Skip to main content

Advertisement

SpringerLink
Log in

Trauma, Psychosocial Factors, and Help-Seeking in Three Immigrant Groups in Finland

  • Published:
The Journal of Behavioral Health Services & Research Aims and scope Submit manuscript

Abstract

Multiple psychosocial factors influence help-seeking behavior among immigrants, but studies have focused on separate issues in single cultural groups. This study tested a model of help-seeking behavior among three ethnically different immigrant groups. Participants were 1356 Somali, Russian, and Kurdish immigrants (18–64 years). They reported past traumatic events, social network, acculturation indices, trust in services, and mental health as well as usage of mental and somatic health services. Structural equation modeling (SEM) with multigroup procedure was applied. First, past traumatic events were associated with seeking more mental health services, indirectly mediated through increased risk for mental health problems in all three ethnic groups. Second, acculturation played a significant role in the use of mental and somatic health services only in Kurds and social networks in Kurds and Russians. The unique culturally influenced dynamics in help-seeking behavior should be considered in the development of health services.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Figure 1
Figure 2
Figure 3
Figure 4

Similar content being viewed by others

References

  1. Ngui EM, Khasakhala L, Ndetei D, et al. Mental disorders, health inequalities, and ethics: a global perspective. International Review of Psychiatry. 2010;22(3):235–244.

    Article  PubMed  Google Scholar 

  2. Andersen RM. Revisiting the behavioral model and access to medical care: does it matter? Journal of Health and Social Behavior. 1995;36(1):1–10.

    Article  CAS  PubMed  Google Scholar 

  3. Cramer K. Psychological antecedents to help-seeking behavior: a reanalysis using path modeling structures. Journal of Counseling Psychology. 1999;46(3):381–387.

    Article  Google Scholar 

  4. Choi S, Davis C, Cummings S, et al. Understanding service needs and service utilization among older Kurdish refugees and immigrants in the USA. International Social Work. 2015;58(1):63–74.

    Article  Google Scholar 

  5. Liao HY, Rounds J, Klein A. A test of Cramer’s (1999) help-seeking model and acculturation effects with Asian/Asian American college students. Journal of Counseling Psychology. 2005;52(3):400–411.

    Article  Google Scholar 

  6. Bhui K, Abdi A, Abdi M, et al. Traumatic events, migration characteristics, and psychiatric symptoms among Somali refugees—preliminary communication. Social Psychiatry and Psychiatric Epidemiology. 2003;38(1):35–43.

    Article  PubMed  Google Scholar 

  7. Lindert J, Ehrenstein OS, Priebe S, et al. Depression and anxiety in labor migrants and refugees—a systematic review and meta-analysis. Social Science and Medicine. 2009;69(2):246–257.

    Article  PubMed  Google Scholar 

  8. Aragona M, Pucci D, Mazzetti M, et al. Post-migration living difficulties as a significant risk factor for PTSD in immigrants: a primary care study. Italian Journal of Public Health. 2012;9(3):7525-1-7525-8.

    Google Scholar 

  9. Matheson K, Jordan S, Anisman H. Relations between trauma experiences and psychological, physical, and neuroendocrine functioning among Somali refugees: mediating role of coping with acculturation stressors. Journal of Immigration and Minority Health. 2008;10(4):291–304.

    Article  Google Scholar 

  10. Slewa-Younan S, Mond JM, Bussion E, et al. Psychological trauma and help-seeking behavior amongst resettled Iraqi refugees attending English tuition classes in Australia. International Journal of Mental Health Systems. 2015;9:5.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Elsouhag D, Arnetz B, Jamil H, et al. Factors associated with healthcare utilization among Arab immigrants and Iraqi refugees. Journal of Immigrant and Minority Health. 2015;17(5):1305–1312.

    Article  CAS  PubMed  Google Scholar 

  12. Weine SM, Razzano L, Brkic N, et al. Profiling the trauma-related symptoms of Bosnian refugees who have not sought mental health services. Journal of Nervous and Mental Diseases. 2000;188(7):416–421.

