scholarly journals Unmet need for mental health medication within the migrant population of Northern Ireland: a record linkage study

2020 ◽  
pp. jech-2019-212774
Author(s):  
Kishan Patel ◽  
Tania Bosqui ◽  
Anne Kouvonen ◽  
Michael Donnelly ◽  
Ari Väänänen ◽  
...  
Keyword(s):  
Mental Health ◽  
Northern Ireland ◽  
Psychotropic Medication ◽  
Record Linkage ◽  
Unmet Need ◽  
Linkage Study ◽  
Poor Mental Health ◽  
Migrant Population ◽  
Data Set ◽  
Migrant Groups

BackgroundMigrant populations are particularly at risk of not receiving the care for mental ill-health that they require for a range of reasons, including language and other barriers to health service access. This record linkage study compares, for migrant and settled communities, the likelihood that a person in Northern Ireland with poor mental health will receive psychotropic medication.MethodsA cohort of 78 267 people aged 16–64 years (including 1736 migrants) who reported chronic poor mental health in the 2011 Census records was followed for 15 months by linkage to a centralised prescribing data set to determine the rates of pharmacological treatment. Logistic regression analyses quantified the relationship between psychotropic medication uptake and migrant status, while accounting for relevant demographic and socioeconomic factors.ResultsOverall, 67% of the migrants with chronic poor mental health received at least one psychotropic medication during the study period, compared to 86% for the settled population; this equates to an OR of 0.32 (95% CI 0.29 to 0.36) in the fully adjusted models. Adjustment for English proficiency did not significantly alter these models. There was also considerable variation between individual migrant groups.ConclusionAlthough this study suggests substantial unmet need for treatment of poor mental health among the migrant population of Northern Ireland, further qualitative studies are required to better understand how different migrant groups respond to mental ill-health.

scholarly journals The Unmet Need for Psychotropic Medication within the Migrant Population of Northern Ireland - A Record Linkage Study

2019 ◽  
Vol 4 (3) ◽  
Author(s):  
Kishan Patel
Keyword(s):  
Mental Health ◽  
Northern Ireland ◽  
Psychotropic Medication ◽  
Record Linkage ◽  
Unmet Need ◽  
Linkage Study ◽  
Poor Mental Health ◽  
Migrant Population ◽  
Migrant Group ◽  
Migrant Groups

BackgroundA large proportion of people with mental ill-health do not receive the care that they require - constituting unmet need. Migrant populations are particularly at risk of not receiving necessary care for a range of reasons including perceptual differences and multiple barriers to health service. Main AimThis record linkage study compares the likelihood of people with poor mental health receiving psychotropic medication between migrant and settled communities and amongst different migrant groups in Northern Ireland. MethodsA cohort of 78,267 people aged 16-64 who reported chronic poor mental health in the 2011 Census records was generated and followed for the next 12 months by linkage to a centralised prescribing dataset to determine rates of treatment. All individual and household attributes were derived from Census forms. Absence of a psychotropic medication prescription from the beginning of 2011 represented unmet need. Logistic regression analyses quantified the relationship between psychotropic medication and migrant status, while accounting for relevant demographic and socio-economic factors. ResultsOverall, 86% of the settled population with chronic poor mental health received at least one psychotropic medication during the study period, compared to 67% of the equivalent population of 1,736 migrants. Although migrants were 61% less likely than the settled community to report poor mental health (OR 0.39 (95% CI 0.37 - 0.41)), those reporting poor mental health were less than one-third as likely as to be on psychotropic medication in fully adjusted models. There also existed considerable variation between individual migrant groups, with uptake of medication lowest amongst the Lithuanian migrant group (OR 0.09 (95% CI 0.05 – 0.14)), and highest amongst German migrant group (OR 1.30 (95% CI 0.87 – 1.94)). ConclusionAlthough this study suggests substantial unmet need for treatment of poor mental health amongst the migrant population of Northern Ireland this may not represent the whole story. Differences between individual migrant groups suggest that other factors may also be at play including differing approaches to treatment, or alternative routes to treatment. The implications of the study will be discussed in the paper.

scholarly journals First-generation migrants’ use of psychotropic medication in Northern Ireland: a record linkage study

2019 ◽  
Vol 13 (1) ◽  
Author(s):  
Tania Bosqui ◽  
Dermot O’Reilly ◽  
Ari Väänänen ◽  
Kishan Patel ◽  
Michael Donnelly ◽  
...  
Keyword(s):  
Mental Health ◽  
Northern Ireland ◽  
Psychotropic Medication ◽  
First Generation ◽  
Linkage Study ◽  
Research Centre ◽  
Care Needs ◽  
Health And Social Care ◽  
Majority Population ◽  
Migrant Groups

