Mental health status of a Latin American community in New South Wales

Ethnicity, Immigration Status, And Driving Under The Influence Of Alcohol

BACKGROUND

Understanding risk factors for driving under the influence of alcohol (DUIA) informs development of effective interventions. This study examined the association between ethnicity, immigration status, and DUIA, exploring psychological distress and hazardous drinking as additional contributors.

METHOD

Data were derived from the 2003-2011 cycles of the Centre for Addiction and Mental Health (CAMH) Monitor of 16,101 adults from Ontario, Canada. Hierarchical binary logistic regression analysis assessed self-identified ethnicity and immigration status as predictors of DUIA, adjusting for sociodemographics and driving exposure (Model 1), psychological distress (Model 2), and hazardous drinking (Model 3).

RESULTS

In Model 1, respondents born outside of Canada had reduced odds of engaging in DUIA compared to those born in Canada (AOR = 0.72, 95%CI = 0.56 - 0.92). Relative to those identifying as Canadian, the odds of DUIA were significantly reduced for those identifying as East Asian (AOR = 0.28, 95%CI = 0.13 - 0.61) and South Asian (AOR = 0.52, 95%CI = 0.27 - 0.98). In Model 3, individuals who reported psychological distress (AOR = 1.69, 95%CI = 1.33 - 2.16) and those who reported hazardous drinking (AOR = 6.28, 95%CI= 5.13 - 7.69) were more likely to DUIA. Those identifying as East Asian continued to have reduced odds of DUIA compared to those identifying as Canadian (AOR = 0.38, 95%CI = 0.17 - 0.85).

CONCLUSION

Individuals born outside of Canada were less likely to engage in DUIA than individuals born in Canada. Drivers who self-identified as East Asian were less likely to DUIA than those who self-identified as Canadian. Understanding ethnic differences underlying divergent risks for DUIA will improve prevention initiatives and remedial measures programming.

Depressive Symptoms among Industrial Workers in Vietnam and Correlated Factors: A Multi-Site Survey

Depressive disorders have been found to be a significant health issue among industrial workers, resulting from work-related factors and causing serious burdens for the workers as well as their employers. Literature on mental health problems of Vietnamese industrial workers has been limited, despite the rapid foreign investment-fueled industrialization process of the country. This study aimed to fill the gap in literature by examining the prevalence of depressive disorders and their potential associated factors among a cohort of Vietnamese industrial workers. A cross-sectional study was conducted in 3 industrial areas in Hanoi and Bac Ninh. A total of 289 workers agreed to participate in the study. Generalized linear mixed models were applied to identify associated factors with depression status of respondents. 38.6% of participants reported suffering depression. Factors found to be positively associated with the possibility of having depression and higher PHQ9 score were long working hours, suffering more health problems, and health hazards exposure at work. Meanwhile, being females, having more children, living with parents, engaging in smoking, and being local workers were found to correlate with lower likelihood of being depressed. The findings suggested the importance of regular health screening, work safety assurance, and social support outside of workplace on the mental health of the workers.

Common mental health problems in rural-to-urban migrant workers in Shenzhen, China: prevalence and risk factors

AIMS

Rural-to-urban migrant workers are a large marginalised population in urban China. Prevalence estimates of common mental health problems (CMHPs) in previous studies varied widely and very few studies have investigated migration-related factors of CMHPs in migrant workers. The objective of this study was to determine the prevalence and risk factors of CMHPs among Chinese migrant workers.

METHODS

A random sample of 3031 migrant workers of ten manufacturing factories in Shenzhen, China, completed a standardised questionnaire containing socio-demographic and migration-related variables and the Chinese 12-item General Health Questionnaire (GHQ-12). A GHQ-12 score of three or higher was used to denote the presence of CMHPs.

RESULTS

The prevalence of CMHPs was 34.4% in Chinese migrant workers. In multiple logistic regression, risk factors for CMHPs included being 16-25 years old (odd ratio [OR] 1.65, 95% confidence interval [CI] 1.28, 2.12), being 26-35 years old (OR 1.36, 95% CI: 1.05, 1.75), low monthly income (OR 1.42, 95% CI 1.04, 1.92), poor living condition (OR: 1.76, 95% CI: 1.22, 2.54), physical illness in the past 2 weeks (OR 1.72, 95% CI 1.43, 2.05), having worked in many cities (OR 1.34, 95% CI 1.03, 1.74), infrequently visiting hometown (OR 1.56, 95% CI 1.22, 1.99), poor Mandarin proficiency (OR 1.51, 95%CI 1.13, 2.01), a low level of perceived benefits of migration (OR 1.33, 95% CI 1.14, 1.55) and working more than 8 h/day (OR 1.39, 95% CI 1.14, 1.70).