    Article  CAS  Google Scholar 

  13. McCrone P, Bhui K, Craig T, et al. Mental health needs, service use, and costs among Somali refugees in the UK. Acta Psychiatrica Scandinavica 2005;111(5):351–357.

    Article  CAS  PubMed  Google Scholar 

  14. Rask S, Suvisaari J, Koskinen S, et al. The ethnic gap in mental health: a population-based study of Russian, Somali, and Kurdish origin migrants in Finland. Scandinavian Journal of Public Health. 2015;44(3):281–290.

    Article  PubMed  Google Scholar 

  15. Orjiako O, So D. The role of acculturative stress factors on mental health and help-seeking behavior of Sub-Saharan African immigrants. International Journal of Culture and Mental Health. 2013;7(3):315–325.

    Article  Google Scholar 

  16. Mirsky J. Mental health implications of migration: a review of mental health community studies on Russian-speaking immigrants in Israel. Social Psychiatry and Psychiatric Epidemiology. 2009;44(3):179–187.

    Article  PubMed  Google Scholar 

  17. Blomstedt Y, Johansson SE, Sundquist J. Mental health of immigrants from the former Soviet bloc: a future problem for primary healthcare in the enlarged European Union? A cross-sectional study. BMC Public Health. 2007;7:27.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Aroian KJ, Vander Wal JS. Health service use in russian immigrant and nonimmigrant older persons. Family and Community Health. 2007;30(3):213–223.

    Article  PubMed  Google Scholar 

  19. Close C, Kouvonen A, Bosqui T, et al. The mental health and wellbeing of first generation migrants: a systematic-narrative review of reviews. Globalization and Health. 2016;12(1):47.

    Article  PubMed  PubMed Central  Google Scholar 

  20. WonPat-Borja AJ, Yang LH, Link BG, et al. Eugenics, genetics, and mental illness stigma in Chinese Americans. Social Psychiatry and Psychiatric Epidemiology. 2012; 47(1):145–156.

    Article  PubMed  Google Scholar 

  21. Guerin B, Guerin P, Diiriye RO, et al. Somali conceptions and expectations concerning mental health: some guidelines for mental health professionals. New Zealand Journal of Psychology. 2004;33(2):59–67.

    Google Scholar 

  22. Koehn P, Tiilikainen M. Migration and transnational healthcare: connecting Finland and Somaliland. Siirtolaisuus-Migration. 2007;1:2–9.

    Google Scholar 

  23. Ma-Kellams C. Cross-cultural differences in Somatic awareness and interoceptive accuracy: a review of the literature and directions for future research. Frontiers in Psychology. 2014;5:1379.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Mölsä ME, Hjelde K, Tiilikainen M. Changing conceptions of mental distress among Somalis in Finland. Transcultural Psychiatry. 2010;47(2):276–300.

    Article  PubMed  Google Scholar 

  25. Moreno O, Cardemil E. Religiosity and mental health services: an exploratory study of help-seeking among Latinos. Journal of Latino Psychology. 2013;1(1):53–67.

    Article  Google Scholar 

  26. Pawlish CL, Noor S, Brandt J. Somali immigrant women and the American health care system: discordant beliefs, divergent expectations, and silent worries. Social Science & Medicine. 2010;7(2):353–361.

    Article  Google Scholar 

  27. Dastjerdi M, Olson K, Ogilvy L. A study of Iranian immigrants´ experiences of accessing Canadian healthcare services: a grounded theory. International Journal for Equity in Health. 2012;11:55.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Miller AM, Sorokin O, Wang E, et al. Acculturation, social alienation, and depressed mood in midlife women from the former Soviet Union. Research Nurse Health. 2006;29(2):134–146.

