1
|
Alarcão V, Candeias P, Stefanovska-Petkovska M, Neves J, Pintassilgo S, Machado FL, Santos O, Virgolino A, Santos RR, Heitor MJ, Costa A. Insights from the EQUALS4COVID19 study on migrant mental health in Portugal: a cross-sectional mixed-methods approach. BMC Public Health 2024; 24:2023. [PMID: 39075428 PMCID: PMC11285180 DOI: 10.1186/s12889-024-19563-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 07/23/2024] [Indexed: 07/31/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic and related disruptive consequences in the economic, health, and educational sectors have impacted people's lives, contributing to a context of increased economic and social vulnerability. The pandemic has revealed and accentuated social inequalities and discrimination based on racial or ethnic origin. This study aimed to contribute to the promotion of the mental health and well-being of migrant populations living in Portugal via the definition of an analytical framework and recommendations emerging from the EQUALS4COVID19 project. METHODS To gather information on the impact of the COVID-19 pandemic and resilience determinants among immigrants, a mixed-methods approach was implemented in 2022, combining a cross-sectional survey targeting immigrant adults in Portugal, focus groups with immigrants, focus groups with healthcare professionals, and in-depth individual interviews with stakeholders involved in the implementation of measures related to mental health and well-being during the pandemic. The analysis followed an integrated framework; quantitative data informed the script of qualitative data collection methods, and qualitative analysis informed the reinterpretation of quantitative data. RESULTS The survey with 604 Brazilian and Cape Verdean immigrants revealed that gender (being a woman) was associated with both psychological distress and depression-related symptomatology and that the perception of discrimination was a major risk factor for psychological suffering, while perceived social support and individuals' resilience characteristics were protective factors. Qualitative data provided deeper insights into these findings, revealing the ways mental health is affected by social structures, such as gender and ethnic hierarchies. Migrants tend to work in precarious jobs requiring physical presence, which, together with dense housing conditions, puts them at higher risk of infection. The deterioration of the economic conditions of the general population has also increased the perception of ethnic-racial discrimination, which was found to be related to the increase in insecurity and anxiety-related symptomatology among the migrant population. Newly arrived migrants, with reduced support networks, experienced a greater sense of insecurity as well as concern and anguish regarding relatives who live far away, in their home country. Migrant women reported greater family-related distress, including work-life balance problems. CONCLUSIONS Proposals to address mental health inequalities should be considered in the context of the necessary global changes both at the societal level and in the delivery of mental health services. Additionally, they should be considered with the active involvement of migrants, families, and communities in the design and delivery of mental health promotion and care processes.
Collapse
Affiliation(s)
- Violeta Alarcão
- Centro de Investigação e Estudos de Sociologia, Iscte - Instituto Universitário de Lisboa, Avenida das Forças Armadas, Lisboa, 1649-026, Portugal.
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, Lisboa, 1649-028, Portugal.
- Iscte - Instituto Universitário de Lisboa, Avenida das Forças Armadas, Lisboa, 1649-026, Portugal.
| | - Pedro Candeias
- Centro de Investigação e Estudos de Sociologia, Iscte - Instituto Universitário de Lisboa, Avenida das Forças Armadas, Lisboa, 1649-026, Portugal
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, Lisboa, 1649-028, Portugal
- Iscte - Instituto Universitário de Lisboa, Avenida das Forças Armadas, Lisboa, 1649-026, Portugal
| | - Miodraga Stefanovska-Petkovska
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, Lisboa, 1649-028, Portugal
| | - Júlia Neves
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, Lisboa, 1649-028, Portugal
| | - Sónia Pintassilgo
- Centro de Investigação e Estudos de Sociologia, Iscte - Instituto Universitário de Lisboa, Avenida das Forças Armadas, Lisboa, 1649-026, Portugal
- Iscte - Instituto Universitário de Lisboa, Avenida das Forças Armadas, Lisboa, 1649-026, Portugal
| | - Fernando Luís Machado
- Centro de Investigação e Estudos de Sociologia, Iscte - Instituto Universitário de Lisboa, Avenida das Forças Armadas, Lisboa, 1649-026, Portugal
- Iscte - Instituto Universitário de Lisboa, Avenida das Forças Armadas, Lisboa, 1649-026, Portugal
| | - Osvaldo Santos
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, Lisboa, 1649-028, Portugal
- Unbreakable Idea Research, Estrada Nacional 115, Sítio da Caniceira, nº 1, Casarão, Painho, 2550-426, Portugal
| | - Ana Virgolino
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, Lisboa, 1649-028, Portugal
| | - Ricardo R Santos
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, Lisboa, 1649-028, Portugal
| | - Maria João Heitor
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, Lisboa, 1649-028, Portugal
- Psychiatry and Mental Health Department, Hospital Beatriz Ângelo, Loures, Portugal
- Centro de Investigação Interdisciplinar em Saúde (CIIS), Faculdade de Medicina, Universidade Católica Portuguesa, Lisboa, Portugal
- Laboratório para a Sustentabilidade do Uso da Terra e dos Serviços dos Ecossistemas - TERRA, Lisboa, Portugal
| | - Andreia Costa
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, Lisboa, 1649-028, Portugal
- Laboratório para a Sustentabilidade do Uso da Terra e dos Serviços dos Ecossistemas - TERRA, Lisboa, Portugal
- Innovation and Development Centre of Lisbon (CIDNUR), Nursing Research, Nursing School of Lisbon, Lisbon, Portugal
| |
Collapse
|
2
|
Crawshaw AF, Vandrevala T, Knights F, Deal A, Lutumba LM, Nkembi S, Kitoko LM, Hickey C, Forster AS, Hargreaves S. Navigating vaccination choices: The intersecting dynamics of institutional trust, belonging and message perception among Congolese migrants in London, UK (a reflexive thematic analysis). PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0002620. [PMID: 38985733 PMCID: PMC11236099 DOI: 10.1371/journal.pgph.0002620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 06/03/2024] [Indexed: 07/12/2024]
Abstract
The COVID-19 pandemic disproportionately impacted intersectionally marginalised migrants, revealing systemic disparities in health outcomes and vaccine uptake. Understanding the underlying social and structural factors influencing health behaviours is necessary to develop tailored interventions for migrants, but these factors have been seldom explored. This qualitative study aimed to explore contextual factors shaping COVID-19 vaccination decision-making among Congolese migrants in the UK.A community-based participatory research study was designed and led by a community-academic partnership in London, UK (2021-2022). Peer-led, semi-structured interviews were conducted in Lingala with 32 adult Congolese migrants and explored beliefs, perceptions and lived experiences of migration, healthcare, vaccination and the COVID-19 pandemic. Reflexive thematic analysis generated two themes and a model conceptualising the vaccination decision-making process. Participants and community partners were financially compensated; ethics was granted by the University of London ethics committee (REC: 2021.0128).Participants highlighted the incompatibility of lockdown restrictions with their communal culture, which intensified feelings of exclusion and alienation. Concerns about COVID-19 vaccination were attributed to safety and effectiveness, partly informed by experiences and legacies of racial discrimination and exploitation. Inequality in the pandemic response and COVID-19 outcomes heightened participants' sense that their views and needs were being overlooked, and government sources and information were perceived as coercive. Our model depicts the interplay between institutional trust, belonging, and message perception, which shaped participants' vaccination decisions and led to (non-)engagement with COVID-19 vaccination. This research enhances understanding of how social and contextual factors may influence migrants' engagement with health interventions. It underscores the importance of partnering with migrant communities to understand their needs in context and co-design tailored interventions and inclusive messaging strategies that promote trust and belonging. Implementing systemic changes to address structural inequalities will be crucial to create an environment that supports engagement with health-protective behaviours and enhances health outcomes among migrant communities.
Collapse
Affiliation(s)
- Alison F. Crawshaw
- Institute for Infection and Immunity, The Migrant Health Research Group, St George’s, University of London, Cranmer Terrace, London, United Kingdom
| | - Tushna Vandrevala
- Faculty of Health, Science, Social Care and Education, Centre for Applied Health and Social Care Research, Kingston University London, London, United Kingdom
| | - Felicity Knights
- Institute for Infection and Immunity, The Migrant Health Research Group, St George’s, University of London, Cranmer Terrace, London, United Kingdom
| | - Anna Deal
- Institute for Infection and Immunity, The Migrant Health Research Group, St George’s, University of London, Cranmer Terrace, London, United Kingdom
- Department of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Laura Muzinga Lutumba
- Hackney Congolese Women Support Group, c/o Hackney CVS, The Adiaha Antigha Centre, London, United Kingdom
| | - Sarah Nkembi
- Hackney Congolese Women Support Group, c/o Hackney CVS, The Adiaha Antigha Centre, London, United Kingdom
| | - Lusau Mimi Kitoko
- Hackney Congolese Women Support Group, c/o Hackney CVS, The Adiaha Antigha Centre, London, United Kingdom
| | - Caroline Hickey
- Hackney Refugee and Migrant Forum and Hackney CVS, The Adiaha Antigha Centre, London, United Kingdom
| | | | - Sally Hargreaves
- Institute for Infection and Immunity, The Migrant Health Research Group, St George’s, University of London, Cranmer Terrace, London, United Kingdom
| |
Collapse
|
3
|
Adzrago D, Chiangong J, Ormiston CK, Dada OM, Jones A, Williams F. Social distancing stress, anxiety/depression, COVID-19 diagnosis, gender identity, and immigration status. Arch Public Health 2024; 82:86. [PMID: 38877517 PMCID: PMC11177535 DOI: 10.1186/s13690-024-01320-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2024] [Accepted: 06/09/2024] [Indexed: 06/16/2024] Open
Abstract
BACKGROUND Strict social distancing public health measures to decrease COVID-19 spread increased social distancing stress. However, differences in social distancing stress by anxiety/depression symptoms are understudied, especially based on COVID-19 diagnosis status, gender identity, and immigration status. We examined whether the association between social distancing stress and anxiety/depression symptoms was moderated by COVID-19 diagnosis status, gender identity, and immigration status. We further examined the associations of social distancing stress with anxiety/depression symptoms, gender identity, and immigration status among individuals with and without COVID-19. METHODS We utilized data from a national cross-sectional survey among adults aged ≥ 18 years in the United States between May 13, 2021, and January 9, 2022 (n = 5,255). Multivariable logistic regression models were used to examine the associations. RESULTS The prevalence of social distancing stress was higher among individuals with COVID-19 (79.23%) than among those without COVID-19 (67.51%). We observed significant associations between social distancing stress and anxiety/depression symptoms, moderated by COVID-19 diagnosis status, immigration status, and gender identity, respectively. Anxiety/depression symptoms were associated with social distancing stress among both individuals with and without COVID-19. Gender identity and immigration status were associated with social distancing stress among only individuals without COVID-19. CONCLUSIONS Our findings revealed that the association between social distancing stress and anxiety/depression varied by COVID-19 diagnosis status, gender identity, and immigration status. The findings underscore the need for more targeted psychological distress strategies to reduce social distancing stress and anxiety/depression among diverse US populations, while considering the impacts of COVID-19 diagnosis status, gender identity, and immigration status.
Collapse
Affiliation(s)
- David Adzrago
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, USA.
| | - Jolyna Chiangong
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, USA
| | - Cameron K Ormiston
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, USA
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Oluwabunmi M Dada
- Department of Occupational Safety and Health, Murray State University, Murray, KY, USA
| | - Antwan Jones
- Department of Sociology, Department of Epidemiology, The George Washington University, Washington, DC, USA
| | - Faustine Williams
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, USA.
| |
Collapse
|
4
|
Thompson N, Kyaw KWY, Singh L, Cikomola JC, Singh NS, Roberts B. The effect of COVID-19 on the non-COVID health outcomes of crisis-affected peoples: a systematic review. Confl Health 2024; 18:37. [PMID: 38664834 PMCID: PMC11044391 DOI: 10.1186/s13031-024-00592-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 04/09/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic posed considerable risks to populations affected by humanitarian crises in low- and middle-income countries (LMICs). However, there is limited understanding of how the pandemic may have affected non-COVID health outcomes among crisis-affected populations. Our aim was to examine the evidence on the impact of the COVID-19 pandemic on non-COVID-19 health outcomes for crisis-affected populations in LMICs. METHODS A systematic review methodology was applied following PRISMA guidelines. Eligibility criteria were: crisis-affected populations in LMICS; COVID-19; and all health topics, except for sexual and reproductive health which was covered in a linked review. Five bibliographic databases and additional grey literature sources were searched. The search period was from 2019 to 31 July 2022. Eligible papers were extracted and analysed using a narrative synthesis approach based on the study objectives and relevant health access and systems frameworks. A quality appraisal was also conducted. FINDINGS 4320 articles were screened, and 15 eligible studies were identified and included in this review. Ten studies collected health outcomes data. Eight related to mental health, which generally showed worse mental health outcomes because of the pandemic, and pandemic-related stressors were identified. Two studies assessed physical health outcomes in children, while none addressed physical health outcomes among adults. Nine studies reported on access to healthcare, revealing worse access levels due to the pandemic and noting key barriers to care. Seven studies reported on the impact on health systems, with key challenges including reduced and distorted health care funding, reduced staff capacity, interrupted medicines and supplies, weak information and mixed-messaging, and weak leadership. All fifteen studies on the social determinants of health, particularly highlighting the effect of increasing poverty, the role of gender, and food insecurity on health outcomes. The quality of papers was limited overall. CONCLUSION This review found some limited evidence indicating negative mental health effects, increased barriers to accessing care, damage to health systems and magnified impacts on the social determinants of health for crisis-affected people during the COVID-19 pandemic. However, the small number and limited quality of the studies make the overall strength of evidence quite weak.
Collapse
Affiliation(s)
- N Thompson
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - K W Y Kyaw
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - L Singh
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - J C Cikomola
- Faculty of Medicine, Université Catholique de Bukavu, Democratic Republic of the Congo, Central African Republic
| | - N S Singh
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Bayard Roberts
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK.
| |
Collapse
|
5
|
Portela V, Hamwi S, Oliveira Martins MR. Exploring refugees' health care access in times of COVID-19: a quantitative study in the Lisbon region, Portugal. Front Public Health 2024; 12:1337299. [PMID: 38347925 PMCID: PMC10859453 DOI: 10.3389/fpubh.2024.1337299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Accepted: 01/04/2024] [Indexed: 02/15/2024] Open
Abstract
Background To address the health needs of refugees, health services must be culturally competent and facilitate this population's access to health care, especially in a context prone to the amplification of social inequities, such as the COVID-19 pandemic. However, few quantitative studies exist in the European Union, and to the extent of our knowledge, there are no published quantitative studies exploring refugees' access to health care during the pandemic in Portugal. The objective of this study is to describe the demographic and socioeconomic characteristics of refugees living in Lisbon and to explore their healthcare access patterns during the COVID-19 pandemic. Methods We conducted a cross-sectional, descriptive, and quantitative study from May to November 2022. Using Levesque' s theory on health care access, we designed and applied a 38-item questionnaire through face-to-face interviews with refugees living in Lisbon for at least 12 months, and used descriptive statistics to characterize sociodemographic and healthcare access profiles during the pandemic. Results The mean age of the 36 recruited refugees was 35 years (SD = 10.24), the majority were male (56%), married (72%), had at least a secondary education (69%), were unemployed (77.8%), and had a median length of stay in Portugal of 17 months (IQR = 45). All were registered in a primary care center, and 94% used healthcare services during the pandemic. The majority never tested positive for the coronavirus (58%) and one out of the positive was admitted to hospital due to severe COVID-19. A total of 97% received COVID-19 vaccination, of which 69% had an incomplete schedule. A quarter of the participants did not have access to information about COVID-19 in a language they understood, and although 97% needed health care during the pandemic, more than half (63%) did not seek it because of structural and cultural barriers. Half of the respondents had difficulty getting medical advice by phone or email, and 39.4% could not afford a medical examination or treatment. Only 18.2% sought counseling services. A total of 58.8% of the participants felt like healthcare professionals did not always show respect towards their culture, and 64.7% reported that healthcare professionals did not always discuss treatment options with them. Conclusion This study's findings highlight the need to endow inclusive communication, cultural competency, and patient involvement in health care, alongside improving the socioeconomic condition of refugees. Identified population characteristics and barriers to health care access by refugees in this study may inform future research on the health care needs of refugees in Portugal and ultimately assist in the devising of strategies to reduce inequalities in health care access.