CONCLUSIONS

CMHPs are very prevalent among Chinese migrant workers. Given the large number of Chinese migrant workers, there is an urgent need to address the mental health burden of China's migrant worker population.

Psychological Wellbeing in Three Groups of Skilled Immigrants to New Zealand

The present study sought to investigate the current levels of psychological wellbeing in three immigrant groups to New Zealand. In addition, we sought to determine whether aspects of the acculturation process were related to mental health outcomes. This is a cross–sectional study from the fifth wave of annual in-depth interviews with three groups of recently arrived skilled immigrants from India, the People's Republic of China and South Africa. Interviews focused on international contacts and the migration of relatives and friends, housing, language, qualifications and employment, and social participation. Participants were also asked about health difficulties, homesickness, and whether they felt settled in New Zealand. The SF-36 Health Status Questionnaire (Ware, 1997), assessed the respondent's functional status and wellbeing in relation to four health concepts: vitality, social functioning, role limitations due to emotional health, and general mental wellbeing. The immigrant group differed significantly from the New Zealand population on only one of the four mental health scales, Vitality, with immigrants reporting higher levels. Different acculturation factors were found to predict different mental health subscales in regression analyses. Gender, home contact and health difficulty explained 22% of the unique variance in Vitality; employment status and health difficulty explained 18% of the variance in Social Functioning; health difficulty significantly contributed to the explained variance (14%) in the Role limitations due to emotional health subscale; gender, home contact and health difficulty explained 27% of the variance in the Mental Health subscale. There was little evidence for lower levels of psychological wellbeing for the three immigrant groups compared to the general New Zealand population, nor for differences between the three groups. However, results highlight the importance of differential predictors in the understanding of psychological health in migrant groups.

Driving under the influence of alcohol: examining ethno-specific rates and the mediating effects of psychological distress and harmful and problematic drinking

This paper examines ethnic disparities in rates of driving under the influence of alcohol (DUIA) in a representative sample of Ontario adults. Data were drawn from the Centre for Addiction and Mental Health (CAMH) Monitor, a survey of 8276 Ontario adults aged 18 and older. We considered 19 distinct ethnic groups based on participants' self-identification of ethno-cultural heritage. Differences in the prevalence of DUIA across ethnic groups were limited. Relative to other ethnic groups, those adults who identified as Irish had a significantly higher rate of DUIA, while those of Italian and Chinese ethnicity had significantly lower rates of DUIA. The mediating effects of psychological distress (General Health Questionnaire) and harmful and problematic drinking (Alcohol Use Disorders Identification Test [AUDIT] consumption, dependence and problems) on the direct relationship between ethnic identity and impaired driving were also considered. Mediation was observed as remaining ethnic differences in DUIA disappeared when AUDIT subscales were introduced. These findings are interpreted in the context of patterns of alcohol consumption among ethnic populations and their impact on DUIA. Implications of study findings are considered with respect to the role of ethnicity in impaired driving research and its impact on programs and policies directed at reducing impaired driving.

Psychotic symptoms and general health in a socially disadvantaged migrant community in Bologna

BACKGROUND AND AIMS

Social exclusion and reduced access to community health services can lead to urgent health problems among immigrants; this may explain their increasing rate of admittance to psychiatric inpatient units. This cross-sectional study aims to evaluate the prevalence of psychotic symptoms among Romanian immigrants living in very poor conditions at an abandoned hotel in Bologna and to highlight the possible correlation with general health status, distress and socio-demographic characteristics.

METHODS

The Psychosis Screening Questionnaire (PSQ) and General Health Questionnaire-12 (GHQ-12) were administered to all immigrants residing at the hotel during two index days with the help of a cultural mediator. Socio-demographic, migration and health characteristics were also collected.

RESULTS

Sixty eight subjects were evaluated. More than 80% had left Romania for economic reasons. Of immigrants, 57% exceeded the four-point GHQ-12 threshold of potential mental disorder and 19% scored positively at the PSQ. Immigrants with positive PSQ showed higher mean GHQ-12 scores (5.9 +/- 3.5 vs. 3.8 +/- 2.75; p = 0.02). The development of post-migration health problems significantly predicts positive PSQ cases even after adjusting for age, sex and GHQ-12 dichotomized score (OR = 21.2, CI = 1.1-169.4).

