A Cross-National Study of the Role of Neighbourhood Context in the Mental Health of Refugees

邻里环境对难民心理健康影响的跨国研究

• 批准号: MR/S025510/1
• 负责人: Peter Schofield
• 金额: $ 52.35万
• 依托单位: King's College London
• 依托单位国家: 英国
• 项目类别: Research Grant
• 财政年份: 2019
• 资助国家: 英国
• 起止时间: 2019 至 无数据
• 项目状态: 已结题
• 来源: https://gtr.ukri.org/projects?ref=MR%2FS025510%2F1
• 关键词: Cross; National; Study; Role; Neighbourhood

We are in the middle of a global refugee crisis with the number of people forced to flee their country of origin as a result of war or persecution increasing at a faster rate than ever before. This is also a mental health crisis with nearly 1 in 10 refugees reported to be suffering post-traumatic stress disorder. Refugees are also more likely to suffer long term severe mental illness, with rates of disorders such as schizophrenia up three times that of the general population. We already know that migrants in general are at a greater risk of mental disorder, and this has been described by some health experts as a public health tragedy. Refugees are at even greater risk although we know much less about what affects their mental health once they arrive than we do for other types of migrant.However, we do know that the circumstances in which refugees find themselves living can make a difference to their mental health. This is particularly important because, while we cannot alter the traumatic events that caused refugees to flee their home country, we can influence their present circumstances. This does, however, depend on our having a good understanding of what matters for refugee mental health and this is the motivation for the present study. The research will concentrate on the kind of areas in which refugees live and how neighbourhood characteristics might be important for their mental health. This matters because refugees often have little or no control over where they live and, from what we know based on research looking at migrants in general, living in certain types of neighbourhood affects their mental health. A large number of studies have shown that migrants in areas where there are fewer people from their own ethnic background show higher rates of mental disorder. We also know, from studies of the general population, that certain types of neighbourhood; typically, those that are more urban, more deprived and less stable; are associated with poorer mental health. These are often exactly the type of area that refugees find themselves living in. However, no studies until now have looked at how refugees might be affected by the place where they live. The proposed research will investigate this in a number of ways. The first part of the study will use health records collected for all refugees arriving in Denmark as children over roughly a 30-year period. This will be linked to a range of data sources allowing us to build up a picture of how the neighbourhoods in which they are living might influence their mental health. I have chosen Denmark because this is one of the few countries with available data about refugee mental health collected on a large scale over a long time period and previous studies show the effect of neighbourhood on mental health to be similar in Denmark and the UK. Denmark also has a refugee dispersal policy that means refugees are sent to live in a wide variety of different neighbourhoods, as in the UK, the effect of which can then be compared. The second part of the study will look at refugees in the UK, concentrating on one refugee group (from Somalia) in one specific area (Lambeth, South East London). Somalis are one of the largest refugee groups in the UK and this part of the study will examine their experiences looking at the same questions as the Danish study but using much more detailed local data. We will use GP records for all patients in the borough that have also been linked to psychiatric records and census data telling us about the type of area where they live. Health records are limited in what they can tell us about the underlying reasons why where people live effects their mental health. Therefore a third component of the research will involve interviewing Lambeth Somali residents to find out more about how they view their neighbourhood and what they think is important about neighbourhoods for mental health and wellbeing.

我们正处于全球难民危机之中，由于战争或迫害而被迫逃离原籍国的人数比以往任何时候都要快。这也是一场心理健康危机，据报道，近十分之一的难民患有创伤后应激障碍。难民也更有可能患有长期严重的精神疾病，精神分裂症等疾病的发病率是普通人群的三倍。我们已经知道，一般来说，移民患精神障碍的风险更大，一些卫生专家将其描述为公共卫生悲剧。难民面临的风险甚至更大，尽管我们对他们抵达后心理健康受到的影响比其他类型的移民了解得少得多，但我们确实知道，难民所处的环境可能会影响他们的心理健康。这一点特别重要，因为虽然我们无法改变导致难民逃离祖国的创伤性事件，但我们可以影响他们目前的处境。然而，这确实取决于我们对难民心理健康的重要性有很好的了解，这就是本研究的动机。这项研究将集中在难民居住的地区，以及邻里特征对他们的心理健康有何重要意义。这一点很重要，因为难民往往很少或根本无法控制自己的居住地，而且根据我们对一般移民的研究所知，生活在某些类型的社区会影响他们的心理健康。大量研究表明，在本民族人口较少的地区，移民精神障碍的发病率较高。我们还从对一般人群的研究中了解到，某些类型的社区，通常是那些更城市化、更贫困和更不稳定的社区，与更差的心理健康有关。这些往往正是难民发现自己生活的地区。然而，到目前为止，还没有研究探讨难民如何受到他们居住地的影响。拟议的研究将以多种方式对此进行调查。该研究的第一部分将使用在大约30年的时间内收集的所有儿童抵达丹麦的难民的健康记录。这将与一系列数据源相关联，使我们能够了解他们所居住的社区如何影响他们的心理健康。我选择了丹麦，因为这是为数不多的几个国家之一，有关于难民心理健康的数据收集了很长一段时间，以前的研究表明，邻里对心理健康的影响是类似的丹麦和英国。丹麦也有一项难民分散政策，这意味着难民被送到各种不同的社区生活，就像在英国一样，其效果可以进行比较。研究的第二部分将着眼于英国的难民，集中在一个特定地区（兰贝斯，南东伦敦）的一个难民群体（来自索马里）。索马里人是英国最大的难民群体之一，这部分研究将研究他们的经历，研究与丹麦研究相同的问题，但使用更详细的当地数据。我们将使用全科医生记录的所有病人在自治市镇，也已被链接到精神病记录和人口普查数据告诉我们有关类型的地区，他们住。健康记录有限，无法告诉我们人们居住的地方影响他们心理健康的根本原因。因此，研究的第三个组成部分将涉及采访兰贝斯索马里居民，以了解更多关于他们如何看待他们的社区，以及他们认为社区对心理健康和福祉的重要性。

项目成果

Somali refugees in urban neighborhoods: an eco-social study of mental health and wellbeing

城市社区的索马里难民：心理健康和福祉的生态社会研究

• DOI: 10.3389/fpsyt.2024.1307509
• 发表时间: 2024
• 期刊: Frontiers in Psychiatry
• 影响因子: 4.7
• 作者: Ermansons G

Refugee mental health and the role of place in the Global North countries: A scoping review.

• DOI: 10.1016/j.healthplace.2023.102964
• 发表时间: 2023-01
• 期刊: HEALTH & PLACE
• 影响因子: 4.8
• 作者: Ermansons, Guntars;Kienzler, Hanna;Asif, Zara;Schofield, Peter
• 通讯作者: Schofield, Peter

A comparison of neighbourhood level variation and risk factors for affective versus non-affective psychosis.

• DOI: 10.1016/j.schres.2022.05.015
• 发表时间: 2023-06
• 期刊: SCHIZOPHRENIA RESEARCH
• 影响因子: 4.5
• 作者: Schofield, Peter;Horsdal, Henriette Thisted;Das-Munshi, Jayati;Thygesen, Malene;Pedersen, Carsten;Morgan, Craig;Agerbo, Esben
• 通讯作者: Agerbo, Esben