Collapse
Affiliation(s)
- Vanessa Portela
- Institute of Hygiene and Tropical Medicine, NOVA University of Lisbon, Lisbon, Portugal
| | - Sousan Hamwi
- NOVA National School of Public Health, Public Health Research Centre, NOVA University of Lisbon, Lisbon, Portugal
| | - Maria R. Oliveira Martins
- Global Health and Tropical Medicine, Institute of Hygiene and Tropical Medicine, NOVA University of Lisbon, Lisbon, Portugal
| |
Collapse
|
6
|
Herrero-Arias R, Halbostad IV, Diaz E. Norwegian "dugnad" as a rhetorical device in public health communication during the COVID-19 pandemic. A qualitative study from immigrant's perspectives. Arch Public Health 2024; 82:11. [PMID: 38238794 PMCID: PMC10797926 DOI: 10.1186/s13690-024-01237-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Accepted: 01/02/2024] [Indexed: 01/22/2024] Open
Abstract
BACKGROUND During the COVID-19 pandemic, the Norwegian government appealed to the term "national dugnad" in the communication of containment measures as a call for collective action to fight the spread of infection. "Dugnad" is traditionally associated with solidarity, social responsibility, and a communal spirit in the form of volunteer work carried out by a local community. Although the word "dugnad" is difficult to translate to other languages, it was used as a rhetorical device by the government to communicate health-related information during the pandemic. This study aims to explore how immigrants understood and related to the term "dugnad" as used in the context of the COVID-19 pandemic in Norway. METHODS We conducted 55 semi-structured interviews in 2020 with immigrants from Poland (10), Syria (15), Somalia (10), Sri Lanka (10), and Chile (10). Interviews were conducted in participants' mother-tongues. We used systematic text condensation following Malterud's four steps to analyze the data. RESULTS The results are organized into three themes corresponding to: (1) meaning making of the term "dugnad"; (2) attitudes towards the term "dugnad"; and (3) reactions to the use of "dugnad" in a public health context. Overall, participants were familiar with the term "dugnad" and positively associated it with volunteering, unity, and a sense of community. However, we found a variety of reactions towards using this term in a public health context, ranging from agreement to disagreement and irritation. CONCLUSION Health communication during pandemics is crucial for maximizing compliance and gaining control of disease spread. In multicultural societies, governments and authorities should be aware of the linguistic and cultural barriers to public health communication if they are to effectively reach the entire population. The use of culturally specific concepts in this context, specially as rhetorical devices, may hinder effective health communication and increase health inequalities.
Collapse
Affiliation(s)
- Raquel Herrero-Arias
- Department of Health Promotion and Development, University of Bergen, Bergen, Norway
| | | | - Esperanza Diaz
- Pandemic Center, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
| |
Collapse
|
7
|
Khozaei F, Islam QU, Ramayah T, Ayub N, Carbon CC. Factors contributing to the mental wellbeing of Afghan migrants in Iran during the COVID-19 pandemic. J Migr Health 2024; 9:100211. [PMID: 38312935 PMCID: PMC10835284 DOI: 10.1016/j.jmh.2024.100211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Revised: 12/26/2023] [Accepted: 01/03/2024] [Indexed: 02/06/2024] Open
Abstract
This study aims to explore the factors contributing mental health of Afghan migrants residing in Iran during the COVID-19 pandemic. With a deep understanding of the unique challenges encountered by migrants, especially during times of crisis, this research delves into the influential factors of experienced anxiety, social cohesion, and stress and their significant contribution to the development of depression among Afghan migrants. The study included a sample of 469 individuals from the Afghan migrant community, aged 15 to 80 years. Data collection took place from December to March 2022 in Iran. The study revealed that anxiety and the burden of the COVID-19 pandemic significantly influenced the occurrence of depression among Afghan migrants. Furthermore, the relationship between these factors and depression was mediated by the experience of stress. Conversely, higher levels of perceived social cohesion in the host country were linked to reduced stress and depression among the migrants. As Afghan migrants in Iran face a heightened risk of developing depression, the importance of social support and integration is underscored by the association between higher levels of perceived social cohesion in the host country and reduced levels of stress and depression. Recognizing the vulnerabilities of this population, it becomes evident that fostering social support networks and promoting integration can play a crucial role in mitigating the negative impact of migration-related stressors and enhancing mental wellbeing among this population.
Collapse
Affiliation(s)
- Fatemeh Khozaei
- Department of Architectural Engineering, College of Engineering, Dhofar University, Salalah, Oman
- Research Group EPÆG (Ergonomics, Psychological Aesthetics, Gestalt), Bamberg, Bavaria, Germany
| | - Qamar Ul Islam
- Department of Electrical Engineering, College of Engineering, Dhofar University, Salalah, Oman
| | - T Ramayah
- School of Management, Universiti Sains Malaysia, Minden, 11800 Penang, Malaysia
- Department of Information Technology & Management, Daffodil International University, Birulia, Bangladesh
- Department of Management, Sunway Business School (SBS), Petaling Jaya, 47500, Selangor, Malaysia
- University Center for Research & Development (UCRD), Chandigarh University, Ludhiana, 140413, Punjab, India
- Faculty of Economics and Business, Universitas Indonesia (UI), Depok City, 16424, West Java, Indonesia
- The University of Jordan (UJ), Aljubeiha, Amman, Jordan
| | - Nadia Ayub
- Institute of Business Management Karachi, Pakistan
| | - Claus-Christian Carbon
- Research Group EPÆG (Ergonomics, Psychological Aesthetics, Gestalt), Bamberg, Bavaria, Germany
- Department of General Psychology and Methodology, University of Bamberg, Bavaria, Germany
| |
Collapse
|
8
|
The effects of traumatic experiences during transit and pushback on the mental health of refugees, asylum seekers, and migrants. Eur J Psychotraumatol 2023; 14:2163064. [PMID: 37052104 PMCID: PMC9873274 DOI: 10.1080/20008066.2022.2163064] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Background: There are 26 million people recognised as refugees worldwide. Many of them spent a prolonged period of time in transit - time after they leave their country of origin and before they reach the receiving country. Transit brings numerous protection and mental health risks refugees are exposed to.Objective: The aim of this study was to assess the stressful and traumatic experiences refugees are exposed to during transit, with a special focus on the experience of pushback - the denial of access to the territory to foreign nationals and forcible return to countries of origin or neighbouring countries without an assessment of their rights to international protection, as well as the impact of these experiences on refugees' mental health and well-being.Method: 201 refugees currently residing in Serbia completed the Stressful and Traumatic Experiences in Transit questionnaire - short version (SET-SF), questionnaire for assessing stressful and traumatic experiences during pushback (SET-SF PB), Refugee Health Screener (RHS-15), and Well-being index (WHO-5).Results: The results showed that refugees experience a large number of stressful and traumatic events (M = 10.27, SD = 4.85). In addition, half of the participants experience severe symptoms of depression (50.7%), while about a third of the participants experience severe symptoms of anxiety (37.8%) and post-traumatic stress disorder (PTSD) (32.3%). Refugees who experienced pushback showed overall higher levels of depression, anxiety, and PTSD. Traumatic experiences during transit and pushback were positively related to the severity of depression, anxiety, and PTSD. In addition, traumatic experiences during pushback showed an incremental contribution in predicting refugees' mental health difficulties over and above traumatic experiences in transit.Conclusions: This study provides valuable insights into the multiple risks refugees are exposed to and emphasise the need for the provision of adequate protection and support.
Collapse
|
9
|
Lemon ED, Crookes DM, Del Carmen Chacón L, Santiago C, Urbina B, Livingston M, Woods-Jaeger B. Facing a dual threat: Pandemic stress and immigration policy vulnerability on mental health among Latinx immigrant parents. Int J Soc Psychiatry 2023; 69:2139-2147. [PMID: 37691431 DOI: 10.1177/00207640231194480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/12/2023]
Abstract
BACKGROUND Exclusionary immigration policies rooted in structural racism threaten the wellbeing of Latinx families, increasing stress, anxiety, depression, and distress among immigrant parents. The COVID-19 pandemic has had devastating and disproportionate impacts on communities of color with unique impacts on Latinx immigrant parents in mixed-status families. AIMS From a syndemic theory lens, we explored the convergence of structural racism and the COVID-19 pandemic to explore if the stress of the COVID-19 pandemic may compound harmful immigration-related policies. METHODS Our community-based participatory research cross-sectional study administered 145 surveys among Latinx immigrant parents in mixed-status families in Georgia. We examined the relationship of pandemic stress and perceived statewide immigration policy vulnerability to depressive, anxiety, and PTSD symptoms. We conducted multiple linear regression analyses to test these relationships and their interaction. RESULTS We found that that greater perceived policy immigration vulnerability and reported pandemic stress were associated with higher symptoms of depression. Increased PTSD symptoms were also associated with immigration policy vulnerability, but not pandemic stress. Tests to assess if pandemic stress strengthened the relationship between policy vulnerability on depressive, anxiety, and PTSD symptoms revealed no statistically significant interactions. CONCLUSION Our findings suggest that stress of the COVID-19 pandemic and longstanding anti-immigrant policies in Georgia were salient for and related to the mental health of these Latinx immigrant parents.
Collapse
Affiliation(s)
- Emily D Lemon
- Department of Behavioral, Social and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Danielle M Crookes
- Department of Health Sciences Bouvé College of Health Sciences and Department of Anthropology and Sociology, College of Social Sciences and Humanities, Northeastern University, Boston, MA, USA
| | - Liliana Del Carmen Chacón
- Department of Behavioral, Social and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | | | | | - Melvin Livingston
- Department of Behavioral, Social and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Briana Woods-Jaeger
- Department of Behavioral, Social and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| |
Collapse
|
10
|
Yamashita T, Quy PN, Nogami E, Seto-Suh E, Yamada C, Iwamoto S, Shimazawa K, Kato K. Depression and anxiety symptoms among Vietnamese migrants in Japan during the COVID-19 pandemic. Trop Med Health 2023; 51:59. [PMID: 37908020 PMCID: PMC10617062 DOI: 10.1186/s41182-023-00542-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 08/25/2023] [Indexed: 11/02/2023] Open
Abstract
This study aimed to examine the mental health status and related factors among Vietnamese migrants in Japan during the COVID-19 pandemic. We conducted an online cross-sectional survey between September 21 and October 21, 2021. Along with Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder 7-item (GAD-7) scores, we collected data on demographics, changes in socioeconomic status due to the pandemic, language proficiency, social support, and health conditions. Multivariate logistic regression was performed to identify factors related to symptoms of depression and anxiety. Among 621 participants who completed the questionnaire, moderate-to-severe symptoms of depression (PHQ-9 score ≥ 10 points) and mild-to-severe symptoms of anxiety (GAD-7 score ≥ 5 points) were observed in 203 (32.7%) and 285 (45.9%) individuals, respectively. Factors related to depressive symptoms were age (95% confidence interval [CI]=0.89-0.99), pre-existing health conditions (95% [CI]=1.61-3.76), and a low subjective socioeconomic status (95% [CI]=1.64-3.71). Factors related to anxiety symptoms were being single (95% [CI]=1.01-2.93), having pre-existing health conditions (95% [CI]=1.63-3.88), subjective socioeconomic status (95% [CI]=1.87-3.97), and absence of a partner to discuss one's health with (95% [CI]=1.11-2.47). Vietnamese migrants in Japan experienced a decrease in income, worsening working conditions, and poor mental health status during the COVID-19 pandemic. Further investigations are necessary to find an effective way to increase their social support and mitigate socioeconomic adversities.
Collapse
Affiliation(s)
- Tadashi Yamashita
- Faculty of Nursing, Kobe City College of Nursing, 3-4 Gakuennishi-Machi, Nishi-ku, Kobe, Hyogo, 651-2103, Japan.
| | - Pham Nguyen Quy
- Department of Medical Oncology, Kyoto Miniren Central Hospital, Kyoto, Japan
| | - Emi Nogami
- Department of Social Welfare, School of Psychology and Social Welfare, Mukogawa Women's University, Nishinomiya, Japan
| | - Erina Seto-Suh
- Human Rights Research Institute, Kindai University, Higashi Osaka, Japan
| | - Chika Yamada
- Department of Environmental Coexistence, Center for Southeast Asian Studies, Kyoto University, Kyoto, Japan
| | - Saori Iwamoto
- Faculty of Nursing, Kobe City College of Nursing, 3-4 Gakuennishi-Machi, Nishi-ku, Kobe, Hyogo, 651-2103, Japan
| | | | - Kenji Kato
- Faculty of Nursing, Kobe Women's University, Kobe, Japan
| |
Collapse
|
11
|
Benavente P, Ronda E, Diaz E. Occupation-related factors affecting the health of migrants working during the COVID-19 pandemic - a qualitative study in Norway. Int J Equity Health 2023; 22:220. [PMID: 37848919 PMCID: PMC10583456 DOI: 10.1186/s12939-023-02013-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 09/14/2023] [Indexed: 10/19/2023] Open
Abstract
BACKGROUND The effects of the COVID-19 pandemic were more pronounced among migrants than in the majority population and went beyond those directly caused by the virus. Evidence suggests that this overburden is due to complex interactions between individual and structural factors. Some groups of working migrants were in vulnerable positions, overrepresented in essential jobs, under precarious work conditions, and ineligible for social benefits or special COVID-19 economic assistance. This study aimed to explore the experience of migrants working in Norway during the COVID-19 pandemic to gather an in-depth understanding of the pandemic´s impact on their health and well-being, focusing on occupation-related factors. METHODS In-depth personal interviews with 20 working migrants from different job sectors in Bergen and Oslo were conducted. Recruitment was performed using a purposive sampling method. Thematic analysis was used. RESULTS At the workplace level, factors such as pressure to be vaccinated, increased in occupational hazards, and increased structural discrimination negatively impacted migrants' health. Other factors at the host country context, such as changes in social networks in and out of the workplace and changes in the labour market, also had a negative effect. However, the good Norwegian welfare system positively impacted migrants' well-being, as they felt financially protected by the system. Increased structural discrimination was the only factor clearly identified as migrant-specific by the participants, but according to them, other factors, such as changes in social networks in and out of the workplace and social benefits in Norway, seemed to have a differential impact on migrants. CONCLUSIONS Occupational-related factors affected the health and well-being of working migrants during the pandemic. The pressure to get vaccinated and increased structural discrimination in the workplace need to be addressed by Norwegian authorities as it could have legal implications. Further research using intersectional approaches will help identify which factors, besides discrimination, had a differential impact on migrants. This knowledge is crucial to designing policies towards zero discrimination at workplaces and opening dialogue arenas for acknowledging diversity at work.
Collapse
Affiliation(s)
- Pierina Benavente
- Pandemic Centre, Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, Bergen, Norway.
| | - Elena Ronda
- Department of Community Nursing, Preventive Medicine and Public Health and History of Science, Faculty of Health Sciences, University of Alicante, Alicante, Spain
- CIBER for Epidemiology and Public Health (CIBERESP), Health Institute Carlos III, Madrid, Spain
| | - Esperanza Diaz
- Pandemic Centre, Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, Bergen, Norway
| |
Collapse
|
12
|
Langkulsen U, Mareke P, Lambonmung A. Migrants and Healthcare during COVID-19, the Case of Kanchanaburi Province in Thailand. Healthcare (Basel) 2023; 11:2724. [PMID: 37893798 PMCID: PMC10606567 DOI: 10.3390/healthcare11202724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 09/30/2023] [Accepted: 10/10/2023] [Indexed: 10/29/2023] Open
Abstract
Since the outbreak of COVID-19, as reported by the WHO in December 2019 and subsequently declared a public health emergency of international concern, a distinct set of risk factors and vulnerabilities faced by migrants are affecting their exposure to the pandemic and its associated outcomes. This study aims to analyze the social determinants of health among migrants and their associated factors and compare the socio-demographic characteristics, patterns of COVID-19, and healthcare attendance and utilization among migrant workers and non-migrants. A descriptive study design was used to analyze COVID-19 morbidity among migrant workers. There were a total of 73,762 migrants living in the province by December 2021, with varied statuses and nationalities. Most of the migrants were from Myanmar, constituting about 80.1%. A total of 24,837 COVID-19 cases in Kanchanaburi province were recorded in 2020-2021. COVID-19 cases among migrant workers accounted for 22.3% during the period under review. Half, 2914 (52.7%) of the migrant female workers were victims of COVID-19 infections. Persons under the age of 18 accounted for about one-fifth of all the COVID-19 cases. Older, over 60 years old, Thais had about twice (10.1%) the COVID-19 cases compared with the older migrants (5.5%). There was a significant increase in healthcare attendance and utilization by non-migrants and migrants during the year under review. Migrants are at high risk of COVID-19 infection. Therefore, public health guidance for the prevention of COVID-19 should prioritize safeguarding the health of migrants by considering their individual characteristics and actions. Enhancing health insurance schemes for migrants, particularly vulnerable migrant groups, is critical for inclusive and expanded healthcare access. Physical, social, and economic environments that impact the health and well-being of migrants should be integral to pandemic prevention, preparedness, response, and recovery.
