Mental health status of Iranian migrants in Sydney

Psychological distress and quality of community life among migratory construction workers in India

Objectives

The objectives of this study are to elicit sociodemographic details, assess the level of psychological distress, and measure the quality of community life (QoCL) of migratory construction workers.

Materials and Methods

A cross-sectional research design and survey method of sampling was followed. The semi-structured interview schedule, self-reporting questionnaire, and QoCL scale were used as measures for the study.

Results

Out of 75 respondents, 37 (49.3%) did not have formal education, 38 (50.7%) have migrated for less than a month duration, 33 (44.0%) respondents migrated with their families. The mean age of respondents was 32.03 ± 9.82 years. About 48 (64.0%) were identified as potential respondents for psychosocial care and female respondents (M = 12.90 ± 4.03, t = -3.03, P < 0.003) have higher distress than males (M = 9.50 ± 4.56, t = -3.03, P < 0.003) ones. Overall, QoCL indicated a below moderate (59.08 ± 8.31) level.

Conclusion

The distress was high and QoCL indicated a below moderate level. Intersectoral and community mental health services were required to enhance QoCL and reduce distress among migratory construction workers.

Psychological Distress in Iranian International Students at an Australian University

This study investigated psychological distress in Iranian international students at UNSW Australia, and explored the psychosocial factors associated with high levels of distress. A total of 180 Iranian international students pursuing undergraduate and postgraduate degrees during 2012/2013 completed an email questionnaire containing socio-demographic items and five standardized and validated scales. Multivariable logistic regression was used to analyse the predictors of psychological distress. Compared to domestic and international students at two other Australian universities, a significantly smaller proportion of Iranian international students scored as distressed on the Kessler Psychological Distress Scale (K10). Greater levels of psychological distress were associated with being female, poorer physical health, less social support, less religious involvement and spirituality, and negative attitudes towards seeking professional psychological help. Findings from this growing group of international students can help inform culturally competent mental health promotion and service provision in their host countries.

A systematic review of studies with a representative sample of refugees and asylum seekers living in the community for participation in mental health research

BACKGROUND

The aim was to review the literature to identify the most effective methods for creating a representative sample of refugee and asylum seeker groups living in the community to participate in health and mental health survey research.

METHODS

A systematic search of academic and grey literature was conducted for relevant literature with 'hidden' groups published between January 1995 and January 2016. The main search used Medline, PsycINFO, EMBASE, CINAHL and SCOPUS electronic databases. Hidden groups were defined as refugees, asylum seekers, stateless persons or hard/difficult to reach populations. A supplementary grey literature search was conducted. Identified articles were rated according to a created graded system of 'level of evidence for a community representative sample' based on key study factors that indicated possible sources of selection bias. Articles were included if they were assessed as having medium or higher evidence for a representative sample. All full-text papers that met the eligibility criteria were examined in detail and relevant data extracted.

RESULTS

The searches identified a total of 20 publications for inclusion: 16 peer-reviewed publications and four highly relevant reports. Seventeen studies had sampled refugee and asylum seekers and three other hidden groups. The main search identified 12 (60.0%) and the grey search identified another eight (40.0%) articles. All 20 described sampling techniques for accessing hidden groups for participation in health-related research. Key design considerations were: an a priori aim to recruit a representative sample; a reliable sampling frame; recording of response rates; implementation of long recruitment periods; using multiple non-probability sampling methods; and, if possible, including a probability sampling component. Online social networking sites were used by one study. Engagement with the refugee and asylum seeker group was universally endorsed in the literature as necessary and a variety of additional efforts to do this were reported.

CONCLUSIONS

The strategies for increasing the likelihood of a representative sample of this hidden group were identified and will assist researchers when doing future research with refugee groups. These findings encourage more rigorous reporting of future studies so that the representativeness of samples of these groups in research can be more readily assessed.

