Eva M. Klein – Migration and Mental Health

Migration and mental health - Identifying psychosocial determinants in representative samples

 

Theoretical Background: The proportion of migrants in Germany has risen to about 21 % of the total population in 2015 and keeps growing strongly [1]. The migratory process is generally regarded as a stressful life event affecting the individuals’ mental and physical health [2]. Epidemiological studies on migrants’ health are scare and results are often contradictory [3]. According to the EU [4] and WHO [5] migrants are exposed to an increased vulnerability of developing mental illness compared to non-migrants.

Migration is not per se a risk factor for reduced well-being, however, migrants face in particular various psychosocial and economic burden, such as lower socio-economic status, less participating in specialist health care, and loss of social network [6,7]. Both internal (e.g. personal traits) and external factors (e.g. immigration laws) are pivotal for coping with acculturation stress [8]. Hence, more recent research has focused on the investigation of risk and resilience factors affecting migrants’ mental well-being. However, there is a lack of representative studies identifying risk groups, psychosocial determinants and their interaction. In addition, little attention has been paid to the role of interindividual and gender differences in health-related outcomes and psychological adjustment among migrants [9. 10].

Therefore, the main purpose of my dissertation project is to identify which psychological and social determinants a) buffer the vulnerability risk to suffer from mental strain and b) enhance psychological adjustment and social integration.

Methods: In order to address the research questions, data of three different representative samples will be analyzed. The samples include socio-demographic, a broad spectrum of health-related (e.g. depression), psychological (e.g. personality traits) and migrations specific variables (e.g. country of origin, acculturation strategy) enhancing our understanding of underlying mechanisms of successful psychological adjustment.

First, based on a representative school survey of 8,518 pupils aged 12–19 years across different school types, cross-sectional data of 1,578 migrants will be analyzed. Psychological strain (internalizing and externalizing problems) of adolescent 1st and 2nd generation migrants will be compared to non-migrants. The focus in this sample is on the role of acculturation strategy (integration, assimilation, separation, marginalization) and mediation effects of personality traits (extraversion, self-efficacy, social insecurity) in predicting psychological adjustment. Structural equation modeling will be used to investigate the hypothesized mediating effect of personality.

Second, cross-sectional data of 14,943 participants of the Gutenberg Health Study (GHS), a population-based survey in Mid-Germany (age 35 to 74 years) will be investigated to explore differences in mental health among 1st, 2nd generation migrants and non-migrants. As indicators for mental health a range of brief and validated self-report measures of depression, generalized anxiety, panic, social phobia and suicidal ideation are applied. Based on this sample, gender differences will be focused and diverse countries of origin will be taken into account using regression models.

Third, in order to identify predictors and to gain a better understanding of processes affecting migrants’ health and social life longitudinal data of the SOEP (Sozio-oekonomisches Panel) will be investigated.

Relevance: The comprehensive data set enables a profound understanding of the heterogeneous group of migrants and their mental well-being. Identifying risk groups, psychosocial risk and protective factors are pivotal to optimize health-care provision and social integration processes. The results aim to carry implications for the advancement of cross-cultural psychotherapy.

Author: Eva M. Klein

 

References:

[1] Statistisches Bundesamt (2015). Bevölkerung und Erwerbstätigkeit: Bevölkerung mit Migrationshintergrund– Ergebnisse des Mikrozensus. Wiesbaden: Statistisches Bundesamt.

[2] Kirkaldy, B., Wittig, U., Furnham, A., Merbach, M., & Siefen, R. (2006). Migration und Gesundheit. Psychosoziale Determinanten. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz, 49, 873-883.

[3] Schouler-Ocak, M., Aichberger, M., Penka, S., Kluge, U., & Heinz, A. (2015). [Mental disorders of immigrants in Germany]. Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz, 58(6), 527-532.

[4] European Commission (2005). Green Paper: Improving the Mental Health of the Population: Towards a Strategy on Mental Health in the European Union: OOPEC.

[5] WHO. (2010). Health of migrants: the way forward: report of a global consultation. Madrid, Spain, 3-5 March 2010.

[6] Kizilhan J. (2011). Psychologie der Migration. In: Machleidt W, Heinz A, Dangl S,

(Hrsg.). Praxis der interkulturellen Psychiatrie und Psychotherapie.(S.55-62). München: Elsevier, Urban Fischer.

[7] Glaesmer, H., Wittig, U., Braehler, E., Martin, A., Mewes, R., & Rief, W. (2011). Health care utilization among first and second generation immigrants and native-born Germans: a population-based study in Germany. International journal of public health, 56(5), 541-548.

[8] Bhugra, D. (2004). Migration and mental health. Acta Psychiatrica Scandinavica, 109(4), 243-258.

[9] Butler, M., Warfa, N., Khatib, Y., & Bhui, K. (2015). Migration and common mental disorder: An improvement in mental health over time? International Review of Psychiatry, 27(1), 51-63.

[10] Binder-Fritz, C., & Rieder, A. (2014). Zur Verflechtung von Geschlecht, sozioökonomischem Status und Ethnizität im Kontext von Gesundheit und Migration. Bundesgesundheitsblatt-Gesundheitsforschung-Gesundheitsschutz, 57(9), 1031-1037.