Impact of migration and stressful life events on women’s mental health

1. Impact of migration and stressful life events on women’s mental health Women’s Health Academic Centre Laura Nellums MSc, PhD Student Dr Stephani Hatch :: Prof. Louise M. Howard Section for Women’s Mental Health, Health Service and Population Research Department Institute of Psychiatry, King’s College London Laura.Nellums@kcl.ac.uk Funding: National Institute for Health Research Biomedical Research Centre for Mental Health at South London and Maudsley NHS Foundation Trust and Institute of Psychiatry, King’s College London / ORS Award / King’s International Graduate Scholarship. • Background • 4.5 million migrants in UK; 3 million in London • No consensus on relationship between migration and mental health • Some migrant women may be at increased risk of poor mental health outcomes • Limited research on predictors of poor mental health for migrant women • Study setting • Women interviewed in South East London Community Health Study (SELCoH Study)1, a cross-sectional survey of individuals living in South East London, identified through random sampling • South East London ethnically diverse; immigrants comprise 30% of the population Migrant Population in Southwark and Lambeth Risk factors for high levels of psychological symptoms (n=755) • Aim: • Investigate impact of migration and stressful life events on risk of high levels of psychological symptoms for women living in South East London • Hypothesis: • Immigrant women are more likely to experience high levels of psychological symptoms than women born in the UK • Methods: • Study population: first generation immigrant women and women born in the UK who participated in the SELCoH Study • Data: SELCoH Study • Outcome measure: high levels of psychological symptoms (Clinical Interview Schedule – Revised Version, cut off 12; 4 item Post Traumatic Stress Disorder screen, cut off 3) • Results: • Characteristics of sample: • Sample size 944: 553 women born in the UK, 391 immigrant women. • High prevalence of psychological symptoms in sample: 28.9% [95% CI: 26.0 – 32.1] • High prevalence of stressful life events e.g. (potentially traumatic lifetime events: immigrant women 66.5% [95% CI 61.4 – 71.3]; women born in the UK 71.4% [95% CI 67.2 – 75.2] • Multivariate analysis: • No difference in mental health outcomes between immigrant women and women born in the UK [AOR: 1.0 [95% CI: 0.7 – 1.6]. • Stressful life events increased risk; social resources protective * p<.05 ** p<.01 *** p<.001 Risk factors for high levels of psychological symptoms (n=732) Exploratory analyses • Aims and measures: • Investigate differences in risk between immigrant women and women born in the UK due to macro-level factors in immigrant women’s countries of origin measured using: • UN Inequality-adjusted Human Development Index (IHDI) • UN Gender Inequality Index (GII) • Results • Women from medium IHDI level countries (including countries in Asia, Central and South America, and Africa) suggested to be twice as likely as women born in the UK to experience high levels of psychological symptoms. • GII not associated with psychological symptoms. • Aims and measures: • Investigate differences in risk among immigrant women due to individual level migration specific factors: • Reason for migration (a better life, family or partner, asylum) • Level of acculturation (years in UK, age at arrival in UK, English as a first language) • Results: • Reason for migration and level of association not associated with psychological symptoms • Conclusions: • Research and services should acknowledge: immigrant populations are heterogeneous; ecological model needed (e.g. migration specific factors, stressful life events, social resources) • Further research (e.g. qualitative) needed on risk factors for poor mental health among migrant women 1SELCoH Study: http://www.slam.nhs. uk/about-us/biomedical-research-centre/about-the-brc/core-facilities/south-east-london-community-health-(selcoh)-survey.aspx Not for reproduction or distribution