Representativeness of Three Survey Methods in Ethnic Health Research

Study objective: To identify the survey method which generates the most representative sample of respondents in an ethnic community

Design: Three survey methods (including sampling from the telephone book and telephone surveys, cluster sampling of households from areas with known high concentrations of migrants from the target community and face-to-face interviews, and sampling of persons listed on the electoral roll and a mailed survey) were employed concurrently in a defined area.

Setting: Metropolitan Sydney, Australia.

Participants: Persons aged 18 years or more born in Lebanon.

Main results: The telephone survey method consistently outperformed cluster sampling and sampling from the electoral roll in terms of cost, response and contact rates, ease and speed of administration and representativeness of the sample. All methods generated a similar age profile but over-represented females compared with census data for the study area. There was relatively little duplication of respondents. The proportion of respondents who rated their health as fair or poor was comparable.

Conclusions: Telephone surveying of migrant populations is a recommended strategy for health research in the Lebanese migrant population in metropolitan Sydney, and is also likely to be recommended for migrant populations with ethnically identifiable surnames.

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.

The impact of migration on the health status of Iranians: an integrative literature review

Background

Immigration, both voluntary and forced, is driven by social, political and economic factors. Accordingly, some discussions and debates have emerged in recent years about the impact of migration on the health status of migrants. The aim of this review was to identify the impact of migration on the health status of Iranian immigrants and present a conceptual framework to facilitate the design and delivery of services and supports for this particular immigrant group.

Methods

Data for this integrative review were collected from Medline, PsycINFO, Scopus, ProQuest, Academic Search Complete, CINAHL, and Google Scholar search engine. The database search was limited to peer-reviewed literature, published in English, between 1980 and 2013.

Results

Twenty six articles were included in the review. Analysis revealed several factors influencing the mental health of immigrants, including language insufficiency; unemployment; sense of discrimination; cultural shock; lack of social support; lack of information about health care services; and intimate partner violence.

Conclusion

Findings of this review have contributed to development of a conceptual framework that delineates the impact of migration on Iranian immigrants’ health. This conceptualization may also help in addressing the needs of other vulnerable groups during the transition phase of migration.

Mental health of intermarried immigrant women and their children in South Korea

This study was aimed to examine the mental health status of immigrant women through international marriages and its effects on emotional and behavioral problems of children. Seventy-four intermarried immigrant women and 86 native Korean women were enrolled from the same district of Seoul metropolitan area. The mental health problems of study participants and their children were examined. Increased risks of having a higher level of anxiety were observed in immigrant women compared to native Korean women. Children of the immigrant group were likely to have more internalizing and externalizing behavioral symptoms than those of the native group. This pattern was more apparent in children of mothers with higher levels of anxiety. The present study found a higher risk for mild anxiety in intermarried immigrants than in native Korean women. Furthermore, considering that immigrant children seemed to have more emotional and behavioral problems relative to native children if their mothers have higher levels of anxiety, special attention should be paid to prevention and early intervention for mental health problems of intermarried immigrant women.

Arabic-speaking religious leaders' perceptions of the causes of mental illness and the use of medication for treatment

OBJECTIVES

The Arabic-speaking clergy is highly revered and considered the first point of contact for people who suffer from mental illness within their community. The current study aimed to explore the beliefs of Arabic-speaking religious leaders regarding the causes of mental illness and the use of medication for their treatment.

METHOD

Participants consisted of 170 Arabic-speaking clerics of Muslim (n = 85) and Christian (n = 85) denominations residing in Sydney, Australia. A questionnaire was administered during face-to-face interviews and included items regarding the causes of mental illness and beliefs about whether psychiatric medications were viewed as helpful or harmful.

RESULTS

Most of the Arabic-speaking clerics viewed drug and alcohol addiction and psychosocial factors as the most important causes of mental illness. Biological causes such as a chemical imbalance in the brain were less frequently endorsed. Although medications were viewed by most religious clerics as helpful in the treatment of mental illness, there were also concerns about the potential harms of medications, particularly among Muslim clerics. Muslim clerics also endorsed the religious causes for mental illness, such as spiritual poverty, as being more important more so than did Christian clerics.

