Research suggests that first generation migrants are at greater risk of mental ill health in comparison to the settled population. Estimating the risk of mental ill-health among migrants and gaining an understanding of the factors which impact upon migrant mental health will facilitate the identification of vulnerable individuals and groups and, in turn, enable improved public health responses to suit the needs of the population.

Reviews of investigations of the mental health of migrants have been conducted in different countries and adjusted for different factors. We conducted a review of such reviews to evaluate and summarise the current evidence from systematic reviews on the prevalence and risk of mental ill-health in first generation migrants as well as potential explanatory factors. Our study was a review of existing systematic reviews. Scientific databases were searched for systematic reviews (inception-November 2015) which provided quantitative data on the mental ill-health of first generation migrants and associated risk factors. Two reviewers screened titles, abstracts and full text papers for their suitability against pre-specified criteria, and methodological quality was assessed. This study was conducted within the of the Administrative Data Research Centre for Northern Ireland working in partnership with NISRA and BSO to utilise administrative data to conduct research into migrant mental health in comparison to the settled population.

This review of reviews focused on first generation migrants mental health and factors which have a negative impact on migrant mental health. Depression was mostly higher in first generation migrants in general, and in refugees/ asylum seekers when analysed separately. However, for both groups there was wide variation in prevalence rates, from 5 to 44 % compared with prevalence rates of 8–12 % in the general population. Post-Traumatic Stress Disorder prevalence was higher for both first generation migrants in general and for refugees/asylum seekers compared with the settled majority. Post-Traumatic Stress Disorder prevalence in first generation migrants in general and refugees/ asylum seekers ranged from 9 to 36 % compared with reported prevalence rates of 1–2 % in the general population. A visualisation of the prevalence of depression in first generation migrations compared to that of the general settled population is below.

Few studies presented anxiety prevalence rates in first generation migrants and there was wide variation in those that did, as indicated in the figure below. Prevalence ranged from 4 to 40 % compared with reported prevalence of 5 % in the general population. Two reviews assessed the psychotic disorder risk, reporting this was two to three times more likely in adult first generation migrants. However, one review on the risk of schizophrenia in refugees reported similar prevalence rates (2 %) to estimates of prevalence among the settled majority (3 %). Risk factors for mental ill-health included low Gross National Product in the host country, downward social mobility, country of origin, and host country.

Our recommendations

First generation migrants may be at increased risk of mental illness and public health policy must account for this and influencing factors. High quality research in the area is urgently needed as is the use of culturally specific validated measurement tools for assessing migrant mental health.

Sharing our findings

Detailed information can be read in this peer reviewed paper: Close, C., Kouvonen, A., Bosqui, T., Patel, K., O'Reilly, D., & Donnelly, M. (2016). The mental health and wellbeing of first generation migrants: a systematic-narrative review of reviews. Globalization and Health, 12, [47]. https://doi.org/10.1186/s12992-016-0187-3 . A pre-print is also available here.

We have also presented our findings at several conferences, such as p. 73 in this text: Royal College of Nursing. 2016. RCN international nursing research conference 2016. Wednesday 6-8 April, Edinburgh (Book of Abstracts available here).

Our findings have been used in the development of a research project to use administrative data to research migrant mental health. The findings have also been referenced in 2 policy documents:

• World Health Organization. Regional Office for Europe. (‎2018)‎. Report on the health of refugees and migrants in the WHO European Region: No public health without refugees and migrant health. World Health Organization. Regional Office for Europe (available here).
• World Health Organization, 2017. Health of Migrants: Resettling the Agenda. Report of the 2nd Global Consultation. Columbia, Sri Lanka (available here).

Dr Ciara Close

School of Psychology

Media

Recommended reference for this page:

Close, C. 2021. The mental health and wellbeing of first generation migrants: a systematic-narrative review of reviews. Blog for Queen's on Ethnic Minorities in Northern Ireland.