Collapse
Affiliation(s)
- Uma Langkulsen
- Faculty of Public Health, Thammasat University, Rangsit Campus, Bangkok 12120, Pathum Thani, Thailand;
| | - Portia Mareke
- Biomedical Research and Training Institute, Harare P.O. Box A178, Zimbabwe;
| | - Augustine Lambonmung
- Faculty of Public Health, Thammasat University, Rangsit Campus, Bangkok 12120, Pathum Thani, Thailand;
- Tamale Teaching Hospital, Ministry of Health, Tamale P.O. Box TL 16, Ghana
| |
Collapse
|
13
|
Morisod K, Martin T, Rawlinson C, Grazioli VS, von Plessen C, Durand MA, Selby K, Le Pogam MA, Bühler N, Bodenmann P. Facing the COVID-19 Pandemic: A Mixed-Method Analysis of Asylum Seekers' Experiences and Worries in the Canton of Vaud, Switzerland. Int J Public Health 2023; 68:1606229. [PMID: 37829084 PMCID: PMC10564980 DOI: 10.3389/ijph.2023.1606229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 09/14/2023] [Indexed: 10/14/2023] Open
Abstract
Objectives: The clinical and social burden of the COVID-19 pandemic were high among asylum seekers (ASs). We aimed to understand better ASs' experiences of the pandemic and their sources of worries. Methods: Participants (n = 203) completed a survey about their worries, sleep disorders, and fear of dying. We also conducted semi-structured interviews with ASs living in a community center (n = 15), focusing on how social and living conditions affected their experiences and worries. Results: ASs in community centers experienced more sleep disorders related to the COVID-19 pandemic than those living in private apartments (aOR 2.01, p = 0.045). Similarly, those with lower education had greater fear for their life due to the COVID-19 pandemic (aOR 2.31, p = 0.015). Qualitative findings showed that sharing living spaces was an important source of worries for ASs and that protective measures were perceived to increase social isolation. Conclusion: Our study highlighted the impact of the COVID-19 pandemic for ASs and the importance of tailoring public health measures to their needs and living conditions.
Collapse
Affiliation(s)
- Kevin Morisod
- Department of Vulnerabilities and Social Medicine, University Center of General Medicine and Public Health, Lausanne, Switzerland
- Chair of Medicine for Vulnerable Populations, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Tiffany Martin
- Department of Vulnerabilities and Social Medicine, University Center of General Medicine and Public Health, Lausanne, Switzerland
- Department of Epidemiology and Health Systems, Center for Primary Care and Public Health (Unisanté), Lausanne, Switzerland
| | - Cloé Rawlinson
- Department of Vulnerabilities and Social Medicine, University Center of General Medicine and Public Health, Lausanne, Switzerland
- Department of Epidemiology and Health Systems, Center for Primary Care and Public Health (Unisanté), Lausanne, Switzerland
| | - Véronique S. Grazioli
- Department of Vulnerabilities and Social Medicine, University Center of General Medicine and Public Health, Lausanne, Switzerland
- Chair of Medicine for Vulnerable Populations, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Christian von Plessen
- Department of Ambulatory Care, Center for Primary Care and Public Health, University Center of General Medicine and Public Health, Lausanne, Switzerland
- Direction Générale de la Santé (DGS), Lausanne, Switzerland
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Marie-Anne Durand
- UMR1295 Centre d’Epidémiologie et de Recherche en Santé des Populations (CERPOP), Toulouse, France
- University Center of General Medicine and Public Health, Lausanne, Switzerland
- The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth College, Lebanon, NH, United States
| | - Kevin Selby
- Department of Ambulatory Care, Center for Primary Care and Public Health, University Center of General Medicine and Public Health, Lausanne, Switzerland
| | - Marie-Annick Le Pogam
- Department of Epidemiology and Health Systems, Center for Primary Care and Public Health (Unisanté), Lausanne, Switzerland
| | - Nolwenn Bühler
- Department of Vulnerabilities and Social Medicine, University Center of General Medicine and Public Health, Lausanne, Switzerland
- Department of Epidemiology and Health Systems, Center for Primary Care and Public Health (Unisanté), Lausanne, Switzerland
- Institute of Social Sciences, Faculty of Social and Political Sciences, University of Lausanne, Lausanne, Switzerland
| | - Patrick Bodenmann
- Department of Vulnerabilities and Social Medicine, University Center of General Medicine and Public Health, Lausanne, Switzerland
- Chair of Medicine for Vulnerable Populations, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| |
Collapse
|
14
|
Anwar A, Yadav UN, Huda MN, Das S, Rosenbaum S, Ali ARMM, Mondal PK, Rizwan AAM, Hossain SFA, Das Shuvo S, Mistry SK. Anxiety and Stress Related to COVID-19 Among the Community Dwelling Older Adults Residing in the Largest Refugee Camp of the World. Community Ment Health J 2023; 59:1181-1192. [PMID: 36879112 PMCID: PMC9988202 DOI: 10.1007/s10597-023-01101-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 01/07/2023] [Indexed: 03/08/2023]
Abstract
The current cross-sectional study was conducted among 864 older adults aged ≥ 60 years residing in Rohingya refugee camp through face-to-face interviews during November-December 2021. COVID-19-related anxiety was measured using the five-point Coronavirus Anxiety Scale (CAS) and perceived stress using the 10-point Perceived Stress Scale (PSS). The linear regression model identified the factors associated with COVID-19-related anxiety and perceived stress. The prevalence of COVID-19-related anxiety and perceived stress was 68% and 93%, respectively. The average COVID-19-related anxiety score expected to be significantly higher among those who were physically inactive, concerned about COVID-19, had a close friend/family member diagnosed with COVID-19, and had some difficulty in getting food and routine medical care during the COVID-19 pandemic. Meanwhile, the average perceived stress score was expected to be significantly higher among those without partners, who were feeling overwhelmed by COVID-19, and who experienced COVID-19-related anxiety during the pandemic. The findings suggest providing immediate psychosocial support to older Rohingya adults.
Collapse
Affiliation(s)
- Afsana Anwar
- Health and Nutrition, Social Assistance &Amp; Rehabilitation for the Physically Vulnerable (SARPV), SARPV Complex, Link Road, Cox's Bazar, 4700, Bangladesh
| | - Uday Narayan Yadav
- National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, Australia
| | - Md Nazmul Huda
- School of Medicine, Translational Health Research Institute, Western Sydney University, Campbelltown, NSW, 2560, Australia
- ARCED Foundation, 13/1, Pallabi, Mirpur-12, Dhaka, Bangladesh
| | - Sukanta Das
- Department of Statistics, Begum Rokeya University, Rangpur, Bangladesh
| | - Simon Rosenbaum
- School of Psychiatry, University of New South Wales, Sydney, Australia
| | | | - Probal Kumar Mondal
- Health and Nutrition, Social Assistance &Amp; Rehabilitation for the Physically Vulnerable (SARPV), SARPV Complex, Link Road, Cox's Bazar, 4700, Bangladesh
| | - Abu Ansar Md Rizwan
- Health and Nutrition, Social Assistance &Amp; Rehabilitation for the Physically Vulnerable (SARPV), SARPV Complex, Link Road, Cox's Bazar, 4700, Bangladesh
| | | | - Suvasish Das Shuvo
- Department of Nutrition and Food Technology, Jashore University of Science and Technology, Jashore, Bangladesh
| | - Sabuj Kanti Mistry
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, Australia.
- ARCED Foundation, 13/1, Pallabi, Mirpur-12, Dhaka, Bangladesh.
- Department of Public Health, Daffodil International University, Dhaka, 1207, Bangladesh.
- Brain and Mind Centre, The University of Sydney, Sydney, Australia.
| |
Collapse
|
15
|
Rees SJ, Mohsin M, Kuowei Tay A, Moussa B, Klein L, Nadar N, Hussain F, Krishna Y, Khalil B, Yousif M, Silove D, Fisher J. COVID-19 stressors and mental health problems amongst women who arrived as refugees and those born in Australia. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0002073. [PMID: 37399172 PMCID: PMC10317230 DOI: 10.1371/journal.pgph.0002073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 05/23/2023] [Indexed: 07/05/2023]
Abstract
Women from refugee background residing in high income countries are at greater mental health risk during the COVID-19 pandemic given their higher baseline prevalence of mental disorders, trauma exposures and social adversities. During the COVID-19 pandemic we drew on data from wave-4 of the WATCH cohort study, collected between October 2019 and June 2021. We conducted a cross-sectional analysis to compare the prevalence of common mental disorders (CMDs) from the sample of 650 consecutively recruited women, 339 (52.2%) from the refugee-background who were resettled in Australia and 311 (48.8%) randomly and contemporaneously selected Australian born women. We assessed COVID-19 psychosocial stressors: 1. COVID-related material hardship and 2. COVID-related fear and stress. We examined for associations between scores on these two items and CMDs in each group respectively. Compared to Australian-born woman, women from refugee background recorded a significantly higher prevalence of Major Depressive Disorder (MDD) (19.8% vs 13.5%), PTSD (9.7% vs 5.1%), Separation Anxiety Disorder (SEPAD) (19.8% vs 13.5%) and Persistent Complicated Bereavement Disorder (PCBD) (6.5% vs 2.9%). In refugee women, associations were found between COVID-related material hardship and CMDs [MDD, Relative Risk (RR) = 1.39, 95%CI: 1.02-1.89, p = 0.02] as well as between COVID-related fear and stress and CMDs (MDD, RR = 1.74, 95%CI: 1.04-2.90, p = 0.02 p = 0.02). For Australian-born women, associations were more commonly found between CMDs and material hardship. Our study demonstrates that both women from refugee background and those born in Australia are experiencing significant rates of CMD during the pandemic and that material hardship is an associated factor. We found that women from refugee background are at greater risk for mental health problems and are more likely to report an association of those problems with fear and stress related to COVID_19. All women, and particularly those from refugee background, require urgent and specialised attention to their mental health and psychosocial problems during this pandemic.
Collapse
Affiliation(s)
- Susan J. Rees
- Faculty of Medicine, Discipline of Psychiatry, School of Clinical Medicine, University of New South Wales, Sydney, Australia
| | - Mohammed Mohsin
- Faculty of Medicine, Discipline of Psychiatry, School of Clinical Medicine, University of New South Wales, Sydney, Australia
- Mental Health Research Unit, Liverpool Hospital, SWSLHD, New South Wales Health, Liverpool, Australia
| | - Alvin Kuowei Tay
- Faculty of Medicine, Discipline of Psychiatry, School of Clinical Medicine, University of New South Wales, Sydney, Australia
| | - Batool Moussa
- Faculty of Medicine, Discipline of Psychiatry, School of Clinical Medicine, University of New South Wales, Sydney, Australia
| | - Louis Klein
- Faculty of Medicine, Discipline of Psychiatry, School of Clinical Medicine, University of New South Wales, Sydney, Australia
| | - Nawal Nadar
- Faculty of Medicine, Discipline of Psychiatry, School of Clinical Medicine, University of New South Wales, Sydney, Australia
| | - Fatima Hussain
- Faculty of Medicine, Discipline of Psychiatry, School of Clinical Medicine, University of New South Wales, Sydney, Australia
| | - Yalini Krishna
- Faculty of Medicine, Discipline of Psychiatry, School of Clinical Medicine, University of New South Wales, Sydney, Australia
| | - Batoul Khalil
- Faculty of Medicine, Discipline of Psychiatry, School of Clinical Medicine, University of New South Wales, Sydney, Australia
| | - Mariam Yousif
- Faculty of Medicine, Discipline of Psychiatry, School of Clinical Medicine, University of New South Wales, Sydney, Australia
| | - Derrick Silove
- Faculty of Medicine, Discipline of Psychiatry, School of Clinical Medicine, University of New South Wales, Sydney, Australia
| | - Jane Fisher
- Division of Social Sciences in Public Health and Preventive Medicine, Global and Women’s Health, Monash University, Melbourne, Victoria, Australia
| |
Collapse
|
16
|
Olson A, Naevestad TO, Orru K, Nero K, Schieffelers A, Frislid Meyer S. The impact of the COVID-19 pandemic on socially marginalised women: Material and mental health outcomes. INTERNATIONAL JOURNAL OF DISASTER RISK REDUCTION : IJDRR 2023; 93:103739. [PMID: 37234353 PMCID: PMC10162841 DOI: 10.1016/j.ijdrr.2023.103739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 03/23/2023] [Accepted: 05/03/2023] [Indexed: 05/27/2023]
Abstract
There is little knowledge about how the COVID-19 pandemic has impacted people who are socially marginalised, including individuals who face barriers when attempting to access services such as social safety nets, the labour market, or housing. There is even less understanding about women living under these circumstances. The aims of this study are therefore to examine the material and mental impacts of COVID-19 among socially marginalised women (compared with socially marginalised men) as well as influencing factors. The study is based on survey data (N = 304) involving people who are clients of social care organisations in thirteen European countries. The sample includes clients: a) living in their homes, b) in facilities, and c) on the street and in temporary accommodations. Results indicate that although material impacts were not significantly different for female and male respondents, socially marginalised women have experienced more severe mental impacts of the COVID-19 pandemic than socially marginalised men. Female respondents have been significantly more worried about COVID-19 infection than men, and they report significantly more PTSD-symptoms related to the pandemic. Quantitative results indicate that these differences are related to the fact that the female respondents worry more about health risks (e.g. falling ill). Female respondents also seem to be harder hit mentally by the material impacts of COVID-19. Among the free text survey answers regarding the biggest problem for the respondents after the outbreak of the pandemic, the most prevalent reply (among both men and women) was related to material impacts of the pandemic (39% of the respondents), particularly the loss of work (65%). While women reported deterioration of social relations more often, men mentioned lacking access to services more frequently.
Collapse
Affiliation(s)
- Alexandra Olson
- The Salvation Army, Place Du Nouveau Marché Aux Grains 34, 1000, Brussels, Belgium
| | - Tor-Olav Naevestad
- Institute of Transport Economics, Norwegian Centre for Transport Research, Gaustadalléen 21, NO-0349, Oslo, Norway
| | - Kati Orru
- Institute of Social Studies, University of Tartu, Lossi 36, 51003, Tartu, Estonia
| | - Kristi Nero
- Institute of Social Studies, University of Tartu, Lossi 36, 51003, Tartu, Estonia
| | - Abriel Schieffelers
- The Salvation Army, Place Du Nouveau Marché Aux Grains 34, 1000, Brussels, Belgium
| | - Sunniva Frislid Meyer
- Institute of Transport Economics, Norwegian Centre for Transport Research, Gaustadalléen 21, NO-0349, Oslo, Norway
| |
Collapse
|
17
|
Yu X, Gao Z, Gao M, Qiao M. Bibliometric Analysis on GABA-A Receptors Research Based on CiteSpace and VOSviewer. J Pain Res 2023; 16:2101-2114. [PMID: 37361426 PMCID: PMC10289248 DOI: 10.2147/jpr.s409380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 05/11/2023] [Indexed: 06/28/2023] Open
Abstract
Background GABA-A receptors are the primary mediators of brain inhibitory neurotransmission. In the past years, many studies focused on this channel to decipher the pathogenesis of related diseases but lacked bibliometric analysis research. This study aims to explore the research status and identify the research trends of GABA-A receptor channels. Methods Publications related to GABA-A receptor channels were retrieved from the Web of Science Core Collection from 2012 to 2022. After screening, the VOSviewer 1.6.18 and Citespace 5.8 R3 were used for bibliometric analysis from journals, countries, institutions, authors, co-cited references and keywords. Results We included 12,124 publications in the field of GABA-A receptor channels for analysis. The data shows that although there was a slight decrease in annual publications from 2012 to 2021, it remained at a relatively high level. Most publications were in the domain of neuroscience. Additionally, the United States was the most prolific country, followed by China. Univ Toronto was the most productive institution, and James M Cook led essential findings in this field. Furthermore, brain activation, GABAAR subunits expression, modulation mechanism in pain and anxiety behaviors and GABA and dopamine were paid attention to by researchers. And top research frontiers were molecular docking, autoimmune encephalitic series, obesity, sex difference, diagnosis and management, EEG and KCC2. Conclusion Taken together, academic attention on GABA-A receptor channels was never neglected since 2012. Our analysis identified key information, such as core countries, institutions and authors in this field. Molecular docking, autoimmune encephalitic series, obesity, sex difference, diagnosis and management, EEG and KCC2 will be the future research direction.