Abstract Purpose There is a recent and growing migrant population in Northern Ireland. However, rigorous research is absent regarding access to mental health care by different migrant groups. In order to address this knowledge gap, this study aimed to identify the relative use of psychotropic medication between the largest first generation migrant groups in Northern Ireland and the majority population. Methods Census (2011) data was linked to psychotropic prescriptions for the entire enumerated population of Northern Ireland using data linkage methodology through the Administrative Data Research Centre Northern Ireland (ADRC-NI). Results Lower prescription dispensation for all psychotropic medication types, particularly antidepressants (OR = 0.35, CI 95% 0.33–0.36) and anxiolytics (OR = 0.42, CI 95% 0.40–0.44), was observed for all migrant groups with the exception of migrants from Germany. Conclusions It is likely that the results reflect poorer access to services and indicate a need to improve access and the match between resources, services and the health and social care needs of migrants. Further research is required to identify barriers to accessing primary care and mental health services.

scholarly journals Unmet need for chronic mental ill health: A population-based record linkage study

2019 ◽  
Vol 4 (1) ◽  
Author(s):  
Michael Rosato ◽  
Foteini Tseliou ◽  
Dermot O'Reilly
Keyword(s):  
Mental Health ◽  
Ethnic Minorities ◽  
Psychotropic Medication ◽  
Record Linkage ◽  
Unmet Need ◽  
Healthcare Services ◽  
Poor Mental Health ◽  
White Background ◽  
Receive Treatment ◽  
To Receive

IntroductionIt is widely recognised that many people with chronic mental ill health do not receive the treatment they need, with socio-demographic and socio-economic factors contributing to mental healthcare access and receipt of treatment. However, recently different perceptions have emerged following reports of over-treatment or over-medication of a proportion of the population presenting to primary care settings with poor mental health. ObjectivesThis study aimed to investigate which factors are associated with the presence of poor mental health and the likelihood of being in receipt of pharmacological treatment for those who report chronic mental ill health. MethodsThe methodology was a record linkage of the 2011 Northern Ireland Census returns and a population-wide database of prescribed medications. The presence of a chronic mental health condition, as assessed through a self-reported question in the 2011 Census, was compared to electronic administrative records on psychotropic medication use in the twelve months following the Census. ResultsThis study shows that those of non-white background (OR 0.38 95%CI 0.26-0.54), who were never married (OR 0.67 95%CI 061-0.73), unemployed (OR 0.65 95%CI 0.53-0.81) or living in a rural area (OR 0.88 95%CI 0.79-0.98) were less likely than their peers to receive medication for their poor mental health. ConclusionsSome but not all of the observed variations may represent unmet need, but further studies are required to understand the knowledge of and attitudes towards healthcare services of groups (such as ethnic minorities and unemployed) who are identified as being less likely to receive treatment. Highlights Self-reported chronic mental ill health varied by socio-demographic and socio-economic characteristics. Although a high proportion of people received psychotropic medication for their mental ill health, there were evident social patterns among those who do not receive treatment. Ethnic minorities, those whose were not married or unemployed were considerably more likely to experience unmet need.

scholarly journals The Mental Health of Migrants in Northern Ireland

2018 ◽  
Vol 3 (2) ◽  
Author(s):  
Kishan Patel ◽  
Anne Kouvonen ◽  
Tania Bosqui ◽  
Ari Vannanen ◽  
Dermot O'Reilly
Keyword(s):  
Mental Health ◽  
Northern Ireland ◽  
Socioeconomic Factors ◽  
Prescription Medication ◽  
Migrant Health ◽  
Poor Mental Health ◽  
Migrant Population ◽  
Logistic Regression Models ◽  
Majority Population ◽  
Migrant Mental Health

BackgroundResearch has shown that the health of migrants can vary dramatically from the health of the settled population of their countries. Whilst migrant health has been studied in other areas of the UK, it is especially important to research the mental health of migrants in Northern Ireland specifically, due to the country’s unique mental health situation. ObjectivesThis study aims to assess the mental health of migrants in Northern Ireland as compared to the settled majority population, both by way of reported poor mental health, and psychotropic prescription medication uptake. MethodsThis study uses a cohort of 1,019,769 people in Northern Ireland, taken from the 2011 Census of Northern Ireland and the BSO Enhanced Prescribing Dataset (2011-2014). The migrant population of Northern Ireland is described in terms of demographic and socioeconomic factors, and logistic regression models are used to analyse the relative risks of reporting poor mental health and uptake of psychotropic medication within the migrant population as compared to the settled population. FindingsThe results show that migrants were significantly less likely to report poor mental health than the settled population of Northern Ireland, when adjusted for demographic characteristics, socioeconomic factors, and reported poor physical health. Migrants were also significantly less likely to use any form of psychotropic prescription medication than the settled population. ConclusionsThese findings are in concordance with most research conducted in other countries. The roles of the healthy migrant effect, the salmon bias, stigma, and lack of access to healthcare are discussed as possible reasons for the percieved migrant mental health advantage. However, such a dramatic difference between the health of migrants and the settled population of Northern Ireland may be due, in part, to certain limitations of the datasets used.

scholarly journals Are volunteering and caregiving associated with suicide risk? A Census-based longitudinal study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Michael Rosato ◽  
Foteini Tseliou ◽  
David M. Wright ◽  
Aideen Maguire ◽  
Dermot O’Reilly
Keyword(s):  
Mental Health ◽  
Longitudinal Study ◽  
Record Linkage ◽  
Suicide Risk ◽  
Linkage Study ◽  
Poor Mental Health ◽  
Cox Models ◽  
Good Mental Health ◽  
Increased Risk

