What do register-based studies tell us about migrant mental health? A scoping review

Abstract

BackgroundPrevious studies investigating the mental health of migrants have shown mixed results. The increased availability of register data has led to a growing number of register-based studies in this research area. This is the first scoping review on the use of registry and record-linkage data to examine the mental health of migrant populations. The aim of this scoping review is to investigate the topics covered and to assess the results yielded from these studies.MethodsWe used a scoping review methodology to search MedLine, PubMed, PsychINFO, Web of Science, and SCOPUS for all register-based studies on the mental health of migrants. Two reviewers screened all papers, independently, using iteratively applied inclusion and exclusion criteria. Using gradually broadening inclusion and exclusion criteria for maximum “scope,” newly published criteria developed to appraise the methodological quality of record-linkage studies were applied to eligible papers and data were extracted in a charting exercise.ResultsA total of 1309 papers were screened and appraised, 51 of which met the eligibility and quality criteria and were included in the review. This review identified four major domains of register-based research within the topic of migrant mental health: rates and risks of psychiatric disorders, rates and risks of suicide mortality, the use of psychotropic drugs, and health service utilisation and mental health-related hospitalisation rates. We found that whilst migrants can be at an increased risk of developing psychotic disorders and suicide mortality, they are less likely to use psychotropic medication and mental health-related services.ConclusionsThis review systematically charts the register-based studies on migrants’ mental health for the first time. It shows the main topics and gaps in knowledge in this research domain, discusses the disadvantages of register-based studies, and suggests new directions for forthcoming studies.Electronic supplementary materialThe online version of this article (doi:10.1186/s13643-017-0463-1) contains supplementary material, which is available to authorized users.

Psychiatric care use among migrants to Sweden compared with Swedish-born residents: a longitudinal cohort study of 5 150 753 people

“…Psychiatric care use by migrants over time is poorly understood, as time in the host country is rarely taken into account in studies, 2 and studies largely focus on either one type of care (eg, outpatient care or psychotropic medication), one diagnosis or one migrant group (eg, refugees). 2 As different forms of psychiatric care have different applications and cannot be used interchangeably, understanding general psychiatric care use among migrants, as well as their use of inpatient and outpatient care and psychotropic medication, is essential to inform policy and ensure mental health needs in this complex vulnerable population are met.…”

“…This could possibly be an explanation for migrants from Western and Southern Europe, and USA, Canada and Oceania as these are primarily labour migrants known for their better mental health 24 and possibilities to psychiatric care in their countries of origin; however, for the other migrants this explanation seems unlikely due to a high prevalence of poor mental health. [1][2][3] Register-based data are collected routinely as measures of healthcare utilisation, and this does not include other forms of help seeking such as seeking care in country of origin, traditional or complementary medicine. Register data grouping prevents most analysis by country of origin, and as such disparate ethnic, cultural and national groups may be inappropriately grouped.…”

Trajectories of sickness absence, disability pension and unemployment in young immigrants with common mental disorders

“…However, the results are mixed due to the heterogeneity of immigrant populations and shortcomings in the respective studies (83). A scoping review on register-based studies on immigrant' mental health highlighted the importance of the reason of migration for mental disorders, finding worse mental health among refugees (84). Also other factors matter.…”

Rates and characteristics of suicide by immigration background in Norway

“…Our data source does not allow us to study more closely characteristics of this subgroup of immigrants. Cases among this population segment might represent intercountry adoptees, which stand out as a high-risk group for psychotic disorders [ 36 ] and suicide death [ 37 , 38 ].…”