Mental Health Services among Migrants Danish Perspectives WPA Athens 2005

1
Mental Health Services among MigrantsDanish
Perspectives WPA Athens 2005

• Marianne Kastrup, Uffe Juul Povlsen, Marianne
  Østerskov
• Centre for Transcultural Psychiatry
• Rigshospitalet Copenhagen
• Denmark

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Overview of presentation

• Introduction
• Organization of mental health services
• Community mental health services
• Census survey
• Results
• Implications

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Organization of Services

• Mental health problems
• Primary health care
• G.P. key role in coordination interventions,
  diagnosis and treatment
• Secondary health care
• Psychiatric clinic
• Admissions
• Emergency care
• Community mental health care
• Social psychiatric services
• E.g. workshops, shelters, fountain house

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Psychiatric Services for ImmigrantsPresent
Status

• In some areas 20-30 of patients with other
  ethnic background
• In forensic psychiatry 30-40 of patients with
  other ethnic background
• No explicit mental health policy for immigrants
• Assessment and treatment depend upon immigrant
  status

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Psychiatric Services for Immigrants

• Rigshospitalet Psychiatric Clinic
• Catchment area Inner Nørrebro
• Approx. 25 population with other ethnic
  background
• Community mental health services with a specific
  transcultural multidisciplinary team
• Close collaboration between inpatient, community
  mental health and social psychiatric services

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Census Survey 2004 Community Mental Health
Services

• Information on
• Age and sex
• Marital group
• Migrant status
• Sheltered housing
• Economic situation
• Children under age

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Census Survey 2004Community Mental Health
Services

• Information on
• Diagnostic group (ICD-10)
• Psychosis diagnosis
• Concomitant substance abuse
• (none, present, previous)
• Admissions
• none, last 2 years 1-3 adm. or lt 50 days, last
  2 years ? 4 adm. or ? 50 days, more than 2 years
  ago
• Clinical Global Impression (1-7)
• Global Assessment of Functioning (1-100)

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Assessment of GAF

• 1-10 persistent inability to maintain minimal
  personal hygiene
• 11-20 occasionally fail to maintain minimal
  personal hygiene
• 21-30 inability to function in almost all areas
• 31-40 major impairment in sevral areas
• 41-50 any serious impairment in functioning
• 51-60 moderate difficulty in functioning
• 61-70 some difficulty in functioning
• 71-80 slight impairment in functioning
• 81-90 good functioning in all areas
• 91-100 superior overall functioning

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Assessment of CGI

• 0 not evaluated
• 1 normal
• 2 borderline mental disorder
• 3 mild degree of mental disorder
• 4 moderate degree of mental disorder
• 5 prominent degree of mental disorder
• 6 severe degree of mental disorder
• 7 among the most extreme mentally ill

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Census Survey 2004
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Diagnostic Distribution
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Housing and Children
Statistik Mann-Whitney Test
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Economic Situation
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Age, Sex, CGI, GAF, BMI
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Diagnostic Group and Abuse
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Housing and Children
Statistik Mann-Whitney Test
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Economic Situation
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Antipsychotics
N 261 hereof 90 psychosesdiagnoses