Uptake of health services for common mental disorders by first-generation Turkish and Moroccan migrants in the Netherlands

Thijs Fassaert,Wilco C Tuinebreijer,Matty As De Wit,Jack Dekker,Wim Hm Gorissen,Aartjan Tf Beekman,Arnoud P Verhoeff

doi:10.1186/1471-2458-9-307

Abstract

BackgroundMigration and ethnic minority status have been associated with higher occurrence of common mental disorders (CMD), while mental health care utilisation by non-Western migrants has been reported to be low compared to the general population in Western host countries. Still, the evidence-base for this is poor. This study evaluates uptake of mental health services for CMD and psychological distress among first-generation non-Western migrants in Amsterdam, the Netherlands.MethodsA population-based survey. First generation non-Western migrants and ethnic Dutch respondents (N = 580) participated in structured interviews in their own languages. The interview included the Composite International Diagnostic Interview (CIDI) and the Kessler psychological distress scale (K10). Uptake of services was measured by self-report. Data were analysed using weighting techniques and multivariate logistic regression.ResultsOf subjects with a CMD during six months preceding the interview, 50.9% reported care for mental problems in that period; 35.0% contacted specialised services. In relation to CMD, ethnic groups were equally likely to access specialised mental health services. In relation to psychological distress, however, Moroccan migrants reported less uptake of primary care services (OR = 0.37; 95% CI = 0.15 to 0.88).ConclusionAbout half of the ethnic Dutch, Turkish and Moroccan population in Amsterdam with CMD contact mental health services. Since the primary purpose of specialised mental health services is to treat "cases", this study provides strong indications for equal access to specialised care for these ethnic groups. The purpose of primary care services is however to treat psychological distress, so that access appears to be lower among Moroccan migrants.

Highlights

Migration and ethnic minority status have been associated with higher occurrence of common mental disorders (CMD), while mental health care utilisation by non-Western migrants has been reported to be low compared to the general population in Western host countries
The present study focuses on uptake of services for anxiety and depression, or common mental disorders (CMD)
Procedure The study was conducted using data from 580 subjects (304 ethnic Dutch and 276 first-generation Turkish and Moroccan migrants). These were sampled from the 2004 Amsterdam Health Monitor (AHM), carried out by the Amsterdam Municipal Health Service (GGD) in collaboration with the National Institute for Public Health and the Environment (RIVM) [31,32]

Summary

Introduction

Migration and ethnic minority status have been associated with higher occurrence of common mental disorders (CMD), while mental health care utilisation by non-Western migrants has been reported to be low compared to the general population in Western host countries. A growing proportion of these migrants have Muslim-religious backgrounds, and current political and social circumstances – by some characterised as "Islamophobia" – have been argued to contribute to the marginalisation of this religious minority [5,6]. Both migration and marginalisation have been suggested as possible risk factors for (mental) health problems [5,6,7,8], which poses challenges for research in determining whether current uptake of health services by non-Western migrants adequately meets their needs. The present study focuses on uptake of services for anxiety and depression, or common mental disorders (CMD)

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