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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

UCSD

MMFRP

September 29th 2011

background
Background
  • “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
background1
Background
  • 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
background2
Background
  • 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
background3
Background
  • 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
slide10

SAN MIGUEL TLACOTEPEC/VISTA, CA. 2011

  • Non-migrants= 23%
  • Return migrants=21%
  • Migrants= 9%
ces d scores
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

formal services available
Formal Services available
  • SMT:
  • Medical health clinic
  • Psychologist in Juxtlahuaca
  • Psychiatrist in Oaxaca
  • Vista:
  • Non-Profit organizations
  • Independent practices
treatment
treatment
  • 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
explaining our findings
Explaining our findings
  • Family Separation in San Miguel Tlacotepec
  • Social Networks, Social Support
  • ‘Healthy Migrant’ Effect
  • ‘Salmon Bias’ Effect
significance
significance
  • 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.
conclusion
Conclusion
  • 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

Questions, Comments?

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