Factors Beyond the Language Barrier in Providing Health Care to Immigrant Patients

Fatahi, Nabi; Krupić, Ferid

doi:10.5455/medarh.2016.70.61-65

“… 26 Substantial barriers that may limit access to mental health care in immigrant women include language insufficiency due to lower level of education compared with male immigrants, 27 ethno-cultural prohibitions on exposing personal or family matters to outsiders 28 and social stigma related to female psychological disorders. 29 The particularly elevated suicide risk in the older women born outside of Nordic countries, in particular, those not treated for depression indicates a need for innovative public health interventions to understand their perceptions of mental health care, in order to reach them. The potential heterogeneity of the socioeconomic conditions, duration of migration and country of origin of old immigrants warrants more research to better elucidate associations with suicide.…”

Section: Discussionmentioning

confidence: 99%

Sociodemographic and gender determinants of late-life suicide in users and non-users of antidepressants

Hedna

¹

,

Hensing

²

,

Skoog

³

et al. 2020

European Journal of Public Health

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Background The treatment of depression is a main strategy for suicide prevention in older adults. Our aim was to examine factors related to suicide in older adults (75+) with and without antidepressant (AD) therapy. Methods A national population-based register study, including all Swedish residents aged ≥75 years between 2006 and 2014 (N = 1 413 806). A nested case–control design was used to investigate sociodemographic factors associated with suicide among users and non-users of ADs. Risk estimates were calculated in adjusted conditional logistic regression models for the entire cohort and by gender. Results In all, 1305 individuals died by suicide (70% men). The suicide rate in men who used ADs was over four times higher than women with such treatment. Being unmarried was a risk factor for suicide in men but not in women. Being born outside of Nordic countries was associated with increased suicide risk; a 3-fold risk increase was observed in non-Nordic women without AD treatment. Lower suicide risk was observed in blue-collar women who used ADs, whereas a higher risk was found in blue-collar men who did not. Conclusions Our differential findings on factors associated with suicide can offer clues for gender-specific preventive strategies that go beyond the healthcare sphere.

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“…Taken together, our results point to a need to improve the monitoring of AD treatment and to reach the mental health needs of older adults with foreign background, and this pertains especially to women. Previous research conducted in younger age groups has shown that immigrant women do not seek or receive adequate mental healthcare [12], because of language limitations and cultural barriers such as the fear of stigma related to mental illness [13,14]. The higher risk found in the older adults from other Nordic countries advocates the need for more research to better elucidate this association.…”

Section: Discussionmentioning

confidence: 99%

What are sociodemographic and gender determinants of non-fatal self-harm in older adults users and non-users of antidepressants? A national population-based study

Hedna

¹

,

Fastbom

²

,

Skoog

³

et al. 2020

Preprint

0

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Background Late-life self-harm (SH) is often linked to depression. However, very few studies have explored the role of other factors and their interaction with depression in the occurrence of late-life SH. The objective of this research was to examine sociodemographic and gender factors associated with non-fatal SH, in older adults with and without antidepressant therapy. Methods We used national longitudinal register data from a total cohort of all Swedish residents aged ≥75 years between 2006-2014 (N=1,413,806). Using personal identity numbers, we linked individuals' data from numerous national registers. We identified all those with at least one episode of non-fatal self-harm (regardless of level of intent to die) and matched 50 controls to each case. A nested case–control design was used to investigate the sociodemographic factors associated with non-fatal SH in the total cohort and among antidepressant users and non-users. Risk factors were analysed in adjusted conditional logistic regression models for the entire cohort and by gender. Results In all, 2242 individuals had at least one episode of a non-fatal SH (980 men and 1262 women). In the total cohort, being married was a protective factor for non-fatal SH in men but not in women. A higher non-fatal SH risk was found in antidepressant users from outside Nordic countries (IRR: 1.44; 95% CI: 1.11-1.86), and in non-users of antidepressants from other Nordic countries (IRR: 1.58; 95% CI: 1.08-2.29). Antidepressant users with higher education had an increased risk of non-fatal SH (IRR: 1.34; 95% CI: 1.12-1.61), in both men and women. Conclusions Being married did not mitigate risk of self-harm in older women. Foreign country of birth and higher education were associated with increased risk of non-fatal SH. Healthcare professionals and social workers must be informed about high-risk groups for suicidal behaviour, and ensure they are adequately monitored both in term of antidepressant therapy and access to psychosocial support.

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“…Taken together, our results point to a need to improve the monitoring of AD treatment and to reach the mental health needs of older adults with foreign background, and this pertains especially to women. Previous research conducted in younger age groups has shown that immigrant women do not seek or receive adequate mental healthcare [13], because of language limitations and cultural barriers such as the fear of stigma related to mental illness [14,15].…”

Section: Discussionmentioning

confidence: 99%

What are sociodemographic and gender determinants of non-fatal self-harm in older adults users and non-users of antidepressants? A national population-based study

Hedna

¹

,

Fastbom

²

,

Skoog

³

et al. 2020

Preprint

0

View full text Add to dashboard Cite

Background Late-life self-harm (SH) is often linked to depression. However, very few studies have explored the role of other factors and their interaction with depression in the occurrence of late-life SH. The objective of this research was to examine sociodemographic and gender factors associated with non-fatal SH, in older adults with and without antidepressant therapy. Methods We used national longitudinal register data from a total cohort of all Swedish residents aged ≥75 years between 2006-2014 (N=1,413,806). Using personal identity numbers, we linked individuals' data from numerous national registers. We identified all those with at least one episode of non-fatal self-harm (regardless of level of intent to die) and matched 50 controls to each case. A nested case–control design was used to investigate the sociodemographic factors associated with non-fatal SH in the total cohort and among antidepressant users and non-users. Risk factors were analysed in adjusted conditional logistic regression models for the entire cohort and by gender. Results In all, 2242 individuals had at least one episode of a non-fatal SH (980 men and 1262 women). In the total cohort, being married was a protective factor for non-fatal SH in men but not in women. A higher non-fatal SH risk was found in antidepressant users from outside Nordic countries (IRR: 1.44; 95% CI: 1.11-1.86), and in non-users of antidepressants from other Nordic countries (IRR: 1.58; 95% CI: 1.08-2.29). Antidepressant users with higher education had an increased risk of non-fatal SH (IRR: 1.34; 95% CI: 1.12-1.61), in both men and women. Conclusions Being married did not mitigate risk of self-harm in older women. Foreign country of birth and higher education were associated with increased risk of non-fatal SH. Healthcare professionals and social workers must be informed about high-risk groups for suicidal behaviour, and ensure they are adequately monitored both in term of antidepressant therapy and access to psychosocial support.

show abstract

Factors Beyond the Language Barrier in Providing Health Care to Immigrant Patients

Cited by 22 publications

References 20 publications

Sociodemographic and gender determinants of late-life suicide in users and non-users of antidepressants

Sociodemographic and gender determinants of late-life suicide in users and non-users of antidepressants

What are sociodemographic and gender determinants of non-fatal self-harm in older adults users and non-users of antidepressants? A national population-based study

What are sociodemographic and gender determinants of non-fatal self-harm in older adults users and non-users of antidepressants? A national population-based study

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