp 169–181
Lindert J, Schouler-Ocak M, Heinz A, Priebe S (2008) Mental health, health care utilisation of migrants in Europe. Eur Psychiatry 23:14–20
Moullan Y, Jusot F (2014) Why is the ‘healthy immigrant effect’ different between European countries? Eur J Pub Health 24(suppl 1):80–86
Nazroo JY (1998) Rethinking the relationship between ethnicity and mental health: the British Fourth National Survey of Ethnic Minorities. Soc Psychiatry Psychiatr Epidemiol 33(4):145–148
Stevens GW, Vollebergh WA (2008) Mental health in migrant children. J Child Psychol Psychiatry 49(3):276–294. doi:10.1111/j.1469-7610.2007.01848.x
Vaage AB, Tingvold L, Hauff E, Van TT, Wentzel-Larsen T, Clench-Aas J, Thomsen PH (2009) Better mental health in children of Vietnamese refugees compared with their Norwegian peers—a matter of cultural difference? Child Adolesc Psychiatry Ment Health 3(1):34. doi:10.1186/1753-2000-3-34
Vega WA, Kolody B, Aguilar-Gaxiola S, Alderete E, Catalano R, Caraveo-Anduaga J (1998) Lifetime prevalence of DSM-III-R psychiatric disorders among urban and rural Mexican Americans in California. Arch Gen Psychiatry 55(9):771–778
Lecerof SS, Stafström M, Westerling R, Östergren P-O (2015) Does social capital protect mental health among migrants in Sweden? Health Promot Int. doi:10.1093/heapro/dav048
Ringard Å, Sagan A, Saunes I, Lindahl A (2013) Norway: health system review. Health Syst Trans 15(8):1–162
Abebe DS, Lien L, Hjelde KH (2014) What we know and don’t know about mental health problems among immigrants in Norway. J Immigr Minor Health 16(1):60–67
Owens PL, Hoagwood K, Horwitz SM, Leaf PJ, Poduska JM, Kellam SG, Ialongo NS (2002) Barriers to children’s mental health services. J Am Acad Child Adolesc Psychiatry 41(6):731–738
Pavuluri MN, Luk S-L, McGEE R (1996) Help-seeking for behavior problems by parents of preschool children: a community study. J Am Acad Child Adolesc Psychiatry 35(2):215–222
Czapka E (2016) Barriers and facilitators in access to health care services by Polish migrants in Norway. Paper presented at the 6th European Conference on Migrant and Ethnic Minority Health, Oslo, Norway, 23–25 June 2016
Bettmann JE, Penney D, Clarkson Freeman P, Lecy N (2015) Somali refugees’ perceptions of mental illness. Soc Work Health Care 54(8):738–757
Kumar B (2008) The Oslo immigrant health profile. Norwegian Institute of Public Health, Oslo
Acknowledgements
This study is part of the research project “Health care utilization among immigrants in Norway”, funded by Research Council of Norway (project number 222100).
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare having no competing interests.
Rights and permissions
About this article
Cite this article
Abebe, D.S., Lien, L. & Elstad, J.I. Immigrants’ utilization of specialist mental healthcare according to age, country of origin, and migration history: a nation-wide register study in Norway. Soc Psychiatry Psychiatr Epidemiol 52, 679–687 (2017). https://doi.org/10.1007/s00127-017-1381-1
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00127-017-1381-1