Determinants of Mental Health Consultations Among Recent Chinese Immigrants in British Columbia, Canada: Implications for Mental Health Risk and Access to Services

Abstract

Linked immigration and health administrative databases were analyzed to study the factors associated with the rate of mental health consultations with physicians in 1992-2001 of over 150,000 Chinese immigrants in British Columbia, Canada. Results showed that number of years since landing and rate of non-mental health visits to general practitioners were the most consistent variables associated with mental health consultations to general practitioners and psychiatrists in all sex and age groups. Other variables associated with the rate of consultations were age, place of origin, educational level, marital status and English skill. Supply of physicians was not observed to be associated with mental health consultations. The findings are consistent with Andersen's behavioral model of health care utilization and introduce components specially pertinent to immigrants and mental health service utilization. They also highlight sub-populations among immigrants who may be at risk of experiencing mental health problems or encountering barriers to care.

What do register-based studies tell us about migrant mental health? A scoping review

“…Register studies are also restricted by the health data that is recorded. Important background information for migrants, such as reasons for migration, length of stay, or health behavior data are typically not reported in health registers [54, 61]. …”

Differences in Prevalence and Treatment of Bipolar Disorder among Immigrants: Results from an Epidemiologic Survey

“…1 The proportion of immigrants in Canada has risen for decades, and currently stands at 18% of the Canadian population. Numerous studies in Canada and elsewhere have examined different aspects of the mental health needs and treatments among immigrant groups [2][3][4][5][6] ; nonetheless, limited data are available on immigrants with BD. The estimated lifetime prevalence of BD is in the range of 1% to 2% 7,8 ; therefore, there are likely up to 100 000 immigrants with BD in Canada.…”

Changes in the Sociocultural Reality of Chinese Immigrants: Challenges and Opportunities in Help-Seeking Behaviour

“…The issue of loss of familial support due to changes in the immigrants' socio-cultural reality appeared to be an extremely important factor that created a major disruption in their familiar help-seeking pathway. Studies have indicated higher distress among Chinese individuals who are in confl ict with their families due to the cultural emphasis on harmonious family relationships (Abe-Kim et al, 2002;Chen et al, 2008). In the case of the study participants, the culture-specifi c feelings of shame associated with their personal failure and fear of judgement from family and peers (Segal, 2002;Sue & Sue, 2003) became a deterrent to seeking support and advice as well as a stressor that severely undermined their mental health both prior to and after the onset of their mental illness.…”