CONCLUSIONS

The beliefs of Arabic-speaking religious leaders influence how they respond to people with mental illness and may determine whether they refer people to professional mental health services or not. Understanding their perspectives allows opportunities to share information to facilitate collaborative work in the care of Arabic-speaking people with mental illness. Arabic-speaking religious leaders need to be better educated about the mechanisms of action and benefits of medication in the treatment of mental illness.

Enhancing social support, hardiness, and acculturation to improve mental health among Asian Indian international students

International students, upon relocation to a foreign country, undergo a major life event which can cause distress that can potentially affect their mental health. This study pilot tested an internet-based intervention to enhance the social support, hardiness, and acculturation among students of Asian Indian origin at a large midwestern university. A pretest-posttest randomized design was employed. The pretest was administered to 60 students who were then randomly assigned to experimental and comparison groups. The experimental group was offered online instruction about social support, hardiness, and acculturation through Blackboard over 2 months. The comparison group received an equivalent protocol based on general wellness. Repeated measures ANOVA was done which showed significant improvement in mental health variable (F(1, 37) = 4.768, p < 0.05). Recommendations for replicating such interventions in other groups of international students are presented.

The health status of migrants in Australia: a review

This review summarizes the findings of studies conducted in Australia between 1980 and 2008 that focused on the health status of migrants in one or more of Australia's National Health Priority Areas (NHPAs), identifies gaps in knowledge, and suggests further research directions. Systematic literature searches were performed on CINAHL, MediText, PsycINFO, and MEDLINE. It was found that the majority of migrants enjoy better health than the Australian-born population in the conditions that are part of the NHPAs, with the exception of diabetes. Mediterranean migrants have particularly favorable health outcomes. The migrant health advantage appears to deteriorate with increasing duration of residence. Many of the analyzed studies were conducted more than 10 years ago or had a narrow focus. Little is known about the health status of migrants with respect to a number of NHPAs, including musculoskeletal conditions and asthma.The health status of recently arrived migrant groups from the Middle East and Africa has not been explored in detail.

Depression and anxiety in labor migrants and refugees--a systematic review and meta-analysis

Prevalence rates of depression and anxiety among migrants (i.e. refugees, labor migrants) vary among studies and it's been found that prevalence rates of depression and anxiety may be linked to financial strain in the country of immigration. Our aim is to review studies on prevalence rates of depression and/or anxiety (acknowledging that Post-traumatic Stress Disorder (PTSD) is within that class of disorders), and to evaluate associations between the Gross National Product (GNP) of the immigration country as a moderating factor for depression, anxiety and PTSD among migrants. We carried out a systematic literature review in the databases MEDLINE and EMBASE for population based studies published from 1990 to 2007 reporting prevalence rates of depression and/or anxiety and or PTSD according to DSM- or ICD- criteria in adults, and a calculation of combined estimates for proportions using the DerSimonian-Laird estimation. A total of 348 records were retrieved with 37 publications on 35 populations meeting our inclusion criteria. 35 studies were included in the final evaluation. Our meta-analysis shows that the combined prevalence rates for depression were 20 percent among labor migrants vs. 44 percent among refugees; for anxiety the combined estimates were 21 percent among labor migrants vs. 40 percent among (n=24,051) refugees. Higher GNP in the country of immigration was related to lower symptom prevalence of depression and/or anxiety in labor migrants but not in refugees. We conclude that depression and/or anxiety in labor migrants and refugees require separate consideration, and that better economic conditions in the host country reflected by a higher GNP appear to be related to better mental health in labor migrants but not in refugees.

Psychological distress and its demographic associations in an immigrant population: findings from the Israeli National Health Survey

OBJECTIVE

This study compared psychological distress and its sociodemographic correlates in immigrant and veteran Israeli populations using data from the Israel National Mental Health Survey, the first nationwide study designed to estimate the prevalence rates of psychological distress and mental disorders in the Israeli adult population, which was carried out in 2003-2004, in conjunction with the World Mental Health survey initiative.