CONCLUSION

This community of immigrants living in deprived conditions showed a high prevalence of distress and psychotic symptoms, related to health problems. Preventing excess of psychosis among immigrants and ethnic minorities in critical socio-economic conditions should mean, first and foremost, facilitating social integration and access to primary care.

Employment status, duration of residence and mental health among skilled migrants to New Zealand: results of a longitudinal study

AIMS

To report findings on employment, duration of residence and mental health from a longitudinal study of 107 skilled immigrants to New Zealand from the People's Republic of China, India and South Africa.

METHODS

Demographic and employment data were collected by face-to-face interviews using a structured questionnaire that included (as the mental health instrument) the General Health Questionnaire 12 (GHQ-12). The initial interview took place after the immigrants had been resident in New Zealand for an average of five months. Four subsequent interviews were conducted annually (1999-2002) on or about the anniversary of the first interview.

RESULTS AND CONCLUSION

Rather than an initial euphoric period followed by a mental health crisis, the results indicated poor mental health status in the first two years irrespective of employment status. Thereafter, mental health slightly improved as did employment rates. A surprising result was that although the South Africans had the highest employment rate, there were neither substantial mental health differences among the three groups nor was there a significant improvement during the course of the longitudinal study.

Psychological distress among immigrants from high- and low-income countries: findings from the Oslo Health Study

This study compared psychological distress between immigrants from high- and low-income countries living in Oslo, and investigated whether pre- or post-migration factors could explain any such differences in distress levels. A cross-sectional survey with self-administered questionnaires was conducted between 2000 and 2001 among 812 immigrants from high-income countries and 1434 immigrants from low-income countries living in Oslo. The Hopkins Symptom Checklist (HSCL)-10 was used to measure psychological distress. The prevalence rates of psychological distress among immigrants from high- and low-income countries were 10.3% and 24.3%, respectively (P=0.001). Unadjusted odds ratio (OR) of distress among the latter group was 2.38 with 95% confidence interval (CI) 1.73-3.29. The first adjustment (socio-demographic variables) hardly attenuated the difference reported (adjusted OR =2.25, 95% CI 1.58-3.21), the second adjustment (socio-demographic and pre-migration variables) reduced the difference (adjusted OR =1.86, 95% CI 1.28-2.69) while the last adjustment (socio-demographic and pre- and post-migration variables) attenuated the difference below the level of significance (adjusted OR =1.33, 95% CI 0.88-2.01). This means that both pre-migration and post-migration factors were associated with the higher level of distress among immigrants from low-income countries, the post-migration factors in the host country probably being the most important.

The mental health of Chinese immigrants in Birmingham, UK

OBJECTIVES

The objectives of this study were to describe the life experiences associated with migration to the UK and to explore in-depth information about the process of life adjustment to migration and the circumstances of mental health in Chinese immigrants living in a large city area.

METHOD

A two-part research strategy using both quantitative and qualitative methods was employed. In the cross-sectional quantitative survey, 113 Chinese respondents completed a questionnaire investigating demographic factors, life experiences associated with migration, proficiency in the English language and mental health status. In the qualitative phase of the research, interviews were conducted with a further 24 immigrants to explore these factors in more depth.

RESULTS

In the questionnaire survey, over 60% of the group reported symptoms of poor mental health. Qualitative research shows that for those who were employed in catering, psychological adjustment was heavily dependent on strong ties with the Chinese community and there was minimal contact with the host society. By contrast, those concerned with professional development experienced conflict as a result of a high perceived need for integration and a recognition of the problems associated with this.

CONCLUSION

The psychological distress experienced by immigrants of Chinese origin continues to be a largely invisible cause for concern.

Implications of Ethnic Group Origin for Israeli Women’s Mental Health

Israel is an immigrant society comprised of diverse ethnic groups differentiated by variables such as emigration history, health status, educational level, and economic status. The major question addressed in this study is whether differences in women's mental health status are related to ethnic group origin, per se, or rather can be explained by the associated social-demographic strata. The impact of ethnic group origin, social support, health status, education, and economic difficulties was assessed on a set of mental health outcomes. The analysis was carried out in a random sample of 522 women residing in the Negev region of Israel-a culturally diverse area. The findings indicate that social support, economic status, health status, and ethnic group origin all contribute to shaping women's mental health status.

