Mental health and undocumented migrants in Portugal
Journal of Public Mental Health
ISSN: 1746-5729
Article publication date: 17 October 2018
Issue publication date: 22 November 2018
Abstract
Purpose
While awaiting resolution of their legal process, undocumented migrants (UM) face several challenges, including limited access to public health care. The purpose of this paper is to survey UM attending a detention centre in Oporto (Portugal) to estimate the prevalence of mental health disorders in this population.
Design/methodology/approach
A retrospective chart review was performed with the relevant sociodemographic and clinical data of all UM in the process of coercive removal from Portuguese territory, observed by Doctors of the World, during three years (2014–2016). The Tenth Version of International Classification of Mental and Behavioural Disorders was used for nosological classification.
Findings
In total, 393 detainees were eligible for the study. Most detainees were male (84 per cent) and 76 months was the mean length of stay in Portugal before detention. In total, 29 per cent of detainees were diagnosed with a mental and behavioural disorder. The most prevalent diagnosis was neurotic, stress-related and somatoform disorders (47 per cent). UM with dual diagnosis (28 per cent) led to the articulation with the integrated centres of drug addiction, which provided and monitored opioid substitution therapy. Female UM were more prone to develop any mental and behavioural disorder when compared to men (χ2=7,017; p<0.05).
Research limitations/implications
In total, 9 per cent of the detainees were excluded from this study due to incomplete data on their medical charts. Some detainees presented oppositional behaviour, hostility towards others and refused to be assessed by the medical team. Both situations could have biased the prevalence of mental disorders. Finally, the appropriateness of the western model of mental health disorders (ICD-10) in the study population is controversial, considering the culture-bound phenomenology and syndromes.
Originality/value
This paper identified the most prevalent mental health disorders in UM detained in Portugal. The most prevalent mental health disorders were either stress-related (associated with the detention itself) or related to previous patterns of substance abuse. Given the study outcomes, it is highly recommended to mobilise human and technical resources to provide specialized mental health care to UM at least while detention policies could not be changed.
Keywords
Acknowledgements
This work has been informed by the input of a wide range of health professionals from across medical and social sciences. The authors wish to acknowledge all the volunteers of the DW team, who put much personal effort and scientific skills on this project. It was thanks to their commitment that this work was possible. Dr Jeffrey Patterson, who was also an undocumented migrant in the past, and Miss Eve Bayram deserve a special mention, for the English revision of the manuscript.
Citation
Santos, G., Soares, C., Rebelo, R. and Ferreira, P. (2018), "Mental health and undocumented migrants in Portugal", Journal of Public Mental Health, Vol. 17 No. 4, pp. 200-209. https://doi.org/10.1108/JPMH-11-2017-0039
Publisher
:Emerald Publishing Limited
Copyright © 2018, Emerald Publishing Limited