METHOD

Personal interviews were held with 3906 veteran Israelis, 845 immigrants from the former Soviet Union (FSU) and 107 immigrants from other countries (all the immigrants immigrated after 1989). Psychological distress was measured on the General Health Questionnaire-12.

RESULTS

Psychological distress among FSU immigrants was significantly higher than among veteran Israelis and immigrants from elsewhere. FSU immigrants were almost twice as likely to report severe psychological distress. Factors associated with psychological distress were female gender, age above 50, being divorced/widowed, being secular, having higher education and being either unemployed or 'not in workforce'.

CONCLUSION

The results support the acculturation stress hypothesis as an explanation for psychological distress in immigrants only in immigrants from the FSU, indicating that policymakers should plan services and prevention programmes differentially for different immigrant populations.

A 'silent' political protest by an asylum seeker presenting to an Irish psychiatric service

We report a case of a male asylum seeker, protesting politically, who stitched his lips together, presenting to a psychiatric service for assessment. We review the literature in this area. Funding of psychiatric services to meet the complex needs of immigrants should be an integral part of service development.

Maintenance of traditional cultural orientation is associated with lower rates of obesity and sedentary behaviours among African migrant children to Australia

BACKGROUND

Migrants from developing to developed countries rapidly develop more obesity than the host population. While the effects of socio-economic status on obesity are well established, the influence of cultural factors, including acculturation, is not known.

OBJECTIVE

To examine the association between acculturation and obesity and its risk factors among African migrant children in Australia.

DESIGN AND PARTICIPANTS

A cross-sectional study using a non-probability sample of 3- to 12-year-old sub-Saharan African migrant children. A bidimensional model of strength of affiliation with African and Australian cultures was used to divide the sample into four cultural orientations: traditional (African), assimilated (Australian), integrated (both) and marginalized (neither).

MAIN OUTCOME MEASURES

Body mass index (BMI), leisure-time physical activity (PA) and sedentary behaviours (SBs) and energy density of food.

RESULTS

In all, 18.4% (95% confidence interval (CI): 14-23%) were overweight and 8.6% (95% CI: 6-12%) were obese. After adjustment for confounders, integrated (beta=1.1; P<0.05) and marginalized (beta=1.4; P<0.01) children had higher BMI than traditional children. However, integrated children had significantly higher time engaged in both PA (beta=46.9, P<0.01) and SBs (beta=43.0, P<0.05) than their traditional counterparts. In comparison with traditional children, assimilated children were more sedentary (beta=57.5, P<0.01) while marginalization was associated with increased consumption of energy-dense foods (beta=42.0, P<0.05).

CONCLUSIONS

Maintenance of traditional orientation was associated with lower rates of obesity and SBs. Health promotion programs and frameworks need to be rooted in traditional values and habits to maintain and reinforce traditional dietary and PA habits, as well as identify the marginalized clusters and address their needs.

Acculturation and mental health among ghanaians in The Netherlands

BACKGROUND

The current literature on the relationship between cultural adaptation and mental health is premature to offer a comprehensive explanation about the ways acculturation exerts either positive or adverse effects on the mental health of migrants.

AIM

This study is an empirical approach towards understanding the magnitude of the relationship between consequences of cultural adaptation and psychological distress.

METHODS

Two samples of Ghanaian migrants in The Netherlands were included: a clinical group (n = 36) and a non-clinical community group (n = 97). Data were acquired by administering a semi-structured interview. Quantified data were analysed using multivariate techniques.

RESULTS

Contradictory to our hypotheses, the reported level of mental health symptoms in both groups was relatively low, suggesting a substantial resilience among the Ghanaian group. Confirming our hypotheses, specific dimensions of the acculturation process were associated with health status, particularly affiliation with cultural traditions and feelings of loss concerning the country of birth.

CONCLUSIONS

Acculturation demands capture critical elements of migrants' experiences that warrant professional interventions tailored to their specific needs. A subtle balance between holding on to the supportive cultural traditions together with moderate involvement in ruminating about pre-migration life, in conjunction with acquiring instrumental skills of the host culture, is a starting position for better health.

