Abstract
Migrants diagnosed with schizophrenia are overrepresented in forensic-psychiatric clinics. A comprehensive characterization of this offender subgroup remains to be conducted. The present exploratory study aims at closing this research gap. In a sample of 370 inpatients with schizophrenia spectrum disorders who were detained in a Swiss forensic-psychiatric clinic, 653 different variables were analyzed to identify possible differences between native Europeans and non-European migrants. The exploratory data analysis was conducted by means of supervised machine learning. In order to minimize the multiple testing problem, the detected group differences were cross-validated by applying six different machine learning algorithms on the data set. Subsequently, the variables identified as most influential were used for machine learning algorithm building and evaluation. The combination of two childhood-related factors and three therapy-related factors allowed to differentiate native Europeans and non-European migrants with an accuracy of 74.5% and a predictive power of AUC = 0.75 (area under the curve). The AUC could not be enhanced by any of the investigated criminal history factors or psychiatric history factors. Overall, it was found that the migrant subgroup was quite similar to the rest of offender patients with schizophrenia, which may help to reduce the stigmatization of migrants in forensic-psychiatric clinics. Some of the predictor variables identified may serve as starting points for studies aimed at developing crime prevention approaches in the community setting and risk management strategies tailored to subgroups of offenders with schizophrenia.
Highlights
A growing number of studies demonstrate that immigration is not related to crime, yet the myth of the criminal immigrant is still influencing public debate and fuels many of the strategies pursued by political stakeholders [1,2]
Given the frequent stigmatization of migrants detained in forensic psychiatric institutions [59], it is important to stress that the group differences we identified were outweighed by a large number of similarities
Of special importance is the finding that forensic patients with spectrum disorders (SSD) of non-European origin do not commit serious types of offences or exhibit severe psychopathological symptoms compared to forensic patients with SSD of European origin
Summary
A growing number of studies demonstrate that immigration is not related to crime, yet the myth of the criminal immigrant is still influencing public debate and fuels many of the strategies pursued by political stakeholders [1,2]. The population of intercontinental migrants in Europe comprised approximately 38 million people in 2019 [3]. Before, during, or even after migration, some of these individuals have been exposed to traumatizing stressors, such as separation from social support, alienation, integration difficulties, or discrimination Such stressors significantly increase the risk of mental illness [4,5,6,7]. With limited or no access to healthcare and healthcare systems involving numerous discriminatory practices, many migrants are prevented from receiving adequate treatment. Res. Public Health 2020, 17, 7922; doi:10.3390/ijerph17217922 www.mdpi.com/journal/ijerph
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