The mental health status of Filipinas in Queensland

OBJECTIVE

To determine the prevalence and investigate potential predictors of psychological distress in Filipino women living in Queensland, Australia.

METHODS

The sample of n = 487 women (88% response rate) was drawn from Filipino organization membership lists and supplemented by snowball sampling. Participants were interviewed in their homes or at a community event in 1996/1997. Follow-up in 1997/1998 involved n = 346 women (71% response rate) who were interviewed either in their homes or by telephone. The two surveys included measurement of demographic, immigration, physical health, satisfaction with life in Australia and life event variables. The GHQ-28 was included in the follow-up survey as a measure of psychological distress.

RESULTS

The proportion of women having an above threshold score (using the cut-off of 4/5) on the GHQ-28 was 23%. Women who were single, dissatisfied with life in Australia, had reported a major change in their financial situation, their relationship or their health in the year between surveys were significantly more likely to have an above threshold score.

CONCLUSIONS

The level of mental distress among Filipinas in Queensland appears to be slightly higher than the levels reported in the general population but lower than other migrant groups. The determinants of mental distress in this population contrast with those in the general Australian population and other migrant groups. The social context of these determinants in Filipinas needs to be elicited for an understanding of these differences.

The social and cultural context of the mental health of Filipinas in Queensland

OBJECTIVE

To describe the social and cultural context of risk surrounding the mental health of Filipino women living in Queensland, Australia and elicit the meaning and experience of mental health and illness for these women.

METHODS

One hundred and thirty-nine in-depth interviews and 7 focus group discussions (FGDs) were nested within the baseline survey of the Filipina cohort of the Australian Longitudinal Study on Women's Health. Seventy-four in-depth interviews and 8 FGDs were conducted at follow-up. A semi-structured interview guide that included sections on emotional health, social support and changes guided these. A subset of responses was fully transcribed and analysed for ethnographic content and themes.

RESULTS

"Mental" problems are highly stigmatized, in comparison to "emotional" problems that are believed to result largely from the absence of close family ties. The loss of these ties and the transition from a collectivist to individualist society are key themes related to emotional distress in Filipinas.

CONCLUSIONS

This understanding of meaning and context of mental health and its risk factors in migrants is important for informing public health and clinical practice and for the improvement of quantitative research instruments.

The validity of the 12-item General Health Questionnaire in Australia: a comparison between three scoring methods

OBJECTIVE

To investigate the specificity and sensitivity of three different scoring methods of the 12-item General Health Questionnaire (GHQ-12) and hence to determine the best GHQ-12 threshold score for the detection of mental illness in community settings in Australia.

METHOD

Secondary data analysis of the 1997 Australian National Survey of Health and Wellbeing (n = 10 641), using the Composite International Diagnostic Interview as the gold standard for diagnosis of mental illness.

RESULTS

The area under the Receiver Operating Characteristic (ROC) curve for the C-GHQ scoring method was 0.84 (95% CI = 0.83-0.86) compared with the area for the standard scoring method of 0.78 (95% CI = 0.76-0.80). The best threshold with C-GHQ was 3/4, with sensitivity 82.9% (95% CI = 80.2-85.5%) and specificity 69.0% (95% CI = 68.6-69.4%). The best threshold score with the standard scoring method was 0/1, with sensitivity 75.4% (95% CI = 72.5-78.4%) and specificity 69.9% (95% CI = 69.5-70.3%). These were also the best thresholds for a subsample of the population who had consulted a health practitioner in the previous 4 weeks.

CONCLUSION

In the Australian setting, the C-GHQ scoring method is preferable to the standard method of scoring the GHQ-12. In Australia the GHQ-12 appears to be a less useful instrument for detecting mental illness than in many other countries.

Mental health status of Iranian migrants in Sydney

OBJECTIVE

The aim of this study was to determine the levels and predictors of psychological distress within the Iranian community in Sydney, Australia.

METHOD

Participants (n = 161) were identified using snowball sampling, and a questionnaire incorporating the General Health Questionnaire (GHQ-20) and other migration-related factors was mailed to their preferred address.

RESULTS

A relatively high proportion of respondents (37%) had GHQ-20 scores above the recommended threshold (4+). Students were significantly more likely to report psychological distress compared with respondents who worked full-time. A feeling that migration had contributed to their distress was also found to be significantly associated with above-threshold GHQ-20 scores.

CONCLUSIONS

Iranian migrants in Sydney may need mental health programs to address migration-related distress.