Canadian Journal of Psychiatry
Volume 52, Issue 5, 2007, Pages 295-304

Use of health care services for psychological distress by immigrants in an urban multicultural milieu (Article) (Open Access)

Kirmayer L.J.* , Weinfeld M. , Burgos G. , Du Fort G.G. , Lasry J.-C. , Young A.
  • a Division of Social and Transcultural Psychiatry, McGill University, Montreal, Que., Canada, Culture and Mental Health Research Unit, Sir Mortimer B Davis-Jewish General Hospital, Montreal, Que., Canada, Institute of Community and Family Psychiatry, 4333 Côte Ste-Catherine Rd, Montreal, Que. H3T 1E4, Canada
  • b Department of Sociology, Canadian Ethnic Studies, McGill University, Montreal, Que., Canada
  • c Department of Sociology, McGill University, Montreal, Que., Canada
  • d Department of Psychiatry, McGill University, Montreal, Que., Canada
  • e Department of Psychology, University of Montreal, Montreal, Que., Canada, Sir Mortimer B Davis-Jewish General Hospital, Montreal, Que., Canada
  • f Department of Social Studies of Medicine, Anthropology, and Psychiatry, McGill University, Montreal, Que., Canada

Abstract

Objective: Research in the United States tends to attribute low rates of use of mental health services by immigrants to economic barriers. The purpose of our study was to examine this issue in the context of Canada's universal health care system. Methods: A survey of the catchment area of a comprehensive clinic in Montreal interviewed random samples of 924 Canadian-born individuals and 776 immigrants born in the Caribbean (n = 264), Vietnam (n = 234), or the Philippines (n = 278) to assess their health care use for somatic symptoms, psychological distress, and recent life events. Results: Overall rates of use of medical services in the past year were similar in immigrant (78.5%) and nonimmigrant (76.5%) groups. Rates of use of health care services for psychological distress were significantly lower among immigrants (5.5% compared with 14.7%, P < 0.001). This difference was attributable both to a lower rate of use of specialty mental health services by immigrants (2.5% compared with 11.7%, P < 0.001) and to differential use of medical services for psychological distress (3.5% compared with 5.8%, P = 0.02). When level of psychological distress was controlled, Vietnamese and Filipino immigrants were one-third as likely as Canadian-born residents to make use of mental health services. The lower rate of use by immigrants could not be explained by differences in sociodemographics, somatic or psychological symptoms, length of stay in Canada, or use of alternative sources of help. Conclusion: Immigrant status is associated with lower rates of use of mental health services, even with universal health insurance. This lower rate of use likely reflects cultural and linguistic barriers to care.

Author Keywords

Mental health service use Caribbean immigrants Vietnamese Filipino Psychological distress Accessibility

Index Keywords

male controlled study ethnic group female distress syndrome immigrant health service socioeconomics health care system mental health service cultural factor Urbanization Article health insurance human adult health survey
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-34248402071&doi=10.1177%2f070674370705200504&partnerID=40&md5=c3ec69f753764440f175abcb6850e801
DOI: 10.1177/070674370705200504
ISSN: 07067437
Cited by: 107
Original Language: English