Collapse
Affiliation(s)
- Xufeng Yu
- College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, People’s Republic of China
| | - Zhan Gao
- College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, People’s Republic of China
| | - Mingzhou Gao
- Innovation Research Institute of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, People’s Republic of China
| | - Mingqi Qiao
- College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, People’s Republic of China
| |
Collapse
|
18
|
Jaschke P, Kosyakova Y, Kuche C, Walther L, Goßner L, Jacobsen J, Ta TMT, Hahn E, Hans S, Bajbouj M. Mental health and well-being in the first year of the COVID-19 pandemic among different population subgroups: evidence from representative longitudinal data in Germany. BMJ Open 2023; 13:e071331. [PMID: 37295837 PMCID: PMC10276970 DOI: 10.1136/bmjopen-2022-071331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 05/19/2023] [Indexed: 06/12/2023] Open
Abstract
OBJECTIVES To examine potential deteriorations in mental health and well-being in the first COVID-19 pandemic year compared with the previous decade focusing on the following vulnerable subgroups in Germany: women with minor children in the household, those living without a partner, younger and older adults, those in a precarious labour market situation, immigrants and refugees, and those with pre-existing physical or mental health risks. DESIGN Analyses of secondary longitudinal survey data using cluster-robust pooled ordinary least squares models. PARTICIPANTS More than 20 000 individuals (aged 16+ years) in Germany. PRIMARY AND SECONDARY OUTCOME MEASURES Mental Component Summary Scale (MCS) of the 12-item Short-Form Health Survey measuring mental health-related quality of life, single item on life satisfaction (LS). RESULTS We find a decline in the average MCS in the 2020 survey that is not particularly striking in the overall time course, still resulting in a mean score below those of all preceding waves since 2010. We find no change in LS from 2019 to 2020 against the background of a general upward trend. Regarding vulnerability factors, only the results on age and parenthood are partially in line with our expectations. In 2020, LS declined among the youngest adults; MCS declined among mothers (and women and men without children) but not fathers. Unlike respective comparison groups, refugees, those unemployed before the pandemic and those with pre-existing mental health risks experienced no MCS declines in 2020, whereas persons living without a partner, the eldest, and those with pre-existing health risks exhibited continued increases in LS. CONCLUSIONS There is no evidence for substantial breakdowns in mental health or subjective well-being in the first pandemic year in the German population or its subgroups, particularly when considering developments of the previous decade. Since the majority of hypothesised vulnerable groups to pandemic stressors showed more stable MCS and LS, our results warrant further study.
Collapse
Affiliation(s)
- Philipp Jaschke
- Migration and International Labour Studies, Institute for Employment Research (IAB), Nuremberg, Germany
| | - Yuliya Kosyakova
- Migration and International Labour Studies, Institute for Employment Research (IAB), Nuremberg, Germany
- Professorship of Migration Research, University of Bamberg, Bamberg, Germany
| | - Coline Kuche
- Department of Sociology, Georg-August-Universität Göttingen, Göttingen, Germany
| | - Lena Walther
- Klinik für Psychiatrie und Psychotherapie, Charite Universitatsmedizin Berlin, Berlin, Germany
| | - Laura Goßner
- Migration and International Labour Studies, Institute for Employment Research (IAB), Nuremberg, Germany
| | - Jannes Jacobsen
- Deutsches Zentrum für Integrations- und Migrationsforschung (DeZIM), Berlin, Germany
- Berlin Social Science Center (WZB), Berlin, Germany
| | - Thi Minh Tam Ta
- Klinik für Psychiatrie und Psychotherapie, Charite Universitatsmedizin Berlin, Berlin, Germany
| | - Eric Hahn
- Klinik für Psychiatrie und Psychotherapie, Charite Universitatsmedizin Berlin, Berlin, Germany
| | - Silke Hans
- Department of Sociology, Georg-August-Universität Göttingen, Göttingen, Germany
| | - Malek Bajbouj
- Klinik für Psychiatrie und Psychotherapie, Charite Universitatsmedizin Berlin, Berlin, Germany
| |
Collapse
|
19
|
Sahoo KC, Negi S, Mahapatra P, Samantaray K, Dash GC, Dubey S, Sahay MR, Sahoo RK, Bhattacharya D, Sahoo B, Pani SP, Otmani del Barrio M, Pati S. Gender dimensions of health-related challenges among urban poor during COVID-19 pandemic in low-and middle-income countries: a systematic review and gap analysis. Front Public Health 2023; 11:1170386. [PMID: 37361176 PMCID: PMC10288984 DOI: 10.3389/fpubh.2023.1170386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 05/11/2023] [Indexed: 06/28/2023] Open
Abstract
The COVID-19 pandemic has varying effects on men, women, and the transgender population. However, there is a paucity of systematic evidence on how gender and other social determinants of health during COVID-19 are affected in resource constraint urban settings. This review describes the gender dimensions of health-related challenges among the urban poor during COVID-19 in LMICs. We searched 11 scholarly online repositories including PubMed, Embase, Web of Science, CINAHL using the domain "slums," "COVID-19", "LMICs" and "gender identities." We used thematic framework analysis to synthesize qualitative data, and meta-analysis to determine the pooled prevalence. We registered in PROSPERO (CRD42020203783). We identified 6490 records, and 37 articles included. The studies reported stress among 74% women and 78% men, depression among 59% women and 62% men, and anxiety among 79% women and 63% men. Men had more stress than women during COVID-19; men are primarily responsible for household sustenance. Women had more anxiety than men, possibly because they are often the primary caregivers for children and the older population. While the severity varies according to gender identity, their vulnerability mostly related to their literacy and economy, highlighting the significance of including all social determinants in future primary studies. Systematic review registration https://www.crd.york.ac.uk/prospero/#recordDetails.
Collapse
Affiliation(s)
- Krushna Chandra Sahoo
- Health Technology Assessment in India, Indian Council of Medical Research (ICMR)-Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Sapna Negi
- Health Technology Assessment in India, Indian Council of Medical Research (ICMR)-Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Pranab Mahapatra
- Department of Psychiatry, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Kajal Samantaray
- Health Technology Assessment in India, Indian Council of Medical Research (ICMR)-Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Girish Chandra Dash
- Health Technology Assessment in India, Indian Council of Medical Research (ICMR)-Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Shubhankar Dubey
- Health Technology Assessment in India, Indian Council of Medical Research (ICMR)-Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Mili Roopchand Sahay
- Health Technology Assessment in India, Indian Council of Medical Research (ICMR)-Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Rakesh Kumar Sahoo
- Health Technology Assessment in India, Indian Council of Medical Research (ICMR)-Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Debdutta Bhattacharya
- Health Technology Assessment in India, Indian Council of Medical Research (ICMR)-Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Banamber Sahoo
- Health Technology Assessment in India, Indian Council of Medical Research (ICMR)-Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | | | - Mariam Otmani del Barrio
- UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR), World Health Organization, Geneva, Switzerland
| | - Sanghamitra Pati
- Health Technology Assessment in India, Indian Council of Medical Research (ICMR)-Regional Medical Research Centre, Bhubaneswar, Odisha, India
| |
Collapse
|
20
|
Melov SJ, Galas N, Swain J, Alahakoon TI, Lee V, Cheung NW, McGee T, Pasupathy D, McNab J. Women's experience of perinatal support in a high migrant Australian population during the COVID-19 pandemic: a mixed methods study. BMC Pregnancy Childbirth 2023; 23:429. [PMID: 37296421 DOI: 10.1186/s12884-023-05745-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 05/29/2023] [Indexed: 06/12/2023] Open
Abstract
BACKGROUND As a COVID-19 risk mitigation measure, Australia closed its international borders for two years with significant socioeconomic disruption including impacting approximately 30% of the Australian population who are migrants. Migrant populations during the peripartum often rely on overseas relatives visiting for social support. High quality social support is known to lead to improved health outcomes with disruption to support a recognised health risk. AIM To explore women's experience of peripartum social support during the COVID-19 pandemic in a high migrant population. To quantify type and frequency of support to identify characteristics of vulnerable perinatal populations for future pandemic preparedness. METHODS A mixed methods study with semi-structured interviews and a quantitative survey was conducted from October 2020 to April 2021. A thematic approach was used for analysis. RESULTS There were 24 participants interviewed both antenatally and postnatally (22 antenatal; 18 postnatal). Fourteen women were migrants and 10 Australian born. Main themes included; 'Significant disruption and loss of peripartum support during the COVID-19 pandemic and ongoing impact for migrant women'; 'Husbands/partners filling the support gap' and 'Holding on by a virtual thread'. Half of the participants felt unsupported antenatally. For Australian born women, this dissipated postnatally, but migrants continued to feel unsupported. Migrant women discussed partners stepped into traditional roles and duties of absent mothers and mothers-in-law who were only available virtually. CONCLUSION This study identified disrupted social support for migrant women during the pandemic, providing further evidence that the pandemic has disproportionately impacted migrant populations. However, the benefits identified in this study included high use of virtual support, which could be leveraged for improving clinical care in the present and in future pandemics. The COVID-19 pandemic impacted most women's peripartum social support with migrant families having ongoing disruption. Gains in the pandemic included greater gender equity for domestic work as husbands/partners increased their contribution to domestic work and childcare.
Collapse
Affiliation(s)
- Sarah J Melov
- Reproduction and Perinatal Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.
- Westmead Institute for Maternal and Fetal Medicine, Research and Education Building, Crn Hawkesbury and Darcy Rd, Westmead, NSW, 2145, Australia.
| | - Nelma Galas
- Women's and Newborn Health, Westmead Hospital, Sydney, NSW, Australia
| | - Julie Swain
- Women's and Newborn Health, Westmead Hospital, Sydney, NSW, Australia
| | - Thushari I Alahakoon
- Westmead Institute for Maternal and Fetal Medicine, Research and Education Building, Crn Hawkesbury and Darcy Rd, Westmead, NSW, 2145, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Vincent Lee
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- Department of Renal Medicine, Westmead Hospital, Sydney, NSW, Australia
| | - N Wah Cheung
- Westmead Applied Research Centre, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
- Department of Diabetes & Endocrinology, Westmead Hospital, Sydney, Australia
| | - Therese McGee
- Women's and Newborn Health, Westmead Hospital, Sydney, NSW, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Dharmintra Pasupathy
- Reproduction and Perinatal Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- Westmead Institute for Maternal and Fetal Medicine, Research and Education Building, Crn Hawkesbury and Darcy Rd, Westmead, NSW, 2145, Australia
| | - Justin McNab
- Reproduction and Perinatal Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
| |
Collapse
|
21
|
Shelest-Szumilas O, Wozniak M. The Fears and Hopes of Ukrainian Migrant Workers in Poland in the Pandemic Era. JOURNAL OF INTERNATIONAL MIGRATION AND INTEGRATION 2023:1-23. [PMID: 37360639 PMCID: PMC10209937 DOI: 10.1007/s12134-023-01051-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/02/2023] [Indexed: 06/28/2023]
Abstract
Due to the COVID-19 pandemic, many immigrants found themselves in extremely unstable situations. The recent contributions show that employment decline in the first several months of the lockdown was higher for migrant workers than for natives. At the same time, migrants were less likely to find new employment in the recovery months. Such circumstances may result in an increased level of anxiety about one's economic situation. On the other hand, an unfavorable environment may induce resources that could help to overcome it. The paper aims to reveal migrants' concerns together with ambitions connected with the economic activity during the pandemic. The study is based on 30 individual in-depth interviews with Ukrainian migrant workers from Poland. The research approach was based on Natural Language Processing techniques. We employed sentiment analysis algorithms, and on a basis of selected lexicons, we extracted fears and hopes that appear in migrants' narrations. We also identified major topics and associated them with specific sentiments. Pandemic induced several matters connected with e.g., the stability of employment, discrimination, relationships, family, and financial situation. These affairs are usually connected on the basis of a cause-and-effect relationship. In addition, while several topics were common for both male and female participants, some of them were specific for each group.
Collapse
Affiliation(s)
- Olena Shelest-Szumilas
- Department of Education and Personnel Development, Poznan University of Economics and Business, Poznan, Poland
| | | |
Collapse
|
22
|
Lotito C, Turrini G, Purgato M, Bryant RA, Felez-Nobrega M, Haro JM, Lorant V, McDaid D, Mediavilla R, Melchior M, Nicaise P, Nosè M, Park AL, McGreevy KR, Roos R, Tortelli A, Underhill J, Martinez JV, Witteveen A, Sijbrandij M, Barbui C. Views and experiences of migrants and stakeholders involved in social and health care for migrants in Italy during the COVID-19 pandemic: a qualitative study. BMC Psychol 2023; 11:164. [PMID: 37208725 DOI: 10.1186/s40359-023-01208-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 05/14/2023] [Indexed: 05/21/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has had major and potentially long-lasting effects on mental health and wellbeing across populations worldwide. However, these impacts were not felt equally, leading to an exacerbation of health inequalities, especially affecting vulnerable populations such as migrants, refugees and asylum seekers. Aiming to inform the adaptation and implementation of psychological intervention programmes, the present study investigated priority mental health needs in this population group. METHODS Participants were adult asylum seekers, refugees and migrants (ARMs) and stakeholders with experience in the field of migration living in Verona, Italy, and fluent in Italian and English. A two-stage process was carried out to examine their needs using qualitative methods including free listing interviews and focus group discussions, according to Module One of the DIME (Design, Implementation, Monitoring, and Evaluation) manual. Data were analyzed using an inductive thematic analyses approach. RESULTS A total of 19 participants (12 stakeholders, 7 ARMs) completed the free listing interviews and 20 participants (12 stakeholders and 8 ARMs) attended focus group discussions. Salient problems and functions that emerged during free listing interviews were discussed during the focus group discussions. During the COVID-19 pandemic, ARMs struggled with many everyday living difficulties in their resettlement country due to social and economic issues, revealing a strong influence of contextual factors in determining mental health. Both ARMs and stakeholders highlighted a mismatch between needs, expectations and interventions as factors that may hamper proper implementation of health and social programmes. CONCLUSIONS The present findings could help in the adaptation and implementation of psychological interventions targeting the needs of asylum seekers, refugees and migrants aiming to find a match between needs, expectations, and the corresponding interventions. TRIAL REGISTRATION Registration number 2021-UNVRCLE-0106707, February 11 2021.
Collapse
Affiliation(s)
- Claudia Lotito
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
- Cochrane Global Mental Health, University of Verona, Verona, Italy
| | - Giulia Turrini
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy.
- Cochrane Global Mental Health, University of Verona, Verona, Italy.
| | - Marianna Purgato
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
- Cochrane Global Mental Health, University of Verona, Verona, Italy
| | - Richard A Bryant
- School of Psychology, University of New South Wales, Sydney, Australia
| | - Mireia Felez-Nobrega
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Déu, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Josep Maria Haro
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Déu, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Vincent Lorant
- Institute of Health and Society (IRSS), Université Catholique de Louvain, Brussels, Belgium
| | - David McDaid
- Care Policy and Evaluation Centre, Department of Health, London School of Economics and Political Science, London, UK
| | - Roberto Mediavilla
- Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain
- Centro de Investigaci?n Biom?dica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
| | - Maria Melchior
- Département d'Epidémiologie Sociale, Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, 27 rue de Chaligny, Paris, 75012, France
| | - Pablo Nicaise
- Institute of Health and Society (IRSS), Université Catholique de Louvain, Brussels, Belgium
| | - Michela Nosè
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
- Cochrane Global Mental Health, University of Verona, Verona, Italy
| | - A-La Park
- Care Policy and Evaluation Centre, Department of Health, London School of Economics and Political Science, London, UK
| | - Kerry R McGreevy
- Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain
- Centro de Investigaci?n Biom?dica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Rinske Roos
- Department of Clinical, Neuro- and Developmental Psychology, Amsterdam Public Health Institute and WHO Collaborating Center for Research and Dissemination of Psychological Interventions, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Andrea Tortelli
- Département d'Epidémiologie Sociale, Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, 27 rue de Chaligny, Paris, 75012, France
| | | | - Julian Vadell Martinez
- Département d'Epidémiologie Sociale, Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, 27 rue de Chaligny, Paris, 75012, France
| | - Anke Witteveen
- Department of Clinical, Neuro- and Developmental Psychology, Amsterdam Public Health Institute and WHO Collaborating Center for Research and Dissemination of Psychological Interventions, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Marit Sijbrandij
- Department of Clinical, Neuro- and Developmental Psychology, Amsterdam Public Health Institute and WHO Collaborating Center for Research and Dissemination of Psychological Interventions, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Corrado Barbui
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
- Cochrane Global Mental Health, University of Verona, Verona, Italy
| |
Collapse
|
23
|
Jarvis GE, Kirmayer LJ. Global migration: Moral, political and mental health challenges. Transcult Psychiatry 2023; 60:5-12. [PMID: 36919356 DOI: 10.1177/13634615231162282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Abstract
Global migration is expected to continue to increase as climate change, conflict and economic disparities continue to challenge peoples' lives. The political response to migration is a social determinant of mental health. Despite the potential benefits of migration, many migrants and refugees face significant challenges after they resettle. The papers collected in this thematic issue of Transcultural Psychiatry explore the experience of migration and highlight some of the challenges that governments and healthcare services need to address to facilitate the social integration and mental health of migrants. Clinicians need training and resources to work effectively with migrants, focusing on their resilience and on long-term adaptive processes. Efforts to counter the systemic discrimination and structural violence that migrants often face need to be broad-based, unified, and persistent to make meaningful change. When migrants are free to realize their talents and aspirations, they can help build local communities and societies that value diversity.
