Immigration and Mental Health Services in the UK

Introduction

The chosen topic for this research study is ‘To examine the relationship between immigration and mental health services’. The topic is significant especially in this time where immigration of foreigners into Europe and particularly the United Kingdom has become common talk. Whereas it is clear that the circumstances under which civilians would flee their homeland is often a source of psychological trauma to some, the medical attention provided at their new places of settlement. Demand for medical attention is needed is bound to increase given that settlement of migrant workers in areas such as Norfolk and Wales is also increasing (George, et al., 2011). In addition, issues such as language barrier, stigma, different religious beliefs and poor documentation of immigrants’ data have negatively affected efforts to increase the mental health of immigrants in the UK (Giacco, et al., 2014). Studies indicate that there are factors that make the provision of mental healthcare complicated for host countries to fully address. To improve the situation recommendations such as improved awareness, collaboration between families and affected communities with the relevant healthcare providers as well as improving the guidelines that dictate healthcare provision to immigrants and asylum seekers coming into the United Kingdom (Giacco, et al., 2014). A recurring suggested solution revolved around using the communities in which immigrants and asylum seekers interact with as the main avenues to ensure better health care for them. As such efforts such as providing interpretation services would address the language barrier whereas clearly outlined care pathways would go a long way in ensuring that immigrants know fully the processes and procedures of British healthcare systems. And finally, given that migration is often a stressful experience to most individuals, given the circumstances that often necessitate the move, a worthy solution would be to provide immigrants with opportunities to flourish in their new environments. Job placements and participation in socio economic activities go a long way in ensuring that that their sense of control over their lives and self-respect is maintained (Bernardes, et al., 2010). Provision of mental health care is particularly important because of the long term effect it has on individuals and family systems at large. Mental health problems cost the UK economy 70-100 billion pounds per year ( The Mental Health Foundation, 2015).

PRIMARY RESEARCH STUDIES

This section of the study required a minimum of four (4) primary research studies that examines the relationship between mental health and immigration, particularly in the UK, as the review in the later section will be based on these primary studies. One of the studies highlights the current challenges faced by immigrants that makes access to good healthcare difficult such as language barrier. It concludes by stating examples of strategies that could be implemented to address the challenges. For example, integration of mental healthcare with primary care (Giacco, et al., 2014)

The second primary study looks at the asylum seekers perspective on their mental health. At one point, participants (asylum seekers) were approached to participate in mental health screening while attending a health clinic (Bernardes, et al., 2010). One of the main aims of the study was to address the gap that exists in literature concerning this topic. Methods used to achieve this included, “investigating the mental health of asylum seekers arrived in the UK using mental health screening”, “investigating asylum seekers’ subjective experiences of the asylum process and its potential impact on their mental health questionnaires” and “reviewing participants’ suggestions for tackling mental health needs, through use of in-depth interviews” (Bernardes, et al., 2010).

Another source (George, et al., 2011) tries to relate the impact of immigrants’ healthcare to public expenditure on the same and whether it is within manageable proportions. One point noted is that by adding to a population, the cost and scope of public services would also increase. However, it further suggests that the effect of immigrants on the total public expenditure should not be based on the total number of immigrants entering the United Kingdom, say in a given year. This is because the whole immigrants’ population varies in terms of age, educational attainment and the specific burden that they impose on the health care system. Such consideration necessitates the need to be more specific in assessing the impact of immigrants towards the total cost of public health care provision in the United Kingdom (George, et al., 2011).

In the last source ( The Mental Health Foundation, 2015) it recognizes that mental health problems in the United Kingdom are indeed preventable and that early diagnosis would go a long way in ensuring that the incidences of people developing mental health problems are greatly reduced.

In these studies, a number of barriers were identified as key to why immigrants and asylum seekers do not have access to the proper mental health care in their new countries of residence. Possible solutions and recommendations were also put across in the study.

MAIN THEMES IN THE STUDIES

Relationship between Mental Health and Immigration

Migrants have been seen to exhibit more signs relating to mental disorders, such as psychosis, mood disorders, anxiety disorders, and particularly posttraumatic stress disorder (Giacco, et al., 2014).A number of factor that are obviously associated with these mental health concerns include migration and post migration stressors, long-term adjustment difficulties in another country, and poor living conditions. With the global immigrant population currently close to 200 million people there is need for targeted healthcare services to be developed so as to care for immigrants and identifying strategies to meet the cultural, religious, and linguistic needs of different immigrant groups.