    Article  Google Scholar 

  29. Fassaert T, Hesselink AE, Verhoeff AP. Acculturation and use of healthcare services by Turkish and Moroccan migrants: a cross-sectional, population-based study. BMC Public Health. 2009;9:332.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Cheung BE, Chudek M, Heine SJ. Evidence for a sensitive period for acculturation: younger immigrants report acculturating at a faster rate. Psychological Sciences. 2011;22(2):147–152.

    Article  Google Scholar 

  31. Abraido-Lanza AF, Armbrister AN, Florez KR, et al. Toward a theory-driven model of acculturation in public health research. American Journal Public Health. 2006;96(8):1342–1346.

    Article  Google Scholar 

  32. Testa N, Nelson TH. Russia. In: S Loue, M Sajatovic (Eds). Encyclopedia of immigrant health. New York: Springer, 2012, pp. 1307–1311.

    Chapter  Google Scholar 

  33. Abe-Kim J, Takeuchi D, Hwang WC. Predictors of help-seeking for emotional distress among Chinese Americans: family matters. Journal of Consulting and Clinical Psychology. 2002;70(5):1186–1190.

    Article  PubMed  Google Scholar 

  34. Kuo BCH, Roldan-Bau A, Lowinger R. Psychological help-seeking among Latin-American immigrants in Canada: testing a culturally-expanded model of the theory of reasoned action using path analysis. International Journal for the Advancement of Counselling. 2015;37(2):179–197.

    Article  Google Scholar 

  35. Shpilko I. Russian–American healthcare: bridging the communication gap between physicians and patients. Patient Education & Counseling. 2006;64(1–3):331–341.

    Article  Google Scholar 

  36. Piwowarczyk L, Bishop H, Yusuf A, et al. Congo and Somali beliefs about mental health services. Journal of Nervous and Mental Diseases. 2014;202(3):209–216.

    Article  Google Scholar 

  37. Taloyan M, Saleh-Stattin N, Johansson LM, et al. Acculturation strategies in migration stress among Kurdish men in Sweden: a narrative approach. American Journal of Men’s Health. 2011;5(3):198–207.

    Article  PubMed  Google Scholar 

  38. Bergmark R, Barr D, Garcia R. Mexican immigrants in the U.S. living far from the border may return to Mexico for health services. Journal of Immigrant and Minority Health. 2010;12(4):610–614.

    Article  PubMed  Google Scholar 

  39. Tudiver F, Talbot Y. Why don’t men seek help? Family physicians’ perspectives on help-seeking behavior in men. Journal of Family Practice. 1999;48(1):47–52.

    CAS  PubMed  Google Scholar 

  40. Masuda A, Suzumura K, Beauchamp KL, et al. United States and Japanese college students’ attitudes toward seeking professional psychological help. International Journal of Psychology. 2005;40(5):303–313.

    Article  Google Scholar 

  41. European Commission: Directorate-General for Employment, Social Affairs, and Equal Opportunities. Access to healthcare and long-term care: equal for women and men? Final synthesis report. Luxembourg: Publications Office of the European Union, 2009.

    Google Scholar 

  42. Berchet C, Jusot F. Immigrants’ health status and use of healthcare services: a review of French research. Issues in Health Economics. 2012;172.

  43. Knipscheer JW, Drogendijk AN, Gülsen CH, et al. Differences and similarities in posttraumatic stress between economic migrants and forced migrants: acculturation and mental health within a Turkish and a Kurdish sample. International Journal of Clinical and Health Psychology. 2009;9(3):373–391.

    Google Scholar 

  44. Varnum MEW, Grossman I, Kitayama S, et al. The origin of cultural differences in cognition: evidence for the social orientation hypothesis. Current Directions in Psychological Science. 2010;19(1):9–13.

    Article  PubMed  PubMed Central  Google Scholar 

  45. Castaneda AE, Rask S, Koponen P, et al. Migrant health and wellbeing. A study on persons of Russian, Somali, and Kurdish origin in Finland. Helsinki, FI: National Institute for Health and Welfare, 2012.

