Experience of discrimination and engagement with mental health and other services by Travellers in Ireland: findings from the All Ireland Traveller Health Study (AITHS)

Abstract

Objectives: Irish Travellers are an indigenous ethnic minority population in Ireland, with poor life expectancy. This study aims to identify factors associated with reported discrimination and how this affects their experiences of accessing and quality of health services, including mental health. Methods: The All Ireland Traveller Health Study was a cross-sectional census study in 2010. All Traveller families completed a survey questionnaire (n = 6540), and at random an adult selected from the family completed either a health status (health status study = 1547) or health services utilisation survey (HSU = 1576). Experience of discrimination (EOD) from the census was analysed in relation to HSU data on services used in the previous 12 months and reported experiences of access and quality of that health service. Census variables were analysed in relation to EOD and perceived discrimination (PD). Results: In the final models, EOD and PD were significantly associated with socio-demographic, socio-cultural and living conditions. The multivariate odds of reporting EOD ranged from OR 1.84 to 2.13 and were significant for those reporting worse opportunities in accessing health services, mental health (p = 0.001), hospitals (p < 0.001) and public health nurses (p < 0.001). The multivariate odds of reporting EOD ranged from OR 1.95 to 2.71 and remained significant for those who reported they had poorer experiences than others when using health services, quality of experience (OR 2.18, p =< 0.001), trust in providers (OR 1.95, p =< 0.001) and appropriate information (OR 2.71, p =< 0.001). Conclusions: Travellers experience high levels of discrimination which negatively affects their engagement with health services. Culturally competent services need to be developed.

A rapid review of Irish Traveller mental health and suicide: a psychosocial and anthropological perspective

“…There is a wide range of international publications (Karlsen, 2007;Paradies et al 2015) which highlight the association between the experience of discrimination and low self-esteem, suicidal tendencies, mental health and psychological stress. We explore the links between experience of discrimination in Travellers and engagement with Mental Health Services in an accompanying paper (Quirke et al 2020).…”

A qualitative reflexive thematic analysis into the experiences of being identified with a BRCA1/2 gene alteration: “So many little, little traumas could have been avoided”

“…In the Irish Travelling community, for example, genetic variants associated with cancer susceptibility have been noted, namely BRCA 2 alterations [ 59 ]. This population are known to experience disparities in both access to and quality of healthcare and health related information [ 60 ]. Future research should ensure that the implications of being a member of minority groups on access to and engagement with genetic healthcare services are examined.…”

Perceived Discrimination Among Adolescents in Ireland

“…For instance, that immigrant adolescents experience more discrimination based on their religion than their non-immigrant peers can be explained by the fact that in Ireland, the majority of people of Irish descent identify as Catholic, while many people from immigrant families have other faiths (Conner, 2019). Similarly, Traveller adolescents may be more likely to experience discrimination based on disability due to the fact that members of the Traveller community are more likely than non-Travellers to have poor health (Quirke et al, 2020).…”