Underinvestment in the Mental Health Sector

There exists a gap in knowledge of the actual immigration specific health care needs. (George, et al., 2011) Page (ix) states that “Data limitations, in both public expenditure data and migrant data, mean that estimates of migrants‟ impact are limited to our approach of allocation of expenditure pro-rata based on age or age and gender.” As a result, non-conclusive research on the impact of immigrants on public health care expenditure and how to accommodate it one is “unable to take into account the long-term implications of migration and, given that most migrants are young, the eventual demands on personal and health care for older people” (George, et al., 2011)

One of the solutions would be to collect data on a national level pertaining the birth of children in hospitals so as to determine the number of children born to UK immigrants and thus necessary prevention steps concerning mental health problems can be instigated o the onset. Another solution put across relating to health care includes the need to integrate mental health care and physical care. (Giacco, et al., 2014) Page 4 states that “General practitioners and primary care services can promote immigrants’ access to and engagement with mental healthcare, as they care for a large number of such patients and are able to build trusting relationships”. The further study says that individuals (of immigrant status in foreign countries” are more likely to present themselves to medical practitioners due to physical ailments as opposed to mental health problems such as trauma and stress. In America “approaches to integrate mental health and primary care services have shown positive results in immigrant populations. They successfully reduced depressive symptoms in Asian-Americans” (Giacco, et al., 2014) page 5.

Distinction of the Immigrants’ Demographics and associated Needs

To address issues of mental health of any population, migrant or not, one of the studies suggests that “Elective prevention has to take account of people as unique individuals who have different needs at various stages of life and be able to take advantage of different settings or structures that play influential roles at points in time, such as schools, workplace, health and social care services” ( The Mental Health Foundation, 2015) page 4. A separation of the needs of various individuals ensures that they receive the proper health care and in a timely manner. For example by providing care to expectant immigrant women, Maternal perinatal mental health complications can be greatly reduced and therefore emphasizes the need to go deeper and obtain information on family sizes and composition over the localities where immigrants live. Distinction of the immigrants would also lead to the identification of high risk groups or those that show little susceptibility of mental health problems during their stay in the United Kingdom. For example, (George, et al., 2011) page (vii) states that “Migrants who enter the UK on work or study-related visas place very limited demands on this expenditure in absolute terms.”

The role of the Socio economic factors in addressing Mental Health Effects on Immigrants

( The Mental Health Foundation, 2015) Page 2 affirms that “much of mental health is determined by the structures and systems in which people live their lives”. Therefore the socio economic impact of immigrants’ surroundings has a bearing on immigrants’ health and in this case, their mental health. As is often the case, stigmatisation and fear among immigrants especially those in the low income bracket prevents them from seeking medical attention. In the studies of (Bernardes, et al., 2010), asylum seekers alluded that they were hesitant to seek medical attention of any kind during the processing period of their asylum requests out of fear that it may negatively impact their prospects of being granted permission to reside in the UK. In addition, some immigrants feared participation in surveys aimed at collecting data concerning their health concerns due to fear of victimization. As such one can see that the same institutions that deal with immigration policy have a role to play in managing the mental health of immigrants in the UK.

Given the adverse circumstances under which some migrants come to the UK and the obvious adjustments required for one to live in a foreign country, the society can play a role in ensuring a smooth transition. Recognition in the labour market and a source of income are but a few examples of ways that immigrants can be able to gain independence, provide for their families and maintain their dignity (Bernardes, et al., 2010). The net benefits of an inclusive immigration policy are positive and aim towards the growth of the economy as a result of the contribution of immigrants (George, et al., 2011).

The training of mental health practitioners on beliefs and cultures of some immigrants and the need to integrate them in the conventional ways of mental healthcare provision would go a long way in ensuring that the specific needs of certain immigrant groups are adequately met when they seek medical attention in public health care facilities ( The Mental Health Foundation, 2015).

RESEARCH NEEDED

Analysis of the four primary studies has shown that immigration effects would always increase. There is thus need to address their specific needs. Whereas most acknowledge the presence of data bases relating to immigrants, there is a deficit of specific data relating to unique demographic markers of the immigrant population. For example, data relating to immigrant women seeking maternal health care which would benefit public health care system by giving it projections on the future demand of heath care and in this case, mental health care of immigrants living in the UK (George, et al., 2011).

RESEARCH QUESTION

After reviewing the information provided after looking through the primary studies, I found the following research question suitable:

• How would the collection of demographic-specific data help in addressing the mental health needs of migrants in the United Kingdom as well as project their future needs?

