Psychiatric Admission Among Migrants Before and During Pandemic: a Retrospective Study in Acute Psychiatric Ward in Bologna, Italy

Abstract

Previous evidence showed significant discrepancies in psychiatric services utilization between migrants and reference populations. Our study aims were to evaluate incidence and characteristics of psychiatric hospitalizations of migrant patients compared with reference populations and to assess how the COVID-19 pandemic affected admissions. All patients admitted to the psychiatric ward "SPDC-Malpighi" of the Bologna Mental Health Department from 01/01/2018 to 31/12/2020 were included. Differences in sociodemographic and clinical characteristics were tested by migrant status. Incidence rate ratios of hospital admissions by migrant status were estimated via Poisson regression considering population-at-risk, gender, and age-group. Migrants had higher hospitalization rates due to any psychiatric disorder (IRR = 1.16). The risk was especially pronounced among women (IRR = 1.25) and within the youngest age-group (IRR = 3.24). Young migrants had also a greater risk of compulsory admission (IRR = 3.77). Regarding admissions due to a specific diagnosis, we found relevant differences in hospitalization rates for psychosis, mood disorders, and personality disorders. Finally, migrants were more likely to be admitted via Emergency Department and less likely to be referred from a specialist. During the year of pandemic (2020) we observed an increase in the proportion of migrants admitted voluntarily or compulsorily. Migrants, especially those from the youngest age-group, had higher hospitalization rates for any disorder. Younger migrants were also at higher risk of compulsory treatment. The distribution of psychiatric admissions during the pandemic period seemed to have further increased discrepancies in mental healthcare needs and provision between migrants and the reference population. Tailored interventions and policies are urgently needed to address this issue.

Mental health law: a comparison of compulsory hospital admission in Italy and the UK

“…Another study showed that the risk of admission to a psychiatric unit is three times higher in migrants compared to non-migrants; compulsory admission among young migrants (15 to 24 years old) is four times higher. According to the same study, 20.7% of sub-Saharan Africans were admitted to psychiatric units versus 6.2% in the general population, and 17.9% of North Africans versus 8.7% in the general population (22). 2.…”

Valoración inicial de enfermería en emergencias psiquiátricas: revisión sistemátic

“…Así mismo, se consideran los niveles de gravedad de los síntomas del paciente y el historial psicosocial, siendo esta importante para detectar causas como maltratos, abusos, estrés, entre otros. La revisión realizada evidenció en algunos casos el uso de autoinformes y de registros médicos electrónicos (EHR), para los cuales usaron un formulario electrónico personalizado de informe de casos (REDCap)(22).Las características sociodemográficas de los pacientes es una información a tener en cuenta, esta se realiza con las categorías de la edad del paciente, número de visitas al departamento de emergencias, situación familiar, diagnóstico psiquiátrico; de allí que se les llame de tipo sociodemográfico(32). De la misma manera, el registro puede abarcar datos generales del paciente como puede ser el sexo, la fecha de nacimiento, fecha de ingreso al departamento de emergencias.Por otro lado, existen en esta categoría los cuestionarios, en los cuales se señalan los síntomas psiquiátricos que el ingresante puede poseer tales como el trastorno alimenticio, agitación, intento de suicidio y antecedentes del mismo(36,35).…”