Perceived need for mental health care among non-western labour migrants.
BACKGROUND
There is a supposed higher prevalence of common mental disorders among many migrant groups. At the same time, problems are reported regarding underutilisation of mental health services by migrants. Since perceived need for care is a powerful predictor of actual care utilisation, we aimed to study the hypothesis that, given the same level of mental morbidity, non-Western migrants would perceive less need for mental health care than ethnic Dutch residents. Additionally, we studied the extent to which needs are met in both groups, as well as several possible barriers to care.


METHODS
A cross-sectional study with data from the 2004/2005 Amsterdam Health Monitor. Data were complete from 626 ethnic Dutch and non-Western (Turkish and Moroccan) labour migrants. Respondents participated in a structured interview in their own language, which included the perceived need for care questionnaire (PNCQ) and the composite international diagnostic interview (CIDI) version 2.1 for anxiety and depressive disorders.


RESULTS
Perceived need was much higher among Turkish migrants. Among Moroccans the perceived need was comparable to ethnic Dutch. Turkish migrants also reported that needs were met less often than ethnic Dutch. Differences were explained by a higher prevalence of common mental disorders and higher symptom levels among Turkish. When differences in mental morbidity were taken into account, Moroccans perceived less need for information, drugs, referral to specialised mental health care, or for counselling. The most important barrier to care in all ethnic groups was the preference to solve the problem on one's own.


CONCLUSIONS
In case of similar mental morbidity, perceived need for care was lower than among ethnic Dutch. The results did not support the hypothesis that in case of similar mental distress, needs of migrants were less often met than needs of ethnic Dutch.
Fassaert
Thijs
T
Dept. of Epidemiology, Documentation and Health Promotion, Amsterdam Municipal Health Service, Amsterdam, The Netherlands. tfassaert@ggd.amsterdam.nl
de Wit
Matty A S
MA
Tuinebreijer
Wilco C
WC
Verhoeff
Arnoud P
AP
Beekman
Aartjan T F
AT
Dekker
Jack
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D004651:Employment; D005260:Female; D006301:Health Services Needs and Demand; D006306:Health Surveys; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D001523:Mental Disorders / Q000503:physiopathology; D008605:Mental Health Services; D008875:Middle Aged; D009426:Netherlands; D012923:Social Class; D014171:Transients and Migrants / Q000523:psychology*; D055815:Young Adult
Soc Psychiatry Psychiatr Epidemiol. 2001 Dec;36(12):595-603
11838831
Am J Psychiatry. 2002 May;159(5):845-51
11986140
J Gen Intern Med. 2005 Feb;20(2):148-54
15836548
Health Serv Res. 2001 Dec;36(6 Pt 1):987-1007
11775672
J Health Soc Behav. 1995 Mar;36(1):1-10
7738325
Depress Anxiety. 2000;12 Suppl 1:95-101
11098422
Psychiatr Serv. 2007 Mar;58(3):357-64
17325109
Psychiatr Serv. 2005 Aug;56(8):988-94
16088017
Soc Psychiatry Psychiatr Epidemiol. 2000 Sep;35(9):427-35
11089671
Am J Public Health. 1997 Jul;87(7):1136-43
9240103
Cult Med Psychiatry. 2000 Dec;24(4):431-52
11128626
Am J Psychiatry. 2001 Dec;158(12):2027-32
11729020
Eur J Public Health. 2001 Jun;11(2):153-9
11420801
Soc Psychiatry Psychiatr Epidemiol. 2007 Jan;42(1):50-6
17080323
Clin Psychol Rev. 2008 Jul;28(6):1038-58
18420323
J Clin Psychiatry. 2007;68 Suppl 2:10-9
17288502
Int J Soc Psychiatry. 2001 Autumn;47(3):42-54
11589335
J Affect Disord. 2007 Jan;97(1-3):229-39
16901547
Clin Pract Epidemiol Ment Health. 2005 Aug 31;1:13
16135246
Soc Psychiatry Psychiatr Epidemiol. 2008 Nov;43(11):905-12
18587679
Adm Policy Ment Health. 2006 Nov;33(6):666-73
16823630
J Hypertens. 2006 Nov;24(11):2169-76
17053537
Soc Psychiatry Psychiatr Epidemiol. 2002 Jun;37(6):276-82
12111033
Gen Hosp Psychiatry. 2006 Jan-Feb;28(1):27-36
16377362
BMC Health Serv Res. 2007 Apr 10;7:51
17425792
Soc Psychiatry Psychiatr Epidemiol. 2006 Oct;41(10):777-81
16845486
Soc Psychiatry Psychiatr Epidemiol. 2004 Jun;39(6):464-71
15205731
N Engl J Med. 1999 Oct 28;341(18):1329-35
10536124
Soc Sci Med. 2004 Apr;58(7):1309-21
14759678
Ment Health Serv Res. 2004 Mar;6(1):33-46
15002679
Int J Geriatr Psychiatry. 2005 May;20(5):436-45
15852443
Arch Gen Psychiatry. 2002 Jan;59(1):77-84
11779286
Fam Pract. 2006 Jun;23(3):325-48
16476700
Int Migr. 1999;37(4):679-713
12295606
J Affect Disord. 2004 Nov 15;83(1):33-41
15546643
CMAJ. 2000 Nov 28;163(11):1468-70
11192655
Soc Sci Med. 2006 Nov;63(9):2407-17
16928417
Soc Psychiatry Psychiatr Epidemiol. 2005 Jul;40(7):529-39
16088372
Psychol Med. 2002 Aug;32(6):959-76
12214795