Collapse
Affiliation(s)
- G Eric Jarvis
- Division of Social & Transcultural Psychiatry, McGill University.,Culture and Mental Health Research Unit, Institute for Community & Family Psychiatry. Jewish General Hospital, Montreal
| | - Laurence J Kirmayer
- Division of Social & Transcultural Psychiatry, McGill University.,Culture and Mental Health Research Unit, Institute for Community & Family Psychiatry. Jewish General Hospital, Montreal
| |
Collapse
|
24
|
Rast E, Perplies C, Biddle L, Bozorgmehr K. Between Care and Coercion: Asylum Seekers’ Experiences With COVID-19 Containment and Mitigation Measures in German Reception Centres. Int J Public Health 2023; 68:1605230. [PMID: 36994090 PMCID: PMC10041458 DOI: 10.3389/ijph.2023.1605230] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 02/27/2023] [Indexed: 03/14/2023] Open
Abstract
Objectives: COVID-19 containment and mitigation measures have been criticised for amplifying pre-existing individual and structural vulnerabilities among asylum seekers. We qualitatively explored their experiences with and attitudes towards pandemic measures to inform people-centred responses in future health emergencies.Methods: We interviewed eleven asylum seekers in a German reception centre (July-December 2020). The semi-structured interviews were recorded, transcribed, and analysed thematically with an inductive-deductive approach.Results: Quarantine was experienced as burdensome by participants. Shortcomings in social support, everyday necessities, information, hygiene, and daily activities exacerbated the strains of quarantine. Interviewees held different opinions about the usefulness and appropriateness of the various containment and mitigation measures. These opinions differed by individual risk perception and the measures’ comprehensibility and compatibility with personal needs. Power asymmetries related to the asylum system furthermore impacted on preventive behaviour.Conclusion: Quarantine can amplify mental health burdens and power asymmetries and can therefore constitute a considerable stressor for asylum seekers. Provision of diversity-sensitive information, daily necessities, and accessible psychosocial support is required to counteract adverse psychosocial impacts of pandemic measures and safeguard wellbeing in this population.
Collapse
Affiliation(s)
- Eilin Rast
- Section Health Equity Studies & Migration, Department of General Practice and Health Services Research, Heidelberg University Hospital, Heidelberg, Germany
| | - Clara Perplies
- Section Health Equity Studies & Migration, Department of General Practice and Health Services Research, Heidelberg University Hospital, Heidelberg, Germany
| | - Louise Biddle
- Section Health Equity Studies & Migration, Department of General Practice and Health Services Research, Heidelberg University Hospital, Heidelberg, Germany
- Department of Population Medicine and Health Services Research, School of Public Health, Bielefeld University, Bielefeld, Germany
| | - Kayvan Bozorgmehr
- Section Health Equity Studies & Migration, Department of General Practice and Health Services Research, Heidelberg University Hospital, Heidelberg, Germany
- Department of Population Medicine and Health Services Research, School of Public Health, Bielefeld University, Bielefeld, Germany
| |
Collapse
|
25
|
Feen-Calligan H, Grasser LR, Smigels J, McCabe N, Kremer B, Al-Zuwayyin A, Yusuf I, Alesawy N, Al-Nouri J, Javanbakht A. Creating Through COVID: Virtual Art Therapy for Youth Resettled as Refugees. ART THERAPY 2023. [DOI: 10.1080/07421656.2023.2172947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
|
26
|
Petrazzuoli F, Collins C, Van Poel E, Tatsioni A, Streit S, Bojaj G, Asenova R, Hoffmann K, Gabrani J, Klemenc-Ketis Z, Rochfort A, Adler L, Windak A, Nessler K, Willems S. Differences between Rural and Urban Practices in the Response to the COVID-19 Pandemic: Outcomes from the PRICOV-19 Study in 38 Countries. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3674. [PMID: 36834369 PMCID: PMC9958860 DOI: 10.3390/ijerph20043674] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 02/16/2023] [Accepted: 02/16/2023] [Indexed: 06/18/2023]
Abstract
This paper explores the differences between rural and urban practices in the response to the COVID-19 pandemic, emphasizing aspects such as management of patient flow, infection prevention and control, information processing, communication and collaboration. Using a cross-sectional design, data were collected through the online PRICOV-19 questionnaire sent to general practices in 38 countries. Rural practices in our sample were smaller than urban-based practices. They reported an above-average number of old and multimorbid patients and a below-average number of patients with a migrant background or financial problems. Rural practices were less likely to provide leaflets and information, but were more likely to have ceased using the waiting room or to have made structural changes to their waiting room and to have changed their prescribing practices in terms of patients attending the practices. They were less likely to perform video consultations or use electronic prescription methods. Our findings show the existence of certain issues that could impact patient safety in rural areas more than in urban areas due to the underlying differences in population profile and supports. These could be used to plan the organization of care for similar future pandemic situations.
Collapse
Affiliation(s)
- Ferdinando Petrazzuoli
- Department of Clinical Sciences, Centre for Primary Health Care Research, Lund University, 21428 Malmö, Sweden
| | - Claire Collins
- Research Centre, Irish College of General Practitioners, D02 XR68 Dublin, Ireland
- Department of Public Health and Primary Care, Ghent University, 9000 Ghent, Belgium
| | - Esther Van Poel
- Department of Public Health and Primary Care, Ghent University, 9000 Ghent, Belgium
| | - Athina Tatsioni
- Research Unit for General Medicine and Primary Health Care, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece
| | - Sven Streit
- Institute of Primary Health Care (BIHAM), University of Bern, Mittelstrasse 43, 3012 Bern, Switzerland
| | - Gazmend Bojaj
- Department of Management of Health Services and Institution, Heimerer College, 1000 Pristina, Kosovo
| | - Radost Asenova
- Department of Urology and General Practice, Faculty of Medicine, Medical University Plovdiv, 4003 Plovdiv, Bulgaria
| | - Kathryn Hoffmann
- Department of Social- and Preventive Medicine, Medical University of Vienna, 1090 Vienna, Austria
| | - Jonila Gabrani
- Faculty of Medicine, University of Basel, 4001 Basel, Switzerland
| | - Zalika Klemenc-Ketis
- Department of Family Medicine, Medical Faculty, University of Maribor, Tabroska 8, 2000 Maribor, Slovenia
- Department of Family Medicine, Medical Faculty, University of Ljubljana, Poljanski Nasip 58, 1000 Ljubljana, Slovenia
- Ljubljana Community Health Centre, Metelkova 9, 1000 Ljubljana, Slovenia
| | - Andrée Rochfort
- Research Centre, Irish College of General Practitioners, D02 XR68 Dublin, Ireland
| | - Limor Adler
- Department of Family Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6195001, Israel
| | - Adam Windak
- Department of Family Medicine, Jagiellonian University Medical College, 31-061 Krakow, Poland
| | - Katarzyna Nessler
- Department of Family Medicine, Jagiellonian University Medical College, 31-061 Krakow, Poland
| | - Sara Willems
- Department of Public Health and Primary Care, Ghent University, 9000 Ghent, Belgium
| |
Collapse
|
27
|
Blay Benzaken Y, Zohar S, Yuval K, Aizik-Reebs A, Gebremariam SG, Bernstein A. COVID-19 and Mental Health Among People Who Are Forcibly Displaced: The Role of Socioeconomic Insecurity. Psychiatr Serv 2023; 74:158-165. [PMID: 35833254 DOI: 10.1176/appi.ps.202200052] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Forcibly displaced persons may be at elevated risk for poor mental health outcomes because of the COVID-19 pandemic. This study sought to examine associations between COVID-19-related socioeconomic insecurity and mental health outcomes among asylum seekers. METHODS The authors evaluated the association between the degree of food, housing, and income insecurity related to the pandemic and mental health outcomes among East African asylum seekers in a high-risk, postdisplacement setting in the Middle East (i.e., Israel). RESULTS Anxiety symptom severity (p=0.03) as well as the rate of suicidal ideation among women (odds ratio [OR]=2.81, p=0.016) were significantly elevated in a community sample of asylum seekers during the COVID-19 pandemic (N=66) relative to a similar sample (N=158) from the same community and context assessed before the pandemic. No differences between the two groups were observed for severity or rate of probable depression or posttraumatic stress disorders. In addition, among the sample assessed during the pandemic, socioeconomic insecurity due to the pandemic was strongly associated with elevated symptom severity and probable anxiety, depression, and posttraumatic stress disorders as well as suicidal ideation (R2 range=0.19-0.35; OR range=4.54-5.46). CONCLUSIONS Findings are consistent with growing evidence of a mental health crisis among asylum seekers that is linked to COVID-19 control policies and residential status policies. The results highlight the risk for suicidal ideation linked to intersectional marginalization among female asylum seekers. These findings may inform postdisplacement policy making, social justice advocacy, humanitarian aid, and clinical science and practice to mitigate poor mental health outcomes associated with COVID-19 among forcibly displaced persons.
Collapse
Affiliation(s)
| | - Shani Zohar
- Department of Psychology, University of Haifa, Haifa, Israel
| | - Kim Yuval
- Department of Psychology, University of Haifa, Haifa, Israel
| | | | | | - Amit Bernstein
- Department of Psychology, University of Haifa, Haifa, Israel
| |
Collapse
|
28
|
Garrido R, Paloma V, Benítez I, Skovdal M, Verelst A, Derluyn I. Impact of COVID-19 pandemic on the psychological well-being of migrants and refugees settled in Spain. ETHNICITY & HEALTH 2023; 28:257-280. [PMID: 35138212 DOI: 10.1080/13557858.2022.2035692] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 01/24/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVES The COVID-19 pandemic has exacerbated health inequalities worldwide, having a disproportionately harsh impact on unprivileged populations such as migrants and refugees. These populations are often more exposed to the virus, but less protected, while at the same time being at higher risk of suffering from poor living and working conditions, limited access to healthcare, and discrimination by the host society, all of which is challenging to their mental health. Empirical evidence on how the COVID-19 pandemic is affecting migrants and refugees is required to design effective actions aimed at ensuring health equity. Therefore, this paper aims to analyse how the pandemic has impacted the psychological well-being of migrants and refugees living in Spain. DESIGN This study was carried out within the framework of the ApartTogether study sponsored by the World Health Organization. Data collection was carried out during March-November 2020, through an online survey completed by 241 participants (age: M = 37 years; 129 women). RESULTS The results indicate that 78.7% of participants had suffered a decrease in their psychological well-being since the onset of the COVID-19 pandemic, with number of difficulties and worries experienced being the best individual predictors of this outcome. Enjoying social connections and perceiving positive treatment from the host society were positively associated with psychological well-being at a relational and community level, respectively. CONCLUSION Based on these findings, we outline priority areas of psychosocial interventions aimed at guaranteeing the mental health of migrants and refugees in the face of the pandemic in Spain.
Collapse
Affiliation(s)
- Rocío Garrido
- Department of Social Psychology, Universidad de Sevilla, Sevilla, Spain
| | - Virginia Paloma
- Department of Social Psychology, Universidad de Sevilla, Sevilla, Spain
| | - Isabel Benítez
- Department of Methodology of Behavioral Sciences, Universidad de Granada, Granda, Spain
| | - Morten Skovdal
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - An Verelst
- Department of Social Work and Social Pedagogy, Ghent University, Gent, Belgium
| | - Ilse Derluyn
- Department of Social Work and Social Pedagogy, Ghent University, Gent, Belgium
| |
Collapse
|
29
|
Jamal Z, ElKhatib Z, AlBaik S, Horino M, Waleed M, Fawaz F, Loffreda G, Seita A, Witter S, Diaconu K. Social determinants and mental health needs of Palestine refugees and UNRWA responses in Gaza during the COVID-19 pandemic: a qualitative assessment. BMC Public Health 2022; 22:2296. [PMID: 36482403 PMCID: PMC9733234 DOI: 10.1186/s12889-022-14771-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 11/29/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Due to pre-existing difficulties, refugees are especially susceptible to the negative effects of the pandemic; nonetheless, the pandemic's effect on this group is still unclear. The purpose of this study was to determine the effects of the COVID-19 pandemic on the mental health of Palestine refugees in Gaza by identifying the role of social determinants. During the pandemic, the United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) enacted a number of policies and measures. The purpose of this research was to assess their efficacy and acceptability. METHODS This qualitative study took place between August and November 2020. Twenty-nine key-informant interviews were conducted remotely with UNRWA Headquarters, field and clinical staff in Gaza and with community members, aged ≥18 years and residing in Rafah and Jabalia camps. We sought informed consent verbally or via email. Data was coded based on the framework for social determinants of mental health. RESULTS Interview results indicated that the relationship might be unidirectional, with COVID-19 causing the degradation of living conditions and vice versa, with living conditions exacerbating the COVID-19 situation by facilitating virus transmission. In other instances, the association between mental health determinants and COVID-19 might be bidirectional. In terms of experiencing violence and anxieties, women, children, and daily-paid employees were significantly more disadvantaged than other groups in the community. UNRWA modified its service delivery techniques in order to continue providing essential services. In general, UNRWA's strategies throughout the pandemic were deemed beneficial, but insufficient to meet the needs of Gazans. CONCLUSION The pandemic highlights the need to go beyond disease treatment and prevention to address social determinants to improve refugees' health and reduce their susceptibility to future shocks. UNRWA has rapidly implemented telemedicine and mental telehealth services, making it imperative to assess the efficacy of these novel approaches to provide care at a distance. A long-term option may be to employ a hybrid strategy, which combines online and in-person therapy.
Collapse
Affiliation(s)
- Zeina Jamal
- grid.104846.fInstitute for Global Health and Development, Queen Margaret University, Musselburgh EH21 6UU Edinburgh, Scotland, UK
| | - Zoheir ElKhatib
- The United Nations for the Relief and Works Agency in the Near East (UNRWA) Field Office, Gaza, Palestine
| | - Shatha AlBaik
- grid.501184.90000 0001 2173 1062The United Nations for the Relief and Works Agency in the Near East (UNRWA) Headquarters, Amman, Jordan
| | - Masako Horino
- grid.501184.90000 0001 2173 1062The United Nations for the Relief and Works Agency in the Near East (UNRWA) Headquarters, Amman, Jordan ,grid.21107.350000 0001 2171 9311Center for Human Nutrition and Sight & Life Global Nutrition Research Institute, Dept of Int’l Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA
| | - Mohammed Waleed
- The United Nations for the Relief and Works Agency in the Near East (UNRWA) Field Office, Gaza, Palestine
| | - Farah Fawaz
- grid.501184.90000 0001 2173 1062The United Nations for the Relief and Works Agency in the Near East (UNRWA) Headquarters, Amman, Jordan
| | - Giulia Loffreda
- grid.104846.fInstitute for Global Health and Development, Queen Margaret University, Musselburgh EH21 6UU Edinburgh, Scotland, UK
| | - Akihiro Seita
- grid.501184.90000 0001 2173 1062The United Nations for the Relief and Works Agency in the Near East (UNRWA) Headquarters, Amman, Jordan
| | - Sophie Witter
- grid.104846.fInstitute for Global Health and Development, Queen Margaret University, Musselburgh EH21 6UU Edinburgh, Scotland, UK
| | - Karin Diaconu
- grid.104846.fInstitute for Global Health and Development, Queen Margaret University, Musselburgh EH21 6UU Edinburgh, Scotland, UK
| |
Collapse
|
30
|
Molenaar J, Van Praag L. Migrants as 'vulnerable groups' in the COVID-19 pandemic: A critical discourse analysis of a taken-for-granted label in academic literature. SSM. QUALITATIVE RESEARCH IN HEALTH 2022; 2:100076. [PMID: 35529889 PMCID: PMC9052635 DOI: 10.1016/j.ssmqr.2022.100076] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 03/23/2022] [Accepted: 03/25/2022] [Indexed: 01/12/2023]
Abstract
The COVID-19 pandemic affects different people unequally, and migrants are frequently among the groups considered particularly vulnerable. However, conceptualizations of 'vulnerability' are often ambiguous and poorly defined. Using critical discourse analysis methods, this article analyses the academic use of the term 'vulnerable' applied to migrants in the context of the COVID-19 pandemic across public health and social science disciplines. Our findings indicate that the concept of vulnerability is frequently applied to migrants in the COVID-19 context as a descriptor with seemingly taken-for-granted applicability. Migrants are considered vulnerable for a wide variety of reasons, most commonly relating to exposure to and risk of contracting COVID-19; poverty or low socio-economic status; precarity; access to healthcare; discrimination; and language barriers. Drivers of migrants' vulnerability were frequently construed as immutable societal characteristics. Additionally, our analysis revealed widespread generalization in the use of the notion of vulnerability, with limited consideration of the heterogeneity among and between diverse groups of migrants. Conceptualizations of migrants' vulnerability in the COVID-19 pandemic were sometimes used to advance seemingly contradictory policy implications or conclusions, and migrants' own views and lived experiences were often marginalized or excluded within these discourses. Our analysis highlights that although some definable groups of people are certainly more likely to suffer harm in crisis situations like the COVID-19 pandemic, the use of 'vulnerable' as a fixed descriptor has potentially negative implications. As an alternative, we suggest thinking about vulnerability as the dynamic outcome of a process of 'vulnerabilisation' shaped by social order and power relations.
