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Title: Shaping mental health services in the community for refugees and elective migrants from former Yugoslavia
Author: Djuretic, Tamara
ISNI:       0000 0004 2693 8611
Awarding Body: Imperial College London
Current Institution: Imperial College London
Date of Award: 2010
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Background Although limited research has been conducted among displaced people it is clear mental health problems are more prevalent than among the general population. To plan services for current and future migrants it is important to establish whether differences in reasons for migration impact on the extent of mental health problems. Null Hypothesis The main hypothesis for this thesis is that there is no significant difference in the prevalence of common mental disorders in refugees compared to elective migrants. Methods A mixed-method research study is conducted in sequential order where a qualitative study gathered detailed and in-depth information to inform the design of a questionnaire employed in a historical cohort study. Findings Refugees are three times more likely to develop CMD than elective migrants (OR 3.0; 95% CI 1.5-6.1) but there is no difference in the severity of the illnesses. Multivariate analyses suggest that factors such as being a refugee and a female (OR 12, 95%CI 1.14 - 123.92), dissatisfaction with current employment (OR 5.56, 95%CI 1.72 - 17.92), dissatisfaction with living conditions 3.53 (1.11 - 11.21) and waiting for longer than a year for a Home Office decision on permission to remain in the United Kingdom 3.27 (1.37 - 7.77) were independent predictors for the common mental disorders among migrants to England from former Yugoslavia. Conclusion Although this study demonstrated a higher long-term prevalence of common mental disorders in asylum seekers and refugees compared to elective migrants it is important to emphasise that many migrants do not have any psychological problems and are economically active making a positive contribution to their host country. However, it is also important to recognise that long-term common mental disorders may be underestimated in previous research among refugee population. It is essential to provide accessible services in primary care settings that are culturally specific and acceptable to this specific population group.
Supervisor: Crawford, Mike Sponsor: Medical Research Council
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral