Mental Health and Service Use of Migrants in Contact with the Public Psychiatry System in Paris

Andrea Tortelli, Florence Perquier, Maria Melchior, François Lair, Fabien Encatassamy, Chloé Masson, Hélène K’ourio, Raphaël Gourevitch and Alain Mercuel
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Andrea Tortelli: Pôle Psychiatrie Précarité, Groupe Hospitalier Universitaire Paris Psychiatrie & Neurosciences, 75014 Paris, France
Florence Perquier: Departement d’Epidémiologie, Groupe Hospitalier Universitaire Paris Psychiatrie & Neurosciences, 75014 Paris, France
Maria Melchior: Pierre Louis Institute for Epidemiology and Public Health (IPLESP/INSERM UMR_S 1136), 75012 Paris, France
François Lair: Pôle Psychiatrie Précarité, Groupe Hospitalier Universitaire Paris Psychiatrie & Neurosciences, 75014 Paris, France
Fabien Encatassamy: CPOA: Centre Psychiatrique d’Orientation et d’Accueil, Hôpital Sainte-Anne, Groupe Hospitalier Universitaire Paris Psychiatrie & Neurosciences-1, rue Cabanis, F-75014 Paris, France
Chloé Masson: Pôle Psychiatrie Précarité, Groupe Hospitalier Universitaire Paris Psychiatrie & Neurosciences, 75014 Paris, France
Hélène K’ourio: CPOA: Centre Psychiatrique d’Orientation et d’Accueil, Hôpital Sainte-Anne, Groupe Hospitalier Universitaire Paris Psychiatrie & Neurosciences-1, rue Cabanis, F-75014 Paris, France
Raphaël Gourevitch: CPOA: Centre Psychiatrique d’Orientation et d’Accueil, Hôpital Sainte-Anne, Groupe Hospitalier Universitaire Paris Psychiatrie & Neurosciences-1, rue Cabanis, F-75014 Paris, France
Alain Mercuel: Pôle Psychiatrie Précarité, Groupe Hospitalier Universitaire Paris Psychiatrie & Neurosciences, 75014 Paris, France

IJERPH, 2020, vol. 17, issue 24, 1-11

Abstract: Background: Migrants, and particularly asylum seekers, are at increased risk of psychiatric disorders in comparison with natives. At the same time, inequalities in access to mental health care are observed. Methods: In order to evaluate whether the Parisian public psychiatric system is optimally structured to meet the needs of this population, we examined data on mental health and service use considering three different levels: the global system treatment level, a psychiatric reception center, and mobile teams specializing in access to psychiatric care for asylum seekers. Results: We found higher treatment rates among migrants than among natives ( p < 0.001) but inequalities in pathways to care: more mandatory admissions (OR = 1.36, 95% CI: 1.02–1.80) and fewer specialized consultations (OR = 0.56, 95% CI: 0.38–0.81). We observed a mismatch between increased need and provision of care among migrants without stable housing or seeking asylum. Conclusions: Inequalities in the provision of care for migrants are observed in the Parisian public psychiatric system, particularly for those experiencing poor social and economic conditions. There is a need to facilitate access to mental health care and develop more tailored interventions to reduce discontinuity of care.

Keywords: migrants; mental health; mental health care provision; asylum seekers; vulnerable groups (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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