Collapse
|
31
|
Sampogna G, Pompili M, Fiorillo A. The Short-Term Consequences of COVID-19 on Mental Health: State of the Art from Available Studies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15860. [PMID: 36497935 PMCID: PMC9738499 DOI: 10.3390/ijerph192315860] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 11/25/2022] [Indexed: 06/17/2023]
Abstract
Since the outbreak of the COVID-19 pandemic, the consequences on mental health have been found to be considerable, with potential effects on the general population and in high-risk groups, with a variety of physiopathological mechanisms [...].
Collapse
Affiliation(s)
- Gaia Sampogna
- Department of Psychiatry, University of Campania “L. Vanvitelli”, 80131 Naples, Italy
| | - Maurizio Pompili
- Department of Neurosciences, Mental Health, and Sensory Organs, Faculty of Medicine and Psychology, Suicide Prevention Centre, Sant’Andrea Hospital, Sapienza University of Rome, 00189 Rome, Italy
| | - Andrea Fiorillo
- Department of Psychiatry, University of Campania “L. Vanvitelli”, 80131 Naples, Italy
| |
Collapse
|
32
|
Blukacz A, Cabieses B, Obach A, Madrid P, Carreño A, Pickett KE, Markkula N. "If I get sick here, I will never see my children again": The mental health of international migrants during the COVID-19 pandemic in Chile. PLoS One 2022; 17:e0277517. [PMID: 36445885 PMCID: PMC9707751 DOI: 10.1371/journal.pone.0277517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 10/28/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has had an impact on the mental health of international migrants globally. Chile has managed its response to the pandemic in an ongoing context of social unrest and combined regional migratory and humanitarian crisis. The country's population presents a high prevalence of common mental disorders and a high suicide rate, with limited access to mental healthcare. International migrants in Chile represent 8% of the total population, and although a socioeconomically heterogenous group, they face social vulnerability, a range of mental health stressors and additional barriers to access mental healthcare. This study describes the mental health outcomes, stressors, response, and coping strategies perceived by international migrants during the COVID-19 pandemic in Chile. METHODS AND FINDINGS A qualitative case study was carried out through individual online interviews to 30 international migrants living in Chile during the pandemic and 10 experts of the social and health care sectors. An inductive content analysis was carried out, a process during which the researchers sought to identify patterns and themes derived from the data. Participants experienced mainly negative mental health outcomes, including anxiety and depression symptomatology. Stressors included the virus itself, work, living and socioeconomic conditions, discrimination, fear for their family and distance caring. Institutional responses to address the mental health of international migrants during the pandemic in Chile were limited and participants relied mainly on individual coping strategies. CONCLUSIONS The pandemic can represent an important opportunity to strengthen mental health systems for the general population as well as for population groups experiencing social vulnerability, if the issues identified and the lessons learned are translated into action at national, regional, and international level. Promoting the mental health of international migrants means recognising migration as a social determinant of mental health and adopting a cross-cultural as well as a Human Rights approach.
Collapse
Affiliation(s)
- Alice Blukacz
- Facultad de Medicina Clínica Alemana, Instituto de Ciencias e Innovación en Medicina, Universidad del Desarrollo, Santiago, Chile
| | - Báltica Cabieses
- Facultad de Medicina Clínica Alemana, Instituto de Ciencias e Innovación en Medicina, Universidad del Desarrollo, Santiago, Chile
- * E-mail:
| | - Alexandra Obach
- Facultad de Medicina Clínica Alemana, Instituto de Ciencias e Innovación en Medicina, Universidad del Desarrollo, Santiago, Chile
| | - Paula Madrid
- Facultad de Medicina Clínica Alemana, Instituto de Ciencias e Innovación en Medicina, Universidad del Desarrollo, Santiago, Chile
| | - Alejandra Carreño
- Facultad de Medicina Clínica Alemana, Instituto de Ciencias e Innovación en Medicina, Universidad del Desarrollo, Santiago, Chile
| | - Kate E. Pickett
- Department of Health Sciences, University of York, York, United Kingdom
| | - Niina Markkula
- Faculty of Medicine, Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| |
Collapse
|
33
|
Bayes-Marin I, Roura-Adserias M, Giné-Vázquez I, Villalobos F, Franch-Roca M, Lloret-Pineda A, Gabarrell-Pascuet A, He Y, Hafi RE, Butt FMA, Mellor-Marsá B, Alós MC, Sainz-Elías H, Ayad-Ahmed W, Aparicio L, Cabeza ME, Bobo ÓÁ, López YO, Haro JM, Cristóbal-Narváez P. Factors Associated with Depression and Anxiety Symptoms among Migrant Population in Spain during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15646. [PMID: 36497721 PMCID: PMC9736595 DOI: 10.3390/ijerph192315646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Revised: 11/04/2022] [Accepted: 11/18/2022] [Indexed: 06/17/2023]
Abstract
Migrants are likely to experience mental health conditions, being one of the most vulnerable groups during the COVID-19 pandemic. The present study aims to: (1) estimate the prevalence of depressive and anxious symptoms and (2) examine the impact of risk and protective factors on this symptomatology. A sample of 129 migrants living in Spain during the COVID-19 pandemic completed an anonymous online survey, including information on sociodemographic and individual characteristics, migration, basic needs, social environment and perceived health domains. Multiple Poisson regression models analysed the effects of risk and protective factors on depression and anxiety symptoms. The prevalence of depressive and anxiety symptoms was 22.3% and 21.4%, respectively. Risk factors such as living in a rented house and previous mental health conditions were associated with higher depression symptoms, whereas unemployment was related to anxiety symptoms. Conversely, older age, better self-esteem, and higher levels of social support were associated with fewer depression symptoms. Older age and better quality of life were related to fewer anxiety symptoms. These findings addressing risk and protective factors (e.g., social support, self-esteem) help to design culturally effective programs, particularly in migrants with pre-existing mental health conditions, adjusting the organisation of mental healthcare services in difficult times in Spain.
Collapse
Affiliation(s)
- Ivet Bayes-Marin
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut—Campus Clínic, Universitat de Barcelona, 08036 Barcelona, Spain
- Centre for Biomedical Research on Mental Health (CIBERSAM), 28029 Madrid, Spain
| | - Maria Roura-Adserias
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, 08950 Barcelona, Spain
| | - Iago Giné-Vázquez
- Centre for Biomedical Research on Mental Health (CIBERSAM), 28029 Madrid, Spain
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, 08950 Barcelona, Spain
| | - Felipe Villalobos
- Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), 08007 Barcelona, Spain
| | - Marta Franch-Roca
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, 08950 Barcelona, Spain
| | - Amanda Lloret-Pineda
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, 08950 Barcelona, Spain
| | - Aina Gabarrell-Pascuet
- Centre for Biomedical Research on Mental Health (CIBERSAM), 28029 Madrid, Spain
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, 08950 Barcelona, Spain
| | - Yuelu He
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, 08950 Barcelona, Spain
- Department of Sociology, University of Barcelona, 08036 Barcelona, Spain
| | - Rachid El Hafi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, 08950 Barcelona, Spain
| | | | - Blanca Mellor-Marsá
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, 08950 Barcelona, Spain
| | - M. Carmen Alós
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, 08950 Barcelona, Spain
| | - Helena Sainz-Elías
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, 08950 Barcelona, Spain
| | - Wala Ayad-Ahmed
- Departamento de Medicina Legal, Psiquiatría y Patología, Facultad de Medicina, Universidad Complutense de Madrid, 28040 Madrid, Spain
- Fundación de Investigación Hospital Clínico San Carlos, 28040 Madrid, Spain
| | - Lola Aparicio
- Servicio de Atención a la Migración en Salud Mental (SATMI), Parc Sanitari Sant Joan de Déu, Avenida Drassanes 19, 08003 Barcelona, Spain
| | - Mercedes Espinal Cabeza
- Servicio de Atención a la Migración en Salud Mental (SATMI), Parc Sanitari Sant Joan de Déu, Avenida Drassanes 19, 08003 Barcelona, Spain
| | - Óscar Álvarez Bobo
- Servicio de Atención a la Migración en Salud Mental (SATMI), Parc Sanitari Sant Joan de Déu, Avenida Drassanes 19, 08003 Barcelona, Spain
| | - Yolanda Osorio López
- Servicio de Atención a la Migración en Salud Mental (SATMI), Parc Sanitari Sant Joan de Déu, Avenida Drassanes 19, 08003 Barcelona, Spain
| | - Josep Maria Haro
- Centre for Biomedical Research on Mental Health (CIBERSAM), 28029 Madrid, Spain
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, 08950 Barcelona, Spain
- Instituto de Investigación Sanitaria Princesa (IP), 28006 Madrid, Spain
| | - Paula Cristóbal-Narváez
- Centre for Biomedical Research on Mental Health (CIBERSAM), 28029 Madrid, Spain
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, 08950 Barcelona, Spain
| |
Collapse
|
34
|
Khai TS, Asaduzzaman M. 'I Doubt Myself and Am Losing Everything I Have since COVID Came'-A Case Study of Mental Health and Coping Strategies among Undocumented Myanmar Migrant Workers in Thailand. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15022. [PMID: 36429741 PMCID: PMC9690308 DOI: 10.3390/ijerph192215022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Revised: 11/07/2022] [Accepted: 11/11/2022] [Indexed: 06/16/2023]
Abstract
Migrant populations have always been vulnerable to a high burden of social exclusion, mental disorders, physical illnesses, and economic crises. The current COVID-19 pandemic has further created a frantic plight among them, particularly for undocumented migrant workers in the global south. We have conducted a mixed method study among the undocumented Myanmar migrant workers (UMMWs) in Thailand to explore how the COVID-19 disruption has impacted their mental health and what coping strategies they have adopted. Following the onset of COVID-19 and the recent coup d'état in Myanmar, our current study is the first attempt to understand the mental health status and predicament of this neglected migrant group. A total of 398 UMMWs were included in the online survey, of which 23 participated in qualitative interviews. The major mental health issues reported by the study participants were depression, generalized anxiety disorder, frustration, stress, and panic disorders, while loss of employment, worries about the pandemic, social stigma, lack of access to healthcare, lockdown, and fear of detention were the predominant contributing factors. In response, we identified two key coping mechanisms: coping at a personal level (listening to music, playing online game, praying, and self-motivation) and coping at a social level (chatting with family and friends and visiting religious institutions). These findings point to the importance of policy and intervention programs aimed at upholding mental health at such humanitarian conditions. Sustainable institutional mental health care support and social integration for the migrant workers, irrespective of their legal status, should be ensured.
Collapse
Affiliation(s)
- Tual Sawn Khai
- Sociology and Social Policy, School of Graduate Studies, Lingnan University, Hong Kong, China
| | - Muhammad Asaduzzaman
- Department of Community Medicine and Global Health, Institute of Health and Society, Faculty of Medicine, University of Oslo, 450 Oslo, Norway
- Planetary Health Working Group, Be-Cause Health, Institute of Tropical Medicine, Nationalestraat 155, 2000 Antwerp, Belgium
- Planetary Health Alliance, Boston, MA 02115, USA
| |
Collapse
|
35
|
Zegarra-López AC, Florentino-Santisteban B, Flores-Romero J, Delgado-Tenorio A, Cernades-Ames A. A Cross-Sectional Study on the Prevalence of Depressive Symptoms and Its Associated Sociodemographic Factors in Peru during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14240. [PMID: 36361118 PMCID: PMC9654240 DOI: 10.3390/ijerph192114240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 10/21/2022] [Accepted: 10/26/2022] [Indexed: 06/16/2023]
Abstract
The present study aims to analyze the prevalence of depressive symptoms and its sociodemographic-associated factors in Peruvian adults. Data was extracted from a nation-wide representative survey in which depression symptoms were measured with the PHQ-9 and sociodemographic information was extracted from household data. Depression severity rates were estimated for each symptom, and responses were modeled through the Rating Scale Model to obtain a depression measure used as dependent variable on a Generalized Mixed Linear Model. The most frequent depression symptoms were emotional, such as discouragement, sad mood, hopelessness, and lack of pleasure when doing activities. Our model showed that, after controlling the effects of all the variables considered, the most relevant predictors were gender, education level, physiographic region, age, marital status, and number of coresidents. Higher depression levels were found in women, people who did not complete higher education, participants living in the Highlands, older adults, single participants, and people living alone. Thus, interventions to promote or prevent depression severity during similar situations as the pandemic should focus on specific sociodemographic groups and their particular needs.
Collapse
Affiliation(s)
- Angel Christopher Zegarra-López
- Faculty of Psychology, Universidad de Lima, Lima 15023, Peru
- Grupo de Investigación en Psicología, Bienestar y Sociedad, Instituto de Investigación Científica, Universidad de Lima, Lima 15023, Peru
| | | | | | | | | |
Collapse
|
36
|
Alarcão V, Virgolino A, Stefanovska-Petkovska M, Neves J. Exploring the Effects of the COVID-19 Pandemic on Mental Health and Well-Being of Migrant Populations in Europe: An Equity-Focused Scoping Review. Behav Sci (Basel) 2022; 12:bs12100393. [PMID: 36285962 PMCID: PMC9598275 DOI: 10.3390/bs12100393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Revised: 10/13/2022] [Accepted: 10/13/2022] [Indexed: 11/16/2022] Open
Abstract
The pandemic is aggravating health inequalities, particularly mental health inequalities, while revealing the social determinants of these inequalities, including migration as a social determinant that mediates the interaction of social, economic, cultural, institutional, and structural factors with health indicators. Therefore, it is of most relevance to identify the multiple interconnected factors that influence the mental health and well-being of migrant populations. A scoping review was developed to map the research performed in this area and to identify any gaps in knowledge, following the PRISMA extension for scoping reviews. MEDLINE, Scopus, and WHO Global Health research databases on COVID-19 were searched from January 2020 to October 2021. The review followed the inclusion criteria Population/Concept/Context (PCC): Population-Adult International migrants (including refugees, asylum seekers, and undocumented migrants); Concept-determinants of (and factors influencing) mental health and well-being; Context-COVID-19 anywhere in the world. Of the sixty-five selected studies, eleven were from European countries and were the focus of this review with special attention to health inequalities experienced by migrants in Europe. The results cover a diversity of themes related to the effects of COVID-19 on the mental health of migrants (country-level environmental factors, social determinants of mental health, mental health indicators and outcomes), responses (such as solidarity and resilience), populations, and study methods. The evidence found can inform recommendations and interventions focused on health promotion and mitigation of the inequalities accentuated by the pandemic.
Collapse
Affiliation(s)
- Violeta Alarcão
- Centro de Investigação e Estudos de Sociologia, Iscte—Instituto Universitário de Lisboa, Avenida das Forças Armadas, 1649-026 Lisboa, Portugal
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, 1649-028 Lisboa, Portugal
- Correspondence:
| | - Ana Virgolino
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, 1649-028 Lisboa, Portugal
| | - Miodraga Stefanovska-Petkovska
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, 1649-028 Lisboa, Portugal
| | - Júlia Neves
- Centro de Investigação e Estudos de Sociologia, Iscte—Instituto Universitário de Lisboa, Avenida das Forças Armadas, 1649-026 Lisboa, Portugal
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, 1649-028 Lisboa, Portugal
| |
Collapse
|
37
|
Dubey S, Sahoo KC, Dash GC, Sahay MR, Mahapatra P, Bhattacharya D, del Barrio MO, Pati S. Housing-related challenges during COVID-19 pandemic among urban poor in low- and middle-income countries: A systematic review and gap analysis. Front Public Health 2022; 10:1029394. [PMID: 36211702 PMCID: PMC9540216 DOI: 10.3389/fpubh.2022.1029394] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Accepted: 09/06/2022] [Indexed: 01/29/2023] Open
Abstract
The abysmal health of the urban poor or slum dwellers was attributed to structural inequities such as inadequate housing, water, and sanitation. This review aimed to assess housing-related opportunities and challenges during the COVID-19 pandemic among urban poor in low-and middle-income countries. For study identification, a comprehensive search was performed in 11 databases that yielded 22 potential studies. The inadequate housing infrastructure makes the lives of the urban poor more precarious during COVID-19. Typically, the houses lacked lighting, ventilation, and overcrowding. This review reflected that it is crucial to reimagine housing policy for the urban poor with an emphasis on pandemic/epidemic guidelines.
