Family social support during the predeparture period: the experience of British migrants

Impact of language proficiency on mental health service use, treatment and outcomes: "Lost in Translation"

BACKGROUND

Mastery of a language is bound to place of origin; low language proficiency is thus related to migration and cultural differences, all of which influence access to mental health care, treatment and outcomes. Switzerland, being multilingual, allows the disentangling of language proficiency from migration and, to some extent, culture. This study uses propensity score matching to explore how language proficiency relates to help-seeking behaviour, service use, treatment and outcomes in patients with mental health disorders.

METHODS

We used the first admission of patients admitted to and discharged from an academic psychiatric hospital in Switzerland between January 1st, 2013 and December 31st, 2019, with an observation period of one-year post-discharge (until December 31st, 2020). We paired 2101 patients with low language proficiency to 2101 language proficient patients, balancing baseline sociodemographic and clinical characteristics using propensity score matching.

RESULTS

Patients with low language proficiency had a higher probability of compulsory admission (OR: 1.79, 99%CI: 1.60-2.02); which remained after adjustment for confounders (OR: 1.51; 99%CI: 1.21-1.89). Whilst in treatment, they had higher rates of compulsory medication (OR: 1.73, 99%CI: 1.16-2.59) and seclusion/restraint (OR: 1.87, 99%CI: 1.25-2.79). Furthermore, patients initially admitted voluntarily had a higher probability of being compulsorily retained (OR: 1.74, 99%CI: 1.24-2.46). Both groups showed similar clinical improvement rates and service use parameters.

CONCLUSIONS

Our results demonstrate that low language proficiency constitutes a risk factor for coercive measures throughout hospitalisation. The results demonstrate the need for an increase in language sensitivity in psychiatric care.

International Migration Decision-Making and Destination Selection Among Skilled Migrants

This research explored how skilled, self-selected migrants make a decision to leave their country of origin and choose a destination. Data were gathered through semi-structured interviews with 20 pre-departure and 26 post-arrival migrants to New Zealand from the United Kingdom/Ireland, India and South Africa. A thematic analysis was conducted separately for each country's data. For these migrants, the decision process contained three major decisions: whether, where and when to go. Regarding the question of whether to go, key factors were both intrapersonal and social. New Zealand was selected as a destination of choice due to quality of life, safety, environment, cultural similarity, job opportunities and the perception that migrants were wanted. On the question of when to go, the decision process was a negotiation between partners, and often extended family, which occurred over a long period of time.