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Women’s Health Academic Centre
Impact of migration and stressful life events on women’s mental health
Laura Nellums MSc, PhD Student
Dr Stephani Hatch :: Prof. Louise M. Howard
Section for Women’s Mental Health, Health Service and Population Research Department
Institute of Psychiatry, King’s College London
[email protected]
Funding: National Institute for Health Research Biomedical Research Centre for Mental Health at South London and Maudsley NHS
Foundation Trust and Institute of Psychiatry, King’s College London / ORS Award / King’s International Graduate Scholarship.
Background
• 4.5 million migrants in UK; 3 million in
London
• No consensus on relationship between
migration and mental health
• Some migrant women may be at
increased risk of poor mental health
outcomes
• Limited research on predictors of poor
mental health for migrant women
Migrant Population in Southwark and Lambeth
Aim:
• Investigate impact of migration and stressful life events on risk
of high levels of psychological symptoms for women living in
South East London
Hypothesis:
Study setting
• Women interviewed in South East
London Community Health Study
(SELCoH Study)1, a cross-sectional
survey of individuals living in South East
London, identified through random
sampling
• South East London ethnically diverse;
immigrants comprise 30% of the
population
Risk factors for high levels of psychological symptoms (n=755)
• Immigrant women are more likely to experience high levels of
psychological symptoms than women born in the UK
Methods:
• Study population: first generation immigrant women and women
born in the UK who participated in the SELCoH Study
• Data: SELCoH Study
• Outcome measure: high levels of psychological symptoms
(Clinical Interview Schedule – Revised Version, cut off 12; 4 item
Post Traumatic Stress Disorder screen, cut off 3)
Results:
Characteristics of sample:
• Sample size 944: 553 women born in the UK, 391 immigrant
women.
• High prevalence of psychological symptoms in sample: 28.9%
[95% CI: 26.0 – 32.1]
• High prevalence of stressful life events e.g. (potentially traumatic
lifetime events: immigrant women 66.5% [95% CI 61.4 – 71.3];
women born in the UK 71.4% [95% CI 67.2 – 75.2]
Multivariate analysis:
• No difference in mental health outcomes between immigrant
women and women born in the UK [AOR: 1.0 [95% CI: 0.7 –
1.6].
• Stressful life events increased risk; social resources protective
Risk factors for high levels of psychological symptoms (n=732)
* p<.05 ** p<.01 *** p<.001
Exploratory analyses
Aims and measures:
Investigate differences in risk between immigrant women and
women born in the UK due to macro-level factors in immigrant
women’s countries of origin measured using:
• UN Inequality-adjusted Human Development Index (IHDI)
• UN Gender Inequality Index (GII)
Results
• Women from medium IHDI level countries (including countries
in Asia, Central and South America, and Africa) suggested to
be twice as likely as women born in the UK to experience high
levels of psychological symptoms.
• GII not associated with psychological symptoms.
Aims and measures:
Investigate differences in risk among immigrant women due to
individual level migration specific factors:
• Reason for migration (a better life, family or partner, asylum)
• Level of acculturation (years in UK, age at arrival in UK, English
as a first language)
Results:
• Reason for migration and level of association not associated
with psychological symptoms
Conclusions:
• Research and services should acknowledge: immigrant populations are heterogeneous; ecological model needed (e.g. migration
specific factors, stressful life events, social resources)
• Further research (e.g. qualitative) needed on risk factors for poor mental health among migrant women
1SELCoH
Study: http://www.slam.nhs. uk/about-us/biomedical-research-centre/about-the-brc/core-facilities/south-east-london-community-health-(selcoh)-survey.aspx
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