Abstract Background Opposing risks have been identified between different prosocial activities, with volunteering having been linked to better mental health while caregiving has been associated with higher prevalence and incidence of depression. This study explored suicide risk of people engaged in prosocial activities of caregiving and/or volunteering. Methods A Census-based record linkage study of 1,018,000 people aged 25–74 years (130,816 caregivers; 110,467 volunteers; and 42,099 engaged in both) was undertaken. Caregiving (light: 1–19; intense: ≥20 h/week), volunteering and mental health status were derived from 2011 Census records. Suicide risk (45 months follow-up) was assessed using Cox models adjusted for baseline mental health. Results Intense caregiving was associated with worse mental health (ORadj = 1.15: 95%CI = 1.12, 1.18) and volunteering with better mental health (OR = 0.87: 95%CI = 0.84, 0.89). For those engaged in both activities, likelihood of poor mental health was determined by caregiving level. There were 528 suicides during follow-up, with those engaged in both activities having the lowest risk of suicide (HR = 0.34: 95%CI = 0.14, 0.84). Engaging in either volunteering or caregiving was associated with lower suicide risk for those with good mental health at baseline (HR = 0.66: 95%CI = 0.49, 0.88) but not for their peers with baseline poor mental health (HR = 1.02: 95%CI = 0.69, 1.51). Conclusions Although an increased risk of poor mental health was identified amongst caregivers, there was no evidence of an increased risk of suicide.

scholarly journals Self-Reported Mental Health Versus Psychotropic Medication Record as A Predictor of Suicide: A Record Linkage Study

2020 ◽  
Vol 5 (5) ◽  
Author(s):  
Ifeoma N Onyeka ◽  
Aideen Maguire ◽  
Dermot O'Reilly
Keyword(s):  
Mental Health ◽  
Psychotropic Medication ◽  
Regression Models ◽  
Linkage Study ◽  
Poor Mental Health ◽  
Self Report ◽  
Suicide Mortality ◽  
Logistic Regression Models ◽  
Medication Record ◽  
Risk Of Death

IntroductionBoth rates of self-reported mental ill-health and the number of individuals in receipt of psychotropic medications are increasing. Research suggests that poor mental health is a major predictor of death by suicide, but measuring individual level mental ill-health can be difficult. Objectives and ApproachThis study assessed if self-reported mental health, psychotropic medication record, or both in combination better predict risk of death by suicide. Data from the 2011 Northern Ireland Census on all individuals living in the community aged 18-74 years (n=1,098,967) were linked to the Enhanced Prescribing Database (EPD) and death registrations until end of 2015. Mental health status was ascertained through a single-item self-reported mental health question from the Census and record of psychotropic medication in the EPD. Deaths by suicide were identified using ICD-10 codes. Logistic regression models examined the association between measures of mental health and death by suicide, with adjustment for individual attributes known to be associated with mental ill-health. ResultsOf the 1,098,967 individuals, 857 died by suicide during the study period; 0.05% of those with no mental ill-health, 0.21% who self-reported poor mental health, 0.16% of those in receipt of psychotropic medication and 0.38% of those with both. In unadjusted regression models, having both self-report and psychotropic medication record was the strongest predictor of suicide (OR=8.23, 95%CI: 6.97–9.72). Upon adjustment, having both remained the strongest suicide predictor (OR=6.13, 95%CI: 4.94–7.61), followed by psychotropic medication record only (OR=4.00, 95%CI: 3.28–4.88) and self-report only (OR=2.88, 95%CI: 2.16–3.84). Conclusion/ImplicationsIndividuals with both self-reported poor mental health and receipt of psychotropic medication had the highest likelihood of death by suicide. Of the two measures individually, receipt of psychotropic medication was associated with a higher likelihood of suicide mortality. Understanding suicide risk is vitally important for the effective targeting of interventions.

scholarly journals Lifestyle Behaviors and Mental Health of American Adults

2007 ◽  
Vol 100 (1) ◽  
pp. 294-302 ◽  
Author(s):  
Elizabeth H. Chaney ◽  
J. Don Chaney ◽  
Min Qi Wang ◽  
James M. Eddy
Keyword(s):  
Mental Health ◽  
Healthy Lifestyle ◽  
Descriptive Analysis ◽  
Experimental Studies ◽  
Poor Mental Health ◽  
Behavioral Risk ◽  
Lifestyle Behaviors ◽  
Unhealthy Lifestyle ◽  
Data Set ◽  
Health Related

The purpose of this study was to test the hypothesis that individuals reporting healthy lifestyle behaviors would also report better self-rated mental health. Logistic regression analyses were conducted utilizing SUDAAN on the Behavioral Risk Factor Surveillance Survey data set. This descriptive analysis suggests that persons reporting poor mental health were more likely to report unhealthy lifestyle behaviors. This set of findings encourages careful design of experimental studies of empirically based associations of mental health and life style, using psychometrically sound measures. Then public health programs focused on change of health-related behaviors might be more suitably devised.

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