Psychiatric healthcare utilisation among refugee adolescents and their peers in Denmark

Soc Psychiatry Psychiatr Epidemiol. 2020 Nov;55(11):1457-1468. doi: 10.1007/s00127-020-01878-w. Epub 2020 May 14.

Abstract

Purpose: To investigate the psychiatric healthcare utilisation of refugees vis-à-vis their peers in Denmark during the ages 15-22.

Methods: This paper utilises comprehensive full-population registry data from 1995 to 2016 to explore the psychiatric healthcare utilisation during the transition from childhood to adulthood for refugees (N = 13,027), a comparison group of children of labour migrants from Morocco, Pakistan, and Turkey (N = 13,413), and the majority population (N = 693,043) in Denmark. To test for population differences in types of admission for particular types of disorders, odds ratios for a first contact during ages 15-22 were calculated using logistic regression. For those with at least one diagnosis-specific hospital contact, differences in the amount and type of treatment were tested using negative binomial regression to estimate means ratios of days hospitalised, days in outpatient care, number of outpatient contacts, consultations with psychiatrists in private practice, and prescribed medicine purchases.

Results: Refugees and the comparison group were generally less likely than the majority population to have a first contact for most disorders (adjusted ORs 0.03-0.88), but not for schizophrenia for boys (adjusted ORs 0.92-2.13). Among those who did have a first contact, youths from the ethnic minority groups tended to have more or similar inpatient and emergency room contacts (MRs 0.89-2.10), hospitalisations of refugee girls being an exception (MR 0.46; CI [0.23-0.94]), but fewer outpatient contacts, consultations with psychiatrists in private practice, and prescribed medicine purchases (MRs 0.23-0.94).

Conclusions: The results suggest that refugee and other ethnic minority groups may face barriers both to initial contact and to completing adequate treatment beyond the first contact.

Keywords: Adolescents; Mental health; Migrants; Psychiatric healthcare utilisation; Refugees.

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Denmark / epidemiology
  • Ethnicity
  • Female
  • Humans
  • Male
  • Mental Health Services*
  • Minority Groups
  • Morocco
  • Pakistan
  • Refugees* / psychology
  • Turkey
  • Young Adult

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