title: The mental health and wellbeing of first generation migrants: a systematic-narrative review of reviews.
abstract: First generation migrants are reportedly at higher risk of mental ill-health compared to the settled population. This paper systematically reviews and synthesizes all reviews on the mental health of first generation migrants in order to appraise the risk factors for, and explain differences in, the mental health of this population.
  
  
  
  Scientific databases were searched for systematic reviews (inception-November 2015) which provided quantitative data on the mental ill-health of first generation migrants and associated risk factors. Two reviewers screened titles, abstracts and full text papers for their suitability against pre-specified criteria, methodological quality was assessed.
  
  
  
  One thousand eight hundred twenty articles were identified, eight met inclusion criteria, which were all moderate or low quality. Depression was mostly higher in first generation migrants in general, and in refugees/asylum seekers when analysed separately. However, for both groups there was wide variation in prevalence rates, from 5 to 44 % compared with prevalence rates of 8-12 % in the general population. Post-Traumatic Stress Disorder prevalence was higher for both first generation migrants in general and for refugees/asylum seekers compared with the settled majority. Post-Traumatic Stress Disorder prevalence in first generation migrants in general and refugees/ asylum seekers ranged from 9 to 36 % compared with reported prevalence rates of 1-2 % in the general population. Few studies presented anxiety prevalence rates in first generation migrants and there was wide variation in those that did. Prevalence ranged from 4 to 40 % compared with reported prevalence of 5 % in the general population. Two reviews assessed the psychotic disorder risk, reporting this was two to three times more likely in adult first generation migrants. However, one review on the risk of schizophrenia in refugees reported similar prevalence rates (2 %) to estimates of prevalence among the settled majority (3 %). Risk factors for mental ill-health included low Gross National Product in the host country, downward social mobility, country of origin, and host country.
  
  
  
  First generation migrants may be at increased risk of mental illness and public health policy must account for this and influencing factors. High quality research in the area is urgently needed as is the use of culturally specific validated measurement tools for assessing migrant mental health.
authors: Administrative Data Research Centre - Northern Ireland, Centre for Public Health, Queen's University Belfast, Belfast, UK. c.close@qub.ac.uk.
authors: Ciara
authors: C
authors: Close
authors: UKCRC Centre of Excellence for Public Health, Queen's University Belfast, Belfast, UK.|Department of Social Research, University of Helsinki, Helsinki, Finland.|SWPS University of Social Sciences and Humanities, Faculty in Wroclaw, Wroclaw, Poland.
authors: Anne
authors: A
authors: Kouvonen
authors: Administrative Data Research Centre - Northern Ireland, Centre for Public Health, Queen's University Belfast, Belfast, UK.|College of Liberal Arts and Social Sciences, University of Guam, Mangilao, Guam.
authors: Tania
authors: T
authors: Bosqui
authors: Administrative Data Research Centre - Northern Ireland, Centre for Public Health, Queen's University Belfast, Belfast, UK.
authors: Kishan
authors: K
authors: Patel
authors: Administrative Data Research Centre - Northern Ireland, Centre for Public Health, Queen's University Belfast, Belfast, UK.|UKCRC Centre of Excellence for Public Health, Queen's University Belfast, Belfast, UK.
authors: Dermot
authors: D
authors: O'Reilly
authors: Administrative Data Research Centre - Northern Ireland, Centre for Public Health, Queen's University Belfast, Belfast, UK.|UKCRC Centre of Excellence for Public Health, Queen's University Belfast, Belfast, UK.
authors: Michael
authors: M
authors: Donnelly
mesh_terms: D003863:Depression / Q000453:epidemiology; D006801:Humans; D001523:Mental Disorders / Q000453:epidemiology*; D015995:Prevalence; D012307:Risk Factors; D000078202:Systematic Reviews as Topic; D014171:Transients and Migrants / Q000523:psychology*
keywords: First generation migrants; Mental health; Prevalence; Risk factors