Collapse
Affiliation(s)
- Shubhankar Dubey
- Health Technology Assessment in India, ICMR-Regional Medical Research Centre, Bhubaneswar, India
| | - Krushna Chandra Sahoo
- Health Technology Assessment in India, ICMR-Regional Medical Research Centre, Bhubaneswar, India
| | - Girish Chandra Dash
- Health Technology Assessment in India, ICMR-Regional Medical Research Centre, Bhubaneswar, India
| | - Mili Roopchand Sahay
- Health Technology Assessment in India, ICMR-Regional Medical Research Centre, Bhubaneswar, India
| | - Pranab Mahapatra
- Health Technology Assessment in India, ICMR-Regional Medical Research Centre, Bhubaneswar, India
- Department of Psychiatry, Kalinga Institute of Medical Sciences, Bhubaneswar, India
| | - Debdutta Bhattacharya
- Health Technology Assessment in India, ICMR-Regional Medical Research Centre, Bhubaneswar, India
| | - Mariam Otmani del Barrio
- UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR), World Health Organization, Geneva, Switzerland
| | - Sanghamitra Pati
- Health Technology Assessment in India, ICMR-Regional Medical Research Centre, Bhubaneswar, India
| |
Collapse
|
38
|
Cui J, Cheung VHM, Huang W, Kan WS. Mental Distress during the COVID-19 Pandemic: A Cross-Sectional Study of Women Receiving the Comprehensive Social Security Allowance in Hong Kong. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10279. [PMID: 36011912 PMCID: PMC9407927 DOI: 10.3390/ijerph191610279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 08/13/2022] [Accepted: 08/16/2022] [Indexed: 06/15/2023]
Abstract
Welfare recipients were often considered the least deserving of COVID-related support. Despite the recent attention paid to the impact of COVID-19 pandemic on mental health, few studies have explored the mental distress experienced by welfare recipients. This cross-sectional study on female Comprehensive Social Security Allowance recipients in Hong Kong aimed to explore their level of mental distress and its association with a range of risk factors specific to welfare recipients. Hence, 316 valid cases from a local community center responded to our online survey. We found that 52.3%, 23.4%, and 78% of the participants showed moderate to extremely severe depression, anxiety, and stress symptoms, respectively. A higher level of mental distress was associated with having a psychiatric diagnosis, poorer social, and greater concerns over disciplining children, the living environment, daily expenses and being infected by COVID-19. Unexpectedly, being married, having a permanent residence, and having a job were not significant protective factors for this group. The models explained 45.5%, 44.6%, and 52.5% of the overall variance in the level of depression, anxiety, and stress (p < 0.01), respectively. Our findings have important implications for supporting female welfare recipients during a public health crisis and may help frontline staff and professionals provide prompt assistance to this group in need.
Collapse
Affiliation(s)
- Jialiang Cui
- Department of Social Work, The Chinese University of Hong Kong, Hong Kong
| | - Vanessa Hoi Mei Cheung
- Felizberta Lo Padilla Tong School of Social Sciences, Caritas Institute of Higher Education, Hong Kong
| | | | - Wan Sang Kan
- Department of Social and Behavioural Sciences, City University of Hong Kong, Hong Kong
| |
Collapse
|
39
|
Gémes K, Bergström J, Papola D, Barbui C, Lam AIF, Hall BJ, Seedat S, Morina N, Quero S, Campos D, Pinucci I, Tarsitani L, Deguen S, van der Waerden J, Patanè M, Sijbrandij M, Acartürk C, Burchert S, Bryant RA, Mittendorfer-Rutz E. Symptoms of anxiety and depression during the COVID-19 pandemic in six European countries and Australia - Differences by prior mental disorders and migration status. J Affect Disord 2022; 311:214-223. [PMID: 35598751 PMCID: PMC9119165 DOI: 10.1016/j.jad.2022.05.082] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 05/04/2022] [Accepted: 05/15/2022] [Indexed: 12/05/2022]
Abstract
BACKGROUND Little is known about changes of mental health during the COVID-19 pandemic in potentially disadvantaged groups. We investigated changes in anxiety and depression symptoms during the first year of the pandemic in six European countries and Australia by prior mental disorders and migration status. METHODS Overall, 4674 adults answered a web-based survey in May-June 2020 and were followed by three repeated surveys up to February 2021. Information on psychosocial, financial and demographic, living conditions, prior mental disorders, depression and anxiety symptoms during the pandemic and migration status was collected. Weighted general estimation equations modelling was used to investigate the association between prior mental disorders, migration status, and symptoms over time. RESULTS Most participants were <40 years old (48%), women (78%) and highly educated (62%). The baseline prevalence of depressive and anxiety symptoms ranged between 19%-45% and 13%-35%, respectively. In most countries, prevalence rates remained unchanged throughout the pandemic and were higher among people with prior mental disorders than without even after adjustment for several factors. We observed interactions between previous mental disorders and symptoms of anxiety or depression over time in two countries. No difference by migration status was noted. LIMITATIONS Convenience sampling limits generalizability. Self-assessed symptoms of depression and anxiety might involve some misclassification. CONCLUSIONS Depression and anxiety symptoms were worse among individuals with prior mental disorders than without, but there was no clear trend of worsening mental health in the observed groups during the observed period.
Collapse
Affiliation(s)
- Katalin Gémes
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
| | - Jakob Bergström
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Davide Papola
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Corrado Barbui
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Agnes Iok Fong Lam
- Centre for Macau Studies, University of Macau, Macao (SAR), People's Republic of China
| | - Brian J Hall
- Center for Global Health Equity, New York University (Shanghai), Shanghai, People Republic of China; School of Public Health, New York University, New York, USA
| | - Soraya Seedat
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Naser Morina
- Department of Consultation-Liason Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Soledad Quero
- Department of Basic, Clinical Psychology and Psychobiology, Universitat Jaume I, Castellón, Spain; CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Carlos III Institute of Health, Madrid, Spain
| | - Daniel Campos
- Department of Psychology and Sociology, University of Zaragoza, Huesca, Spain; Instituto de Investigación Sanitaria Aragón (IISAragon), Zaragoza, Spain
| | - Irene Pinucci
- Department of Human Neurosciences, Sapienza University of Rome, Italy; Department of Clinical, Neuro-, and Developmental Psychology, WHO Collaborating Center for Research and Dissemination of Psychological Interventions, Vrije Universiteit, Amsterdam, the Netherlands
| | - Lorenzo Tarsitani
- Department of Human Neurosciences, Sapienza University of Rome, Italy
| | - Séverine Deguen
- INSERM U1136, Sorbonne Université, Institut Pierre Louis d'Épidémiologie et de Santé Publique, Social Epidemiology Research Team, Paris, France; EHESP School of Public Health, Department of Environmental and Occupational Health, Rennes, France
| | - Judith van der Waerden
- INSERM U1136, Sorbonne Université, Institut Pierre Louis d'Épidémiologie et de Santé Publique, Social Epidemiology Research Team, Paris, France
| | - Martina Patanè
- Department of Clinical, Neuro-, and Developmental Psychology, WHO Collaborating Center for Research and Dissemination of Psychological Interventions, Vrije Universiteit, Amsterdam, the Netherlands
| | - Marit Sijbrandij
- Department of Clinical, Neuro-, and Developmental Psychology, WHO Collaborating Center for Research and Dissemination of Psychological Interventions, Vrije Universiteit, Amsterdam, the Netherlands
| | - Ceren Acartürk
- Department of Psychology, Koc University, Istanbul, Turkey
| | - Sebastian Burchert
- Department of Education and Psychology, Freie Universität Berlin, Berlin, Germany
| | | | - Ellenor Mittendorfer-Rutz
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| |
Collapse
|
40
|
Mental Health Consequences of COVID-19 Pandemic Period in the European Population: An Institutional Challenge. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159347. [PMID: 35954706 PMCID: PMC9367746 DOI: 10.3390/ijerph19159347] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 07/23/2022] [Accepted: 07/26/2022] [Indexed: 11/17/2022]
Abstract
The worldwide spread of SARS-CoV-2 has been responsible for an infectious pandemic, with repercussions on socio-economic aspects and on the physical and mental health of the general population. The present systematic review aimed to evaluate the data belonging to the European framework, analyzing the population by age group. Original articles and reviews on the state of mental health of the general European population have been researched starting from 2021. Initially, a total of 1764 studies were found, among which a total of 75 were selected. Youth were the age group most affected by pandemic consequences on mental health, with emotional and behavioral alterations observed from a third to more than a half of children and adolescents examined. Among both adolescents and adults, the female gender had a higher prevalence of psychopathological symptoms. The main risk factors were poor social support, economic difficulties, and, in particular, unemployment or job changes. Additional individual risk factors were the perception of loneliness, the presence of pre-pandemic mental illness/distress, and some personality traits, such as neuroticism, impulsiveness, and the use of maladaptive coping strategies. Unexpectedly, the elderly maintained good resilience towards change, even if a stress factor was represented by the feeling of loneliness and poor social contact. As regards suicidal behaviors, among adolescents, there was an increase in attempts of 25%, with a greater risk for the female gender. This risk increased also among adults, in association with symptoms of anxiety and depression, and poor socio-environmental conditions. In conclusion, some population groups were found to be at greater risk of psychological burden during pandemic waves, thus representing priority targets for socio-health interventions.
Collapse
|
41
|
Mattar S, Gellatly R. Refugee mental health: Culturally relevant considerations. Curr Opin Psychol 2022; 47:101429. [DOI: 10.1016/j.copsyc.2022.101429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 07/06/2022] [Accepted: 07/11/2022] [Indexed: 11/25/2022]
|
42
|
Bruggeman H, Smith P, Berete F, Demarest S, Hermans L, Braekman E, Charafeddine R, Drieskens S, De Ridder K, Gisle L. Anxiety and Depression in Belgium during the First 15 Months of the COVID-19 Pandemic: A Longitudinal Study. Behav Sci (Basel) 2022; 12:bs12050141. [PMID: 35621438 PMCID: PMC9137576 DOI: 10.3390/bs12050141] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 05/05/2022] [Accepted: 05/10/2022] [Indexed: 02/01/2023] Open
Abstract
The COVID-19 pandemic and policy measures enacted to contain the spread of the coronavirus have had nationwide psychological effects. This study aimed to assess the impact of the first 15 months of the COVID-19 pandemic on the level of anxiety (GAD-7 scale) and depression (PHQ-9 scale) of the Belgian adult population. A longitudinal study was conducted from April 2020 to June 2021, with 1838 respondents participating in 6 online surveys. Linear mixed models were used to model the associations between the predictor variables and the mental health outcomes. Results showed that the prevalence of symptoms of anxiety and depression was higher in times of stricter policy measures. Furthermore, after the initial stress from the outbreak, coping and adjustment were observed in participants, as symptoms of anxiety and depression decreased during times of lower policy restrictions to almost the same level as in pre-COVID times (2018). Though time trends were similar for all population subgroups, higher levels of both anxiety and depression were generally found among women, young people, people with poor social support, extraverts, people having pre-existing psychological problems, and people who were infected/exposed to the COVID-19 virus. Therefore, investment in mental health treatment programs and supports, especially for those risk groups, is crucial.
Collapse
Affiliation(s)
- Helena Bruggeman
- Sciensano, Epidemiology and Public Health, 1050 Brussels, Belgium; (P.S.); (F.B.); (S.D.); (L.H.); (E.B.); (R.C.); (S.D.); (K.D.R.); (L.G.)
- Correspondence:
| | - Pierre Smith
- Sciensano, Epidemiology and Public Health, 1050 Brussels, Belgium; (P.S.); (F.B.); (S.D.); (L.H.); (E.B.); (R.C.); (S.D.); (K.D.R.); (L.G.)
- Institute of Health and Society, Université Catholique de Louvain, 1200 Brussels, Belgium
| | - Finaba Berete
- Sciensano, Epidemiology and Public Health, 1050 Brussels, Belgium; (P.S.); (F.B.); (S.D.); (L.H.); (E.B.); (R.C.); (S.D.); (K.D.R.); (L.G.)
| | - Stefaan Demarest
- Sciensano, Epidemiology and Public Health, 1050 Brussels, Belgium; (P.S.); (F.B.); (S.D.); (L.H.); (E.B.); (R.C.); (S.D.); (K.D.R.); (L.G.)
| | - Lize Hermans
- Sciensano, Epidemiology and Public Health, 1050 Brussels, Belgium; (P.S.); (F.B.); (S.D.); (L.H.); (E.B.); (R.C.); (S.D.); (K.D.R.); (L.G.)
| | - Elise Braekman
- Sciensano, Epidemiology and Public Health, 1050 Brussels, Belgium; (P.S.); (F.B.); (S.D.); (L.H.); (E.B.); (R.C.); (S.D.); (K.D.R.); (L.G.)
| | - Rana Charafeddine
- Sciensano, Epidemiology and Public Health, 1050 Brussels, Belgium; (P.S.); (F.B.); (S.D.); (L.H.); (E.B.); (R.C.); (S.D.); (K.D.R.); (L.G.)
| | - Sabine Drieskens
- Sciensano, Epidemiology and Public Health, 1050 Brussels, Belgium; (P.S.); (F.B.); (S.D.); (L.H.); (E.B.); (R.C.); (S.D.); (K.D.R.); (L.G.)
| | - Karin De Ridder
- Sciensano, Epidemiology and Public Health, 1050 Brussels, Belgium; (P.S.); (F.B.); (S.D.); (L.H.); (E.B.); (R.C.); (S.D.); (K.D.R.); (L.G.)
| | - Lydia Gisle
- Sciensano, Epidemiology and Public Health, 1050 Brussels, Belgium; (P.S.); (F.B.); (S.D.); (L.H.); (E.B.); (R.C.); (S.D.); (K.D.R.); (L.G.)
| |
Collapse
|
43
|
Marchi M, Magarini FM, Chiarenza A, Galeazzi GM, Paloma V, Garrido R, Ioannidi E, Vassilikou K, de Matos MG, Gaspar T, Guedes FB, Primdahl NL, Skovdal M, Murphy R, Durbeej N, Osman F, Watters C, van den Muijsenbergh M, Sturm G, Oulahal R, Padilla B, Willems S, Spiritus-Beerden E, Verelst A, Derluyn I. Experience of discrimination during COVID-19 pandemic: the impact of public health measures and psychological distress among refugees and other migrants in Europe. BMC Public Health 2022; 22:942. [PMID: 35538463 PMCID: PMC9090600 DOI: 10.1186/s12889-022-13370-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 05/04/2022] [Indexed: 11/10/2022] Open
Abstract
Background The COVID-19 pandemic has had a disproportionately hard impact on refugees and other migrants who are often exposed to the virus with limited means to protect themselves. We tested the hypothesis that during the COVID-19 pandemic, refugees and other migrants have suffered a negative impact on mental health and have been unjustly discriminated for spreading the disease in Europe (data collection from April to November 2020). Methods Participants in the ApartTogether Survey (N = 8297, after listwise deletion of missing items final N = 3940) provided data regarding to their difficulties to adhere to preventive recommendations against COVID-19 infection (CARE), self-perceived stigmatization (SS), and psychological distress (PD). Structural Equation Modeling was used to investigate PD as a mediator in the pathway linking CARE to SS, while adjusting for the housing and residence status. To improve confidence in the findings, single hold-out sample cross-validation was performed using a train/test split ratio of 0.8/0.2. Results In the exploratory set (N = 3159) SS was associated with both CARE (B = 0.200, p < 0.001) and PD (B = 0.455, p < 0.001). Moreover, PD was also associated with CARE (B = 0.094, p = 0.001) and mediated the effect of CARE on SS (proportion mediated = 17.7%, p = 0.001). The results were successfully replicated in the confirmation set (N = 781; total effect = 0.417, p < 0.001; proportion mediated = 29.7%, p < 0.001). Follow-up analyses also found evidence for an opposite effect (i.e., from SS to CARE, B = 0.132; p < 0.001), suggesting that there might be a vicious circle between the self-perceived stigmatization and the access to health care and the use of preventive measures against COVID-19 infection. Conclusions Refugees and other migrants who had more difficulties in accessing health care and preventive measures against COVID-19 infection experienced worse mental health and increased discrimination. These negative effects appeared to be stronger for those with more insecure housing and residence status, highlighting from one side the specific risk of insecure housing in the impact of COVID-19 upon mental health and infection protection, and for another side the need to proper housing as a strategy to prevent both COVID-19 and mental distress. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13370-y.
