Psychiatric healthcare utilisation among refugee adolescents and their peers in Denmark
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ORIGINAL PAPER
Psychiatric healthcare utilisation among refugee adolescents and their peers in Denmark Christopher J. de Montgomery1 · J. H. Petersen2 · S. S. Jervelund1 Received: 12 September 2019 / Accepted: 2 May 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose To investigate the psychiatric healthcare utilisation of refugees vis-à-vis their peers in Denmark during the ages 15–22. Methods This paper utilises comprehensive full-population registry data from 1995 to 2016 to explore the psychiatric healthcare utilisation during the transition from childhood to adulthood for refugees (N = 13,027), a comparison group of children of labour migrants from Morocco, Pakistan, and Turkey (N = 13,413), and the majority population (N = 693,043) in Denmark. To test for population differences in types of admission for particular types of disorders, odds ratios for a first contact during ages 15–22 were calculated using logistic regression. For those with at least one diagnosis-specific hospital contact, differences in the amount and type of treatment were tested using negative binomial regression to estimate means ratios of days hospitalised, days in outpatient care, number of outpatient contacts, consultations with psychiatrists in private practice, and prescribed medicine purchases. Results Refugees and the comparison group were generally less likely than the majority population to have a first contact for most disorders (adjusted ORs 0.03–0.88), but not for schizophrenia for boys (adjusted ORs 0.92–2.13). Among those who did have a first contact, youths from the ethnic minority groups tended to have more or similar inpatient and emergency room contacts (MRs 0.89–2.10), hospitalisations of refugee girls being an exception (MR 0.46; CI [0.23–0.94]), but fewer outpatient contacts, consultations with psychiatrists in private practice, and prescribed medicine purchases (MRs 0.23–0.94). Conclusions The results suggest that refugee and other ethnic minority groups may face barriers both to initial contact and to completing adequate treatment beyond the first contact. Keywords Refugees · Mental health · Adolescents · Psychiatric healthcare utilisation · Migrants
Introduction Refugee children have been found to be a vulnerable group with a high risk of mental ill health due to risk factors before, during, and after flight, such as exposure to violence, loss of or separation from parents, and socioeconomic adversity [1–8]. The absence of proper care can have a lasting * Christopher J. de Montgomery [email protected] 1
Department of Public Health, Danish Research Centre for Migration, Ethnicity and Health (MESU), University of Copenhagen, Øster Farimagsgade 5, 1014 Copenhagen K, Denmark
Section of Bio‑Statistics, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1014 Copenhagen K, Denmark
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effect on their life course, both in terms of their possibilities for a life of health and well-being, and their socioeconomic trajectories [9]. Ensuring that this gr
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