title: Utilisation of psychiatrists and psychologists in private practice among non-Western labour immigrants, immigrants from refugee-generating countries and ethnic Danes: the role of mental health status.
abstract: OBJECTIVE
  The stressful migration process has been associated with higher vulnerability for mental health problems, implying a greater need for mental healthcare among immigrants compared with native-born. Our objective was to investigate whether potential differences in the use of psychiatrists and psychologists in labour immigrants, immigrants from refugee-generating countries (RGC), and ethnic Danes could be fully explained by mental health status.
  
  
  METHODS
  We conducted a nationwide survey in 2007 with 3,573 individuals aged 18-66 comprising ethnic Danes, labour immigrants (Pakistan and Turkey), and immigrants from RGC (Iran, Iraq, Lebanon, and Somalia). Survey data was linked to healthcare utilisation registries. Using Poisson regression, contacts with private practising psychiatrists and psychologists were estimated. Analyses were adjusted for socioeconomic factors and mental health status.
  
  
  RESULTS
  Overall, 2.2 % among ethnic Danes, 1.4 % among labour immigrants and 6.5 % among immigrants from RGC consulted a psychiatrist or psychologist. In adjusted analyses, for psychiatrists, compared with ethnic Danes, labour-immigrant women (multiplicative effect = 1.78), and immigrant women from RGC (multiplicative effect = 2.49) had increased use, while labour-immigrant men had decreased use (multiplicative effect = 0.03). For psychologists, immigrant men from RGC had increased use (multiplicative effect = 2.96), while labour-immigrant women had decreased use (multiplicative effect = 0.27) compared with ethnic Danes.
  
  
  CONCLUSIONS
  Mental health status had a somewhat explanatory effect on the use of psychiatrists and psychologists. These selected parts of the Danish mental healthcare system seem responsive to health needs across different population groups, particularly for immigrants from RGC. Yet more attention should be given to non-Western labour immigrants to meet their mental health needs.
authors: Danish Research Centre for Migration, Ethnicity, and Health, Section for Health Services Research, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5A, 1014, Copenhagen K, Denmark, ssn@sund.ku.dk.
authors: Signe Smith
authors: SS
authors: Nielsen
authors: Natasja Koitzsch
authors: NK
authors: Jensen
authors: Svend
authors: S
authors: Kreiner
authors: Marie
authors: M
authors: Norredam
authors: Allan
authors: A
authors: Krasnik
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000553:Ambulatory Care / Q000706:statistics & numerical data*; D003718:Denmark / Q000453:epidemiology; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data*; D005006:Ethnicity / Q000145:classification / Q000706:statistics & numerical data; D005260:Female; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data*; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D007492:Iran / Q000208:ethnology; D007493:Iraq / Q000208:ethnology; D007861:Lebanon / Q000208:ethnology; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data*; D008875:Middle Aged; D010154:Pakistan / Q000208:ethnology; D044382:Population Groups; D011331:Private Practice / Q000706:statistics & numerical data*; D011570:Psychiatry / Q000706:statistics & numerical data; D011584:Psychology / Q000706:statistics & numerical data; D012036:Refugees / Q000706:statistics & numerical data; D012042:Registries / Q000706:statistics & numerical data; D012737:Sex Factors; D012959:Socioeconomic Factors; D012998:Somalia / Q000208:ethnology; D014421:Turkey / Q000208:ethnology; D055815:Young Adult