Mental health service use among migrant and Swedish-born children and youth: a register-based cohort study of 472,129 individuals in Stockholm.

Publisher: Springer International Country of Publication: Germany NLM ID: 8804358 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1433-9285 (Electronic) Linking ISSN: 09337954 NLM ISO Abbreviation: Soc Psychiatry Psychiatr Epidemiol Subsets: MEDLINE

Original Publication: [Berlin] : Springer International, [c1988-

Mental Health Services* ; Refugees* ; Transients and Migrants*; Adolescent ; Child ; Cohort Studies ; Humans ; Sweden/epidemiology

Purpose: Migrant children underutilize mental health services (MHS), but differences according to age, reason for migration, type of problem, and time have not been thoroughly analyzed. We aimed to explore utilization of MHS among migrant children and youth and to study if the hypothesized lower utilization could be explained by fewer neurodevelopmental assessments.
Methods: A cohort of the population aged 0-24 years in Stockholm, comprising 472,129 individuals were followed for maximum 10 years, between January 1, 2006 and December 31, 2015. We categorized individuals as accompanied refugee migrants, unaccompanied refugee migrants and non-refugee migrants, or Swedish-born. We used survival and logistic analyses to estimate rates of utilization of MHS.
Results: Migrant children and youth utilized less MHS than the majority population, with hazard ratios ranging from 0.62 (95% CI: 0.57; 0.67) to 0.72 (95% CI: 0.69; 0.76). Refugee and non-refugee children utilized less mental health care than their Swedish peers, apart from the youngest refugees (0-10 years) who had similar utilization as Swedish-born. The lower rates were partly explained by all migrant youths' lower risk of being diagnosed with a neurodevelopmental condition. Time in Sweden had a major impact, such that unaccompanied refugee minors had a higher utilization in their first 2 years in Sweden (OR: 3.39, 95% CI: 2.96; 3.85).
Conclusion: Migrant youth use less MHS compared with native-born peers, and this is partly explained by fewer neurodevelopmental diagnoses. Strengthening the awareness about unmet needs, and the referring capacity by professionals in contact with migrant children could help reduce barriers to care.
(© 2021. The Author(s).)

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2016-00870 Forskningsrådet om Hälsa, Arbetsliv och Välfärd; 523-2010-1052 Vetenskapsrådet

Keywords: Child and adolescent health; Health services utilization; Mental health and psychiatry; Migrants; Refugees

Date Created: 20210728 Date Completed: 20220118 Latest Revision: 20220218

20240829

PMC8761127

10.1007/s00127-021-02145-2

34319406