Kurdish men's experiences of migration-related mental health issues

Mortality among immigrant patients 20-45 years of age with chronic back pain in primary care in Sweden: A 15-year follow-up cohort study

BACKGROUND

Mortality rates among immigrant patients undergoing rehabilitation for musculoskeletal backache are unknown.

OBJECTIVE

To study the association between marital status, severe psychosocial strain, receiving long-term time-limited sickness allowance (TLSA) and all-cause mortality (ACM) in a cohort of immigrants aged 20-45 years with long-standing backache in Sweden.

METHODS

We studied 318 patients (92% foreign-born, 76% non-European) of known marital status on sick-leave for musculoskeletal backache. They were followed up for ACM until 2015. Socio-demographic data, TLSA and psychosocial strain, including major depression, severe psychosocial stressors and pessimistic thoughts, were analysed using multiple-imputation Cox regression.

RESULTS

Over a mean (standard deviation) follow-up time of 15 (5.0) years, 11 (3.5%) participants died. At baseline, 34% were unmarried, 19% were receiving TLSA, and 71% had ⩾ 1 psychosocial strain component (38% depression; 47% severe stressors; 35% pessimistic thoughts). After concomitant risk factors were adjusted for, being unmarried and receiving TLSA were associated with higher mortality by factors of 6.2 (p= 0.005) and 5.8 (p= 0.006), respectively. Psychosocial strain was only significantly associated with higher mortality in the unadjusted analyses.

CONCLUSIONS

Being unmarried and receiving TLSA were associated with significantly higher ACM in this highly marginalized group of immigrant patients.

How do people seeking asylum in the United Kingdom conceptualize and cope with the asylum journey?

People seeking asylum experience traumatic events and psychological difficulties in country-of-origin, in 'flight', and during re-settlement. Research with this population has focussed on using quantitative methods to examine psychopathology from exposure to traumatic events, and there is a paucity of qualitative research exploring subjective experiences of this population throughout their asylum journey. Few studies have examined ways asylum seekers might cope with such events. This study aimed to address this gap by employing Constructivist Grounded Theory to understand the ways people seeking asylum conceptualize and cope with their experiences across the asylum process. Semi-structured interviews were conducted with eleven people seeking asylum accessing a third sector mental health project and/or primary-care health service. Four main themes emerged from the data: 'Before Asylum', 'Displacement', 'Identity in the UK' and 'Reflections on the Future'. The stress of the asylum system and adaptation to new environments are core aspects of the theory, along with an exploration of how people cope with these circumstances, via internal psychological strategies and external support sources. Prior experiences (including the development of 'inner strength') impacted upon how participants conceptualized their everyday experiences, and this shaped their considerations for the future. Service implications are discussed.

Internet-based treatment of depressive symptoms in a Kurdish population: A randomized controlled trial

OBJECTIVE

Kurdish immigrants in Sweden have a doubled risk of mental health problems, and refugee and immigrant populations underutilize mental health services. The present study investigated the efficacy of culturally adapted guided internet-based cognitive behavior therapy (ICBT) for depressive symptoms in a Kurdish population.

METHOD

We included 50 individuals who were randomized to either an 8-week treatment or a wait-list. The Beck Depression Inventory-II was the primary outcome measure, and measures of anxiety and insomnia were secondary outcomes.

RESULTS

Depressive symptoms were significantly reduced (intention-to-treat analysis) in the treatment group, with a between-group effect size at posttreatment of Cohen's d = 1.27. Moderate to large between-group effects were also observed on all secondary outcome measures. Treatment effects were sustained at 11-month follow-up.

CONCLUSION

The results provide preliminary support for culturally adapted ICBT as a complement to other treatment formats for treating symptoms of depression in a Kurdish population.

'I Wanted to Come Here Because of My Child': Stories of Migration Told by Turkish-Speaking Families Who Have a Son or Daughter with Intellectual Disabilities

BACKGROUND

Despite growing interest in the experiences and social barriers experienced by people with intellectual disabilities from ethnic minorities, the specific challenges associated with migration from abroad faced by these individuals and their families have been overlooked. This research focuses on narratives told by Turkish-speaking families about migrating to the UK with a family member with intellectual disabilities.

METHOD

Semi-structured interviews were carried out with five Turkish-speaking families who have a son or daughter with an intellectual disability and had migrated to the UK. Interviews were analysed using narrative analysis.

RESULTS

Seeking help for the person with intellectual disabilities in a new country was a central part of migration narratives. The family member with intellectual disabilities was described as being caught up in wider geo-political conflicts. Families continued to face challenges within their own communities and with accessing local services.

CONCLUSIONS

Eliciting narratives about families' migration to their new homes can provide professionals with important information about family experiences of trauma and clarify hopes and expectations regarding service provision.