Immigration, lack of control and psychological distress: findings from the Oslo Health Study

The aims of this study are to compare the level of psychological distress between Norwegian born and immigrants from countries with different income levels and culture, and to investigate the explanatory effect of socioeconomic and psychosocial factors, with special emphasis on lack of control (powerlessness and self-efficacy). A cross-sectional survey with self-administered questionnaire was conducted in 2000-2001 in a sample of 15,723 adults living in Oslo. Psychological distress was measured by a ten-item shortened version of Hopkins Symptom Checklist-25 items, whereas psychosocial variables were measured by various instruments. The results show that the level of psychological distress is significantly higher in immigrants from low- and middle-income countries than in the Norwegian born and the immigrants from high-income countries. They also report more powerlessness, more negative life events, less social support, less income and less paid work. It is concluded that negative life events, mainly related to social network, somatic health and economic situations, as well as lack of social support, are important mediators between immigration from low- and middle-income countries to Norway and psychological distress. Powerlessness also plays a role, but this is mainly because of a concept overlap between psychological distress and powerlessness.

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.

Mortality from external causes among ethnic German immigrants from former Soviet Union countries, in Germany

BACKGROUND

Diaspora migration flows from the former Soviet Union to Western Europe and Israel have increased since the late 1980s. Risk factors responsible for the East-West mortality gap and post-migration factors may lead to higher mortality from external causes of death like suicide amongst such Diaspora immigrants. We investigated whether ethnic German immigrants from the former Soviet Union had increased mortality from external causes compared to native Germans.

METHODS

We conducted a retrospective cohort study of 34 393 adults, so-called Aussiedler who arrived in Germany's largest federal state between 1990 and 2001. We ascertained vital status and causes of death from registry data. Standardized mortality ratios (SMRs) were calculated using the native German population as comparison. Multivariate effects were assessed using Poisson regression.

RESULTS

1 657 members (4.8%) died, 88 from external causes. Overall SMR was 1.29 (95% confidence intervals 1.05-1.61). Males had a 39% higher mortality from all external causes and accidents, and a 30% higher mortality from suicide than German males. Females had slightly higher mortality from accidents but comparable mortality from all external causes. Aussiedler aged <65 years had rate ratios above one for external causes and accidents in multivariate models. SMRs for suicide and all external causes decreased with length of stay.

CONCLUSION

While ethnic German immigrants have a mortality disadvantage compared to the NRW population, it is on a much lower scale than expected if they were representative of their source populations in former Soviet Union countries.

Culturing settlement using pre- and post-migration strategies

Appropriate pre- and post-migration strategies could buffer the possible negative impact of migration and assist in settlement. This cross-sectional study used both quantitative and qualitative approaches to establish the impact of migration on women from Britain (n = 154) now living in Perth, Western Australia; from these participants 40 were selected for in-depth interview. Bowlby's grieving process was used as a theoretical framework to explore grief reactions to leaving the homeland (homesickness) resulting from exposure to a new culture. Crucial to successful settlement was the nature of strategies the women used to negotiate the grieving process. Participants who successfully settled and re-invented themselves engaged in more social, cultural and country activities--those participants who were less successful in this endeavour tended toward more solitary strategies. The study has social implications for future migrants to utilize appropriate strategies that could reduce the psychological impact of relocation.

Cultural identity, acculturation, and mental health among adolescents in east London's multiethnic community

STUDY OBJECTIVE

To investigate cultural identity as a risk factor for mental health problems among adolescents.

DESIGN

A cross sectional school based population survey. Mental health problems were measured using the strengths and difficulties questionnaire. Pupils were classified into one of four cultural identity types on the basis of friendship and clothing choices.

SETTING

East London.

PARTICIPANTS

2623 adolescents (aged 11-14) from a representative sample of 28 schools in east London.