Collapse
Affiliation(s)
- Mattia Marchi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Via Giuseppe Campi, 287 -, 41125, Modena, Italy.,Dipartimento di Salute Mentale e Dipendenze Patologiche, Azienda USL-IRCCS di Reggio Emilia, Via Giovanni Amendola 2 -, 42122, Reggio Emilia, Italy
| | - Federica Maria Magarini
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Via Giuseppe Campi, 287 -, 41125, Modena, Italy
| | - Antonio Chiarenza
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Via Giuseppe Campi, 287 -, 41125, Modena, Italy
| | - Gian Maria Galeazzi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Via Giuseppe Campi, 287 -, 41125, Modena, Italy. .,Dipartimento di Salute Mentale e Dipendenze Patologiche, Azienda USL-IRCCS di Reggio Emilia, Via Giovanni Amendola 2 -, 42122, Reggio Emilia, Italy.
| | - Virginia Paloma
- Department of Social Psychology, Universidad de Sevilla, 41018, Seville, Spain
| | - Rocío Garrido
- Department of Social Psychology, Universidad de Sevilla, 41018, Seville, Spain
| | - Elisabeth Ioannidi
- Research Center for Greek Society, Academy of Athens, 15126, Athens, Greece
| | | | | | - Tania Gaspar
- Institute of Environmental Health/ISAMB, University of Lisbon, Lisbon, Portugal
| | | | - Nina Langer Primdahl
- Department of Public Health, University of Copenhagen, 1014, Copenhagen, Denmark
| | - Morten Skovdal
- Department of Public Health, University of Copenhagen, 1014, Copenhagen, Denmark
| | - Rebecca Murphy
- Department of Psychology, Maynooth University, W23 F2K8, Co. Kildare, Maynooth, Ireland
| | - Natalie Durbeej
- Department of Child Health and Parenting, Uppsala University, 75236, Uppsala, Sweden
| | - Fatumo Osman
- Department of Child Health and Parenting, Uppsala University, 75236, Uppsala, Sweden.,School of Health and Welfare, Dalarna University, Högskolegatan 2, 79188, Falun, Sweden
| | - Charles Watters
- Department of School of Education and Social Work, University of Sussex, Sussex, UK
| | | | - Gesine Sturm
- LCPI Laboratory, EA-4591, Department Clinique du Sujet, University of Toulouse 2, 31058, Toulouse, France
| | - Rachid Oulahal
- La Reunion University FR, DIRE research center, French Collaborative Institute on Migration, CS, 92003, 15 Av. René Cassin, Saint-Denis, Cedex 9 97400, Réunion
| | - Beatriz Padilla
- Department of Sociology, University of South Florida, Tampa, FL, 33620, USA
| | - Sara Willems
- Department of Public Health and Primary Care, Quality and Safety Ghent, Ghent University, 9000, Ghent, Belgium
| | - Eva Spiritus-Beerden
- Department of Social Work and Social Pedagogy, Ghent University, 9000, Ghent, Belgium
| | - An Verelst
- Department of Social Work and Social Pedagogy, Ghent University, 9000, Ghent, Belgium
| | - Ilse Derluyn
- Department of Social Work and Social Pedagogy, Ghent University, 9000, Ghent, Belgium
| |
Collapse
|
44
|
Oliva-Arocas A, Benavente P, Ronda E, Diaz E. Health of International Migrant Workers During the COVID-19 Pandemic: A Scoping Review. Front Public Health 2022; 10:816597. [PMID: 35252094 PMCID: PMC8888537 DOI: 10.3389/fpubh.2022.816597] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 01/21/2022] [Indexed: 11/13/2022] Open
Abstract
Background The coronavirus (COVID-19) pandemic and control measures adopted have had a disproportionate impact on workers, with migrants being a group specifically affected but poorly studied. This scoping review aims to describe the evidence published on the impact of the COVID-19 pandemic on the physical and mental health of migrant workers. Methods Papers written in English covering physical and mental health among international migrant workers during the COVID-19 pandemic, retrieved from six electronic databases searched on July 31, 2021, were included. A total of 1,096 references were extracted, of which 26 studies were finally included. Results Most of the migrant populations studied were born in Asia (16 of 26) and Latin America (8 of 26) and were essential workers (15 of 26). Few studies described the length of stay in the host country (9 of 26), the legal status of the migrant population (6 of 26), or established comparison groups (7 of 26). Ten studies described COVID-19 outbreaks with high infection rates. Fourteen studies evaluated mental health (anxiety, depression, worries, fears, stress, and post-traumatic stress disorder). Three of the 26 studies presented collateral positive effects of the COVID-19 pandemic because of improved hygiene. Conclusion There is a limited number of original publications related to the impact of the COVID-19 pandemic on the physical and mental health of migrant workers around the world. These publications mainly focus on migrants born in Asia and Latin America. The physical, long-term impact of the COVID-19 pandemic has, so far, not been evaluated. The positive collateral effects of improving healthcare conditions for migrant workers should also be further investigated.
Collapse
Affiliation(s)
- Adriana Oliva-Arocas
- Department of Community Nursing, Preventive Medicine and Public Health and History of Science, Faculty of Health Sciences, University of Alicante, Alicante, Spain
- *Correspondence: Adriana Oliva-Arocas
| | - Pierina Benavente
- Pandemic Centre, Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Elena Ronda
- Department of Community Nursing, Preventive Medicine and Public Health and History of Science, Faculty of Health Sciences, University of Alicante, Alicante, Spain
- CIBER for Epidemiology and Public Health, Health Institute Carlos III, Madrid, Spain
| | - Esperanza Diaz
- Pandemic Centre, Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, Bergen, Norway
- Unit for Migration and Health, Norwegian Public Health Institute, Oslo, Norway
| |
Collapse
|
45
|
How Did the COVID-19 Pandemic Affect Migrant Populations in Lisbon, Portugal? A Study on Perceived Effects on Health and Economic Condition. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031786. [PMID: 35162809 PMCID: PMC8835335 DOI: 10.3390/ijerph19031786] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 01/26/2022] [Accepted: 02/01/2022] [Indexed: 12/18/2022]
Abstract
Increasing evidence on the effects of the COVID-19 pandemic suggests that its social and health impacts are being disproportionately shouldered by socioeconomically disadvantaged populations, including migrants. Knowledge of how these populations are experiencing the COVID-19 crisis is scarce. We examined the effects of the pandemic on the perceived individual financial situation and health condition of migrants in Lisbon, Portugal, and described the most affected subgroups. A cross-sectional survey was conducted with a diverse community-based sample of 1126 migrants. A worsening of their financial situation since the pandemic was reported by 55.6% of the participants and a worsening of their health condition by 19.9%. A worsened financial situation was most often reported by those ≥45 years old and with a lower income (<EUR 650). Likewise, a worsened health condition was most often reported by older and lower-income migrants, as well as by women and those with a lower level of education. Migration-related factors such as length of stay and migration status were not associated with worsened health conditions. Socioeconomic characteristics appear to be more important when assessing differences in perceived effects of the pandemic among migrants. The social impact of the pandemic both exacerbates economic and gender inequalities and may lead to worse health conditions within the population in the medium and long terms.
Collapse
|
46
|
Crouzet L, Scarlett H, Colleville AC, Pourtau L, Melchior M, Ducarroz S. Impact of the COVID-19 pandemic on vulnerable groups, including homeless persons and migrants, in France: a qualitative study. Prev Med Rep 2022; 26:101727. [PMID: 35155084 PMCID: PMC8824256 DOI: 10.1016/j.pmedr.2022.101727] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 02/02/2022] [Accepted: 02/05/2022] [Indexed: 11/02/2022] Open
Abstract
Social inequalities in health increased especially during lockdown. Homeless persons felt neglected as lockdown was designed for those with stable housing. Access to an emergency shelter had positive impacts on homeless persons. Sudden implementation of lockdown reminded prior violent or traumatic circumstances. Crisis communication should be adapted to improve adherence to preventive measures.
Social inequalities tended to increase in the context of the pandemic, particularly in relation to the measures taken to manage and reduce the risk of COVID-19. When lockdown measures required the general population “to stay home”, what were homeless people expected to do? The ECHO study is a cross-sectional, descriptive study with a convergent mixed-method design. Data were collected across shelters in France both during and immediately following the lockdown (April – June 2020). This article presents the study’s qualitative findings, with a focus on understanding both the experiences and perceptions among these populations of the measures taken to limit the COVID-19 infection. A total of 26 semi-directed individual interviews were conducted across seven shelters in both Lyon (42%) and Paris (58%). Data were analysed using thematic content analysis with partial blinded coding. Four key themes were identified: 1- Reactions to the introduction of lockdown: a sudden implementation reminiscent of prior violent or traumatic circumstances amongst participants, 2- Accommodation during lockdown: participants’ conflicting visions of the shelter, 3- Influence of the media and public communication: an abundant flow of information impacting participant’s wellbeing and representations on the pandemic, and 4- The individual impact of lockdown: perceived health and limitations to daily life activities. The most vulnerable populations have borne the heaviest burden during the pandemic. It is therefore crucial that we improve both the availability of information, and the health literacy of, all groups within the national population.
Collapse
|
47
|
Renkens J, Rommes E, van den Muijsenbergh M. Refugees' Agency: On Resistance, Resilience, and Resources. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19020806. [PMID: 35055628 PMCID: PMC8775689 DOI: 10.3390/ijerph19020806] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 01/04/2022] [Accepted: 01/07/2022] [Indexed: 02/04/2023]
Abstract
This study set out to answer the question ‘Which kinds of agency do refugees perform when dealing with mental health problems of themselves and their children?’. Aiming to gain more insight in why it seems harder for refugee parents and minors than for the native population to talk to health professionals about their mental health and wellbeing, we combined two theoretical notions of agency to investigate a broad spectrum of informants’ behaviour. We conducted 25 interviews with 30 refugees from 8 countries (Syria, Yemen, Iran, Afghanistan, Armenia, Eritrea, Turkish Kurdistan, Vietnam), whose Dutch residence permit varied from 26 years to less than one year. Data were analysed through open and axial coding, followed by pattern analyses. Although sometimes refugees seek (mental) healthcare, at other times they show agency by doing ‘nothing’ or by deliberately using distracting activities to deal with severe stress. Making use of resources available to them, oftentimes refugees show agency in ways that are less visible to healthcare professionals, by surviving, showing resilience, and suffering. In these cases, we think healthcare for refugees should intervene in a non-medical way, e.g., by supporting them to obtain resources that help refugees to (re)gain agency.
Collapse
Affiliation(s)
- José Renkens
- Department of Primary and Community Care, Radboud University Medical Centre, 6500 HB Nijmegen, The Netherlands;
- Gender & Diversity Studies, Radboud University, 6525 GD Nijmegen, The Netherlands;
- School of Oganisation and Development, HAN University of Applied Sciences, 6525 EM Nijmegen, The Netherlands
- Correspondence: ; Tel.: +31-6-2819-6221
| | - Els Rommes
- Gender & Diversity Studies, Radboud University, 6525 GD Nijmegen, The Netherlands;
| | - Maria van den Muijsenbergh
- Department of Primary and Community Care, Radboud University Medical Centre, 6500 HB Nijmegen, The Netherlands;
- Pharos, Dutch Centre of Expertise on Health Disparities Utrecht, 3507 LH Utrecht, The Netherlands
| |
Collapse
|
48
|
Zanin A, Santini A, Furlan E, Benini F. Taking the rights of children with complex conditions seriously: New ethics challenges arisen during the COVID-19 pandemic. Front Pediatr 2022; 10:1001706. [PMID: 36245738 PMCID: PMC9559213 DOI: 10.3389/fped.2022.1001706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Accepted: 09/02/2022] [Indexed: 11/18/2022] Open
Affiliation(s)
- Anna Zanin
- Palliative Care and Pain Service, Department of Women's and Children's Health, University of Padua, Padua, Italy
| | - Anna Santini
- Palliative Care and Pain Service, Department of Women's and Children's Health, University of Padua, Padua, Italy
| | - Enrico Furlan
- Research Group "Moral Philosophy and Bioethics", Department of Molecular Medicine, University of Padua, Padua, Italy
| | - Franca Benini
- Palliative Care and Pain Service, Department of Women's and Children's Health, University of Padua, Padua, Italy
| |
Collapse
|
49
|
Mezzina R, Gopikumar V, Jenkins J, Saraceno B, Sashidharan SP. Social Vulnerability and Mental Health Inequalities in the "Syndemic": Call for Action. Front Psychiatry 2022; 13:894370. [PMID: 35747101 PMCID: PMC9210067 DOI: 10.3389/fpsyt.2022.894370] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 04/12/2022] [Indexed: 12/16/2022] Open
Abstract
Covid-19 is referred to as a "syndemic," i.e., the consequences of the disease are exacerbated by social and economic disparity. Poor housing, unstable work conditions, caste, class, race and gender based inequities and low incomes have a profound effect on mental health and wellbeing. Such disparities are increasing between, among and within countries and are exacerbated by human rights violations, in institution and in society, stigma and discrimination. Social capital can mediate health outcomes, through trust and reciprocity, political participation, and by mental health service systems, which can be coercive or more open to demand of emancipation and freedom. Societal inequalities affect especially vulnerable groups, and Covid itself had a wider impact on the most socially vulnerable and marginalized populations, suffering for structural discrimination and violence. There are complex relations among these social processes and domains, and mental health inequalities and disparity. Participation and engagement of citizens and community organizations is now required in order to achieve a radical transformation in mental health. A Local and Global Action Plan has been launched recently, by a coalition of organizations representing people with lived experience of mental health care; who use services; family members, mental health professionals, policy makers and researchers, such as the International Mental Health Collaborating Network, the World Federation for Mental Health, the World Association for Psychosocial Rehabilitation, the Global Alliance of Mental Illness Advocacy Networks (GAMIAN), The Mental Health Resource Hub in Chennai, India, The Movement for Global Mental Health (MGMH) and others. The Action Plan addresses the need for fundamental change by focusing on social determinants and achieving equity in mental health care. Equally the need for the politics of wellbeing has to be embedded in a system that places mental health within development and social justice paradigm, enhancing core human capabilities and contrasting discriminatory practices. These targets are for people and organizations to adopt locally within their communities and services, and also to indicate possible innovative solutions to Politics. This global endeavor may represent an alternative to the global mental discourse inspired by the traditional biomedical model.
Collapse
Affiliation(s)
- Roberto Mezzina
- World Federation for Mental Health, Woodbridge, VA, United States
| | - Vandana Gopikumar
- The Banyan Academy of Leadership in Mental Health, Chennai, India.,Madras School of Social Work, Chennai, India
| | - John Jenkins
- International Mental Health Collaborating Network, Exeter, United Kingdom
| | | | - S P Sashidharan
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| |
Collapse
|
50
|
Michalski T, Brosz M, Stepien J, Biernacka K, Blaszczyk M, Grabowski J. Perceived Stress Levels among Ukrainian Migrant and LGBT+ Minorities in Poland during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:12838. [PMID: 34886564 PMCID: PMC8657859 DOI: 10.3390/ijerph182312838] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 11/25/2021] [Accepted: 12/03/2021] [Indexed: 11/16/2022]
Abstract
The Coronavirus disease 2019 (COVID-19) pandemic, immigrant status and being a member of the LGBT+ community are all independent factors associated with increased stress levels. Few studies provide more complex analysis on this issue, and there has been no research on the cumulative burden of perceived stress that people belonging to both minorities experience in the current epidemiological situation. The aim of this study was to assess the ability to deal with an external situation during the third wave of the COVID-19 pandemic in Poland in the following groups with different stress levels (total sample n = 370): Polish heterosexual men (n = 202), heterosexual men from Ukraine (n = 131) and homo- and bisexual men (men who have sex with men-MSM) from Ukraine (n = 37). A Perceived Stress Scale (PSS-10) was used. The analysis of the survey did not show statistically significant differences between the three study groups in the general level of perceived stress (24.71, 24.77 and 26.49 points, respectively, p = 0.551), but it revealed numerous differences in coping with various aspects of everyday functioning between these groups. Negative assessment of one's own health proved to be the main factor negatively affecting the level of perceived stress, however specific health risks, medical history or the participants' previous experience have not been taken into account in the study. Our research shows differences in the needs, resources and methods of coping with stress between men who are Polish citizens and migrants from Ukraine, both heterosexual and belonging to the MSM group. Proper identification and addressing of these needs, taking into account different availability of health services, could be the responsibility of NGOs or insurance providers. This should result in the reduction of mental health burdens and the risk of developing serious mental disorders, and consequently in better functioning of persons belonging to minorities and in a reduced burden on the health care system.
Collapse
Affiliation(s)
- Tomasz Michalski
- Department of Regional Development, Faculty of Social Science, University of Gdansk, 80-309 Gdansk, Poland;
| | - Maciej Brosz
- Institute of Sociology, Faculty of Social Sciences, University of Gdansk, 80-309 Gdansk, Poland;
| | - Joanna Stepien
- Department of Socio-Economic Geography, Faculty of Social Science, University of Gdansk, 80-309 Gdansk, Poland;
| | - Karolina Biernacka
- Adult Psychiatry Scientific Circle, Division of Developmental Psychiatry, Psychotic and Geriatric Disorders, Department of Psychiatry, Faculty of Medicine, Medical University of Gdansk, 80-210 Gdansk, Poland; (K.B.); (M.B.)
| | - Michal Blaszczyk
- Adult Psychiatry Scientific Circle, Division of Developmental Psychiatry, Psychotic and Geriatric Disorders, Department of Psychiatry, Faculty of Medicine, Medical University of Gdansk, 80-210 Gdansk, Poland; (K.B.); (M.B.)
| | - Jakub Grabowski
- Division of Developmental Psychiatry, Psychotic and Geriatric Disorders, Department of Psychiatry, Faculty of Medicine, Medical University of Gdansk, 80-210 Gdansk, Poland
| |
Collapse
|