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Migration and mental health. Hugo Salgado, MPH UCSD MMFRP September 29 th 2011. Background.

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Migration and mental health

Migration and mental health

Hugo Salgado, MPH



September 29th 2011



  • “Mental health is not just the absence of a mental disorder. It is defined as a state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community” -WHO



  • Exposure to traumatic conditions, coupled with difficulties in acculturationlong-lasting psychological and behavioral problems, including depression, anxiety, posttraumatic stress disorder

  • Many immigrants experience traumatic circumstances in their native country, including extreme poverty, human trafficking, exposure to war, and natural disasters



  • Many immigrants have difficulty acculturating to their new environments in the U.S. , which is exacerbated by experiences with prejudice and discrimination

  • Immigrants have less access to, and lower utilization of, mental health services



  • Many studies have examined the mental health status of Latino migrants. (Hummer et al. 2007; Palloni and Arias 2004; Lara et al. 2005)

  • Protective factors include Social Networks, Social Support

  • Day laborers in North San Diego/Acculturative Stress/Social Support

Current depression among adults united states 2006 and 2008

Current Depression Among Adults --- United States, 2006 and 2008

Source: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5938a2.htm

San miguel tlacotepec vista ca 2011

SAN MIGUEL tlacotepec/vista, Ca. 2011

  • Literature

  • Studies of Migrant Mental Health

  • Very few studies compare mental health outcomes of migrants, non-migrants and returned migrants from the same sending and satellite community

San miguel tlacotepec vista ca 20111

SAN MIGUEL tlacotepec/vista, Ca. 2011

  • CESD-10

  • - Focuses on clinical depression

  • - (feelings of sadness, loss, anger, or frustration interfere with everyday life for a period of two weeks or longer )

  • - Has been administered in rural communities across the - Mexican state of Jalisco,

  • - High internal consistency

San miguel tlacotepec 2011

San Miguel Tlacotepec, 2011

  • Results:

  • Mental health among Tlacotepense migrants is better than that of Tlacotepec residents, including return migrants.

  • Reasons:

    • Family Separation

    • Social Networks

    • ‘Healthy Migrant’ Effect

    • ‘Salmon Bias’ Effect

Migration and mental health


  • Non-migrants= 23%

  • Return migrants=21%

  • Migrants= 9%

Ces d scores


  • Overall 16% with depressive symptoms

  • Non-migrants = more likely to report depressive symptoms

  • Men = less likely to report symptoms of depression

  • Higher education = less depressive symptoms

  • Women = more likely to report depression

Regression analysis

Regression Analysis

N=720. p< 0.001***; p< 0.01**; p<0.05 *

Dependent Variable: CES-D Score

Migration and mental health

Self-Reported causes of depression

Formal services available

Formal Services available

  • SMT:

  • Medical health clinic

  • Psychologist in Juxtlahuaca

  • Psychiatrist in Oaxaca

  • Vista:

  • Non-Profit organizations

  • Independent practices



  • Migrants, return migrants, and non-migrants all show preference for medical and psychological services

  • Migrants sought less formal treatments

  • Lack of access to formal services = use of informal treatment

Services sought for depression

Services sought for depression

Explaining our findings

Explaining our findings

  • Family Separation in San Miguel Tlacotepec

  • Social Networks, Social Support

  • ‘Healthy Migrant’ Effect

  • ‘Salmon Bias’ Effect



  • Mental health is a pressing public health issue

  • Depression is “among the leading causes of disability worldwide” (WHO)

  • Essential to understand health among a population that is the largest ethnic-minority group in U.S.



  • Immigrant mental health promotion requires multi-sectoral action:

  • 1) Government sectors

  • 2) Non-governmental or community-based organizations

  • 3) Civil society

  • 4) Media

  • Pay special attention availability of social support and social networks, social support, pre-migration conditions and migration experience itself

Thank you

Thank you

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