    Google Scholar 

  46. Robins JM, Rotnizky A, Zhao LP. Estimation of regression coefficients when some regressors are not always observed. Journal of the American Statistical Association. 1994;89(427):846–866.

    Article  Google Scholar 

  47. Derogatis LR, Lipman RS, Rickels K, et al. The Hopkins Symptom Checklist (HSCL): a self-report symptom inventory. Behavioral Sciences. 1974;19(1):1–15.

    Article  CAS  Google Scholar 

  48. Tinghög P, Carstensen J. Cross-Cultural Equivalence of HSCL-25 and WHO (ten) Wellbeing Index: findings from a population-based survey of immigrants and non-immigrants in Sweden. Community Mental Health Journal. 2010;46(1):65–76.

    Article  PubMed  Google Scholar 

  49. Derogatis LR, Lipman RS, Covi L. SCL-90: an outpatient psychiatric rating scale—preliminary report. Psychopharmacology Bulletin. 1973;9(1):13–28.

    CAS  PubMed  Google Scholar 

  50. Hu L, Bentler PM. Cutoff criteria for fit indices in covariance structure analysis: conventional criteria versus new alternatives. Structural Equation Modeling. 1999;6(1):1–55.

    Article  Google Scholar 

  51. Yuan KH, Hayashi K, Bentler PM. Normal theory likelihood ratio statistic for mean and covariance structure analysis under alternative hypotheses. Journal of Multivariate Analysis. 2007;98(6):1262–1282.

    Article  Google Scholar 

  52. Lamkaddem M, Stronks K, Devillé WD, et al. Course of post-traumatic stress disorder and healthcare utilisation among resettled refugees in the Netherlands. BMC Psychiatry. 2014;14:90.

    Article  PubMed  PubMed Central  Google Scholar 

  53. Schubert CC, Punamäki RL. Torture and PTSD: prevalence, sequelae, protective factors, and therapy. In: CR Martin, VR Preedy, VB Patel (Eds). Comprehensive guide to post-traumatic stress disorder. New York: Springer, 2015, pp. 1–26.

    Google Scholar 

  54. Jenkins R, Lancashire S, McDaid D, et al. Mental health reform in the Russian Federation: an integrated approach to achieve social inclusion and recovery. Bulletin of the World Health Organization. 2007;85(11):858–866.

    Article  PubMed  PubMed Central  Google Scholar 

  55. Kuittinen S, Punamäki RL, Mölsä M, et al. Depressive symptoms and their psychosocial correlates among older Somali refugees and native Finns. Journal of Cross-Cultural Psychology. 2014;45(9):1434–1452.

    Article  Google Scholar 

  56. Pahwa P, Karunanayake CP, McCrosky J, et al. Longitudinal trends in mental health among ethnic groups in Canada. Chronic Diseases and Injuries in Canada. 2012;32(3):164–176.

    CAS  PubMed  Google Scholar 

  57. Szaflarski M, Cubbins LA, Ying J. Epidemiology of alcohol abuse among US immigrant populations. Journal of Immigrant and Minority Health. 2011;13(4):647–658.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Faculty of Social Sciences, Psychology, University of Tampere, FI-33014, Tampere, Finland

    Carla C. Schubert & Raija-Leena Punamäki

  2. National Institute for Health and Welfare, Helsinki, Finland

    Jaana Suvisaari, Päivikki Koponen & Anu Castaneda

Authors
  1. Carla C. Schubert
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Raija-Leena Punamäki
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jaana Suvisaari
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Päivikki Koponen
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Anu Castaneda
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Carla C. Schubert.

Ethics declarations

Conflict of Interest

The authors declare that they have no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Schubert, C.C., Punamäki, RL., Suvisaari, J. et al. Trauma, Psychosocial Factors, and Help-Seeking in Three Immigrant Groups in Finland. J Behav Health Serv Res 46, 80–98 (2019). https://doi.org/10.1007/s11414-018-9587-x

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11414-018-9587-x

Search

Navigation