My preference is to survey on the number of adults in the UK born to immigrants

METHODOLOGY

This section explains the approach that this researcher will start to design a research study to answer the research questions developed. Primary data would be the sole source of data. Primary data can be defined as “information that is collected first-hand, generated by original research tailored-made to answer specific research questions.” While, secondary data can be explained as “information that has already been collected for other purposes and thus is readily available. The use of primary data would require the researcher’s interpretation of the data in relation to the subject matter. While the method’s effectiveness is dependent on the researchers’ ability to draw relevant conclusions from the data, its use is advantageous over the use of secondary data because of inaccuracies of information presented in them.

The population group I was interested in studying based on my research question is the would comprise of university students (aged above 18 years old) which would have a require the carrying out of surveys number would be extremely helpful to have data on the place of birth of parents in major surveys in order to be able to identify adults who were born in the UK to migrants.

DATA COLLECTION METHODS

There are important differences between qualitative and quantitative research, quantitative research have large sample while qualitative have small, quantitative research are also descriptive and qualitative is investigative, and the objective of quantitative research is to quantify the data and generalize the results from the sample to the population of interest (Anon., 2017)

Questionnaires would form part of the quantitative data. Expected outcomes of the questionnaires would include the year of birth, whether the parents are still residing in the country etc.

The data collection that will be used and most appropriate to achieve the research questions is quantitative research. It will be in the form of a questionnaire that will be given to participants who study in the institution and understand the impact immigrants are having on mental health services on the country as a whole. In addition, given the research question I am addressing one would expect that as the share of this group increases in the population, this will be of considerable research and policy interest going forward (George, et al., 2011).

JUSTIFICATION OF THE METHOD USED

There are various benefits associated with using quantitative research and using questionnaire as a source of data collection. Quantitative research will enable this researcher to measure and analyse the data, this approach will also help the researcher to study the relationship between an independent and dependent variable in detail.

RESEARCH POPULATION AND SAMPLE

A research population is defined as a large collection of individuals that are the main focus of scientific query and a sample is defined as a separation of the population. Target population is the main group of people from which we choose a sample and use this population for our research. The population for this research will be young adults and those that use higher education facilities but the sample will come mainly from those who participate in the survey are those born in the UK whose parents are immigrants and this is because as stated earlier one would expect that as the share of this group increases in the population, this will be of considerable research and policy interest going forward (George, et al., 2011).

CONCLUSION

The issue of immigration is a dynamic issue that needs specific measures put in place to address the unique challenges it brings especially concerning the mental health of immigrants residing in the United Kingdom. As suggested by (George, et al., 2011) “Integrating mental healthcare with physical healthcare can help to engage immigrants” and bridge the gap between a thriving physical healthcare system and a mental health care system that does not meet all the needs of immigrants. There is also need to improve the collaboration between “immigrants specific” organizations and public mental health care facilities that would improve on synergy and minimize overlap of activities meant to help the same population (Giacco, et al., 2014).

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REFERENCES

• The Mental Health Foundation, 2015. Prevention Review: Landscape Paper, s.l.: s.n.
• Anon., 2017. Atlasti. [Online] Available at: https://atlasti.com/quantitative-vs-qualitative-research/ [Accessed February 2017].
• Bernardes, D. et al., 2010. Asylum Seekers’ Perspectives on their Mental Health and Views on Health and Social Services: Contributions for Service Provision Using a Mixed-Methods Approach , s.l.: s.n.
• George, A., Meadows, P. & Rolfe, H. M. a. H., 2011. Impact of migration on the consumption of education and children’s services and the consumption of health services, social care and social services, London: s.n.
• Giacco, D., Matanov, A. & Priebe, S., 2014. Providing mental healthcare to immigrants: current, s.l.: s.n.

APPENDICES

Approach to conducting literature review

By reading material on Immigrants currently residing in the United Kingdom and the need of the Public Health sector to address their needs I gained interest in furthering my knowledge on the topic. I narrowed down to mental health because I viewed it as a major health concern of immigrants. This is due to the circumstances under which most of them leave their home countries, the hustle of adjusting to a new environment and the often lack of knowledge (or assistance by their local community) and processes required before immigrants and asylum seekers can access proper health care.

I proceeded to search for “mental health in the United Kingdom” and “implication of immigrants on the healthcare sector”. I was able to get helpful primary studies on the subject. In the findings I discovered common themes revolving around the issue such as the current situation of mental health care of immigrants as well as recommendations aimed at improving it. These items I have discussed in my submission.