RESULTS

In comparison with marginalised adolescents who chose friends from neither their own or other cultures, fewer mental health problems were found among adolescents making culturally integrated friendship choices (friends from own and other cultures: OR = 0.6, 0.4 to 0.9), boys making integrated friendship choices (OR = 0.45, 0.22 to 0.91), and specifically among Bangladeshi pupils with integrated friendship choices (OR = 0.15, 0.04 to 0.55).

CONCLUSION

As measures of cultural identity, integrated friendship choices overall, and specifically for boys and Bangladeshi pupils, are associated with lower levels of adolescent mental health problems.

Gender differences in factors associated with psychological distress among immigrants from low- and middle-income countries--findings from the Oslo Health Study

OBJECTIVE

Despite the high rate of migration from low- and middle-income countries to high-income countries, there is still a lack of comprehensive studies of gender-specific differences in psychological distress in a diverse group of immigrants. We compared psychological distress between male and female immigrants from low- and middle-income countries living in Oslo, and identified factors associated with distress for men and women, separately.

METHOD

A cross-sectional survey with self-administered questionnaires was conducted among 1536 immigrants from low- and middle-income countries living in Oslo. The Hopkins Symptom Checklist (HSCL-10) was used to measure psychological distress. Data on their sociodemographic characteristics, negative and traumatic life events, and social integration and possible discrimination in the Norwegian society were also collected.

RESULTS

One-fourth of the study population was found to be psychologically distressed, with almost equal levels among men and women. Lack of salaried job and recent negative life events were independently associated with psychological distress for both genders. Furthermore, experience of denial of job and past traumatic experiences were other associated negative factors among men, while visits made by Norwegians appeared as a protective factor against distress among men. Older age, Middle East background, living without a partner, and experiencing denial of housing were other associated negative factors among women.

CONCLUSION

Our findings show that, except for adverse living conditions, there are gender differences with regard to factors associated with psychological distress among immigrants living in Oslo. Such gender issues are relevant for assisting immigrants in the integration process as well as for future research in migration and health.

Changes in mental health status amongst children of migrants to Australia: a longitudinal study

This paper examines the mental wellbeing of children of Australian migrants. Migration can be viewed as a natural experiment in which persons of one culture have their beliefs, values and behaviours challenged by the host culture. Such a process could be expected to lead to impaired mental health amongst migrants and their children. This paper investigates the relationship between migrants' region of origin, length of stay in Australia and indicators of impaired mental health. The data were taken from the Mater-University of Queensland Study of Pregnancy (MUSP), a longitudinal study of mothers and children which started in Brisbane, Australia, in 1981. The study comprises a cohort of over 5,000 women interviewed at their first ante-natal clinic visit and followed up at 3-5 days, six months, 5 and 14 years after the baby was born. Results showed no significant differences between the mental health of 'second generation' children and their Australian counterparts. Length of stay in Australia was not associated with internalising symptoms (anxiety and depression). There was a positive association, however, between the length of stay in Australia and increased externalising problems (aggression and delinquency) amongst the children at both 5- and 14-years follow-up. We conclude that children of migrants do not differ from comparable children of Australian-born parents in their mental health. Children of migrant parents have fewer symptoms of some behaviour problems in the years after their arrival in Australia, but these rates increase to the Australian level over time.

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.

Mental health among Afghan refugees settled in Shiraz, Iran

This study was designed to investigate the mental health of Afghan refugees settled in Shiraz, the capital of a southern province of Iran. They were mostly refugees from Afghanistan by reason of internal war during the last two decades. A version of the General Health Questionnaire (GHQ-28) in Persian was administered on a group of randomly selected Afghan refugees (n=81) from a pool of Afghan residents in the Shiraz district. 34.5% of the subjects scored high enough to be considered as having psychiatric problems. There was a significant positive correlation between refugees' years of age and GHQ-28 factor scores, i.e., Physical Health and Social Functioning. The mental health of the subjects was not related to education or marital status. The years of settling in Iran were not significantly correlated with any GHQ-28 indices. The overall findings suggest that the rate of psychiatric problems in the refugees is higher than in the native population.