Mental health and undocumented migrants in Portugal

Abstract

While awaiting resolution of their legal process, undocumented migrants (UM) face several challenges, including limited access to public health care. The purpose of this paper is to survey UM attending a detention centre in Oporto (Portugal) to estimate the prevalence of mental health disorders in this population.,A retrospective chart review was performed with the relevant sociodemographic and clinical data of all UM in the process of coercive removal from Portuguese territory, observed by Doctors of the World, during three years (2014–2016). The Tenth Version of International Classification of Mental and Behavioural Disorders was used for nosological classification.,In total, 393 detainees were eligible for the study. Most detainees were male (84 per cent) and 76 months was the mean length of stay in Portugal before detention. In total, 29 per cent of detainees were diagnosed with a mental and behavioural disorder. The most prevalent diagnosis was neurotic, stress-related and somatoform disorders (47 per cent). UM with dual diagnosis (28 per cent) led to the articulation with the integrated centres of drug addiction, which provided and monitored opioid substitution therapy. Female UM were more prone to develop any mental and behavioural disorder when compared to men (χ2=7,017; p<0.05).,In total, 9 per cent of the detainees were excluded from this study due to incomplete data on their medical charts. Some detainees presented oppositional behaviour, hostility towards others and refused to be assessed by the medical team. Both situations could have biased the prevalence of mental disorders. Finally, the appropriateness of the western model of mental health disorders (ICD-10) in the study population is controversial, considering the culture-bound phenomenology and syndromes.,This paper identified the most prevalent mental health disorders in UM detained in Portugal. The most prevalent mental health disorders were either stress-related (associated with the detention itself) or related to previous patterns of substance abuse. Given the study outcomes, it is highly recommended to mobilise human and technical resources to provide specialized mental health care to UM at least while detention policies could not be changed.