Risk and protective factors for common mental disorders among populations during migration. A pilot cohort study among migrants and asylum seekers in Mexico

流动人口中常见精神障碍的危险因素及保护因素

• 批准号: 10730324
• 负责人: Martha Claire Greene
• 金额: $ 62.68万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-08-14 至 2026-08-13
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10730324
• 关键词: Address; Adolescent; Adult; Area; Capital; Caribbean region; Child; Cities; Climate; Cohort Studies; Collaborations; Communities; Complex; Country; Data; Data Analyses; Data Collection; Destinations; Development; Distress; Economics; Emergency Situation; Employment Opportunities; Enrollment; Epidemiology; Ethics; Face; Family; Generalized Anxiety Disorder; Goals; Health; Human; Human Rights; Incidence; Individual; Intention; International; Intervention; Investigation; Latin America; Legal; Legal Status; Literature; Location; Longitudinal Studies; Longitudinal cohort; Major Depressive Disorder; Measures; Mental Health; Mental disorders; Methods; Mexico; Migrant; Monitor; National Institute of Mental Health; Natural History; Outcome; Participant; Phase; Policies; Population; Post-Traumatic Stress Disorders; Preparation; Prevalence; Prevention; Procedures; Prospective cohort; Prospective, cohort study; Psychosocial Assessment and Care; Public Health; Research; Resources; Risk; Risk Factors; Risk Reduction; Safety; Sampling Studies; Services; Shelter facility; Social Protection; Specific qualifier value; Symptoms; Time; Underrepresented Populations; United States National Institutes of Health; Universities; Violence; Woman; Work; acceptability and feasibility; data quality; design; displaced person; experience; follow-up; gender-based violence; improved; innovation; insight; interest; member; men; mental disorder prevention; migration; modifiable risk; novel; population migration; prevent; preventive intervention; programs; protective factors; psychologic; recruit; response; retention rate; risk mitigation; service utilization; social; social determinants; structural determinants; traumatic event; violence prevention

PROJECT SUMMARY Forced displacement has reached unprecedented levels and is becoming increasingly protracted with over 75% of the estimated 100 million displaced persons globally expected to live in exile for over five years. Latin America has experienced the greatest proportional increase in forced displacement across international borders since 2017. Due to delays in processing asylum applications and policies permitting the widespread expulsion of migrants and asylum seekers, many migrants and displaced persons are temporarily residing in northern Mexico near the US border awaiting safety and more durable solutions in another destination. Displaced populations face significant adversity, human rights violations, and potentially traumatic events that increase their risk for common mental disorders (CMDs) during their migration journey. The point prevalence of CMDs is more than three times higher in displaced populations relative to global averages. Despite this elevated burden, migrants without legal status in the transit or destination country face significant barriers in accessing basic needs and services, further contributing to distress and the risk of CMDs. Most available data on mental health among migrants is cross-sectional due to practical and ethical challenges following mobile populations over time. Longitudinal data are needed to identify modifiable risk and protective factors that could serve as targets for CMD prevention interventions in this population. Our study team, which represents an established academic-humanitarian partnership, has expertise conducting mental health research among displaced populations and providing community-based mental health and psychosocial support to these communities, including in Mexico. We aim to further this partnership by piloting feasible, effective, and ethical strategies for recruiting and retaining a prospective cohort of 300 migrants in transit to clarify the factors that contribute to prevention of CMDs. Using data from this cohort this study aims to: 1) identify risk and protective factors for CMDs; 2) Estimate the short-term effect of economic services, social protection, legal assistance, and mental health interventions on reducing the risk of CMDs; and 3) evaluate the feasibility and acceptability of conducting a fully powered prospective cohort study of migrants in transit in Mexico followed over three years. This research is the first longitudinal investigation of mental health among migrants in transit, including underrepresented groups (women, children, separated families), and will innovatively measure the impact of multisectoral services on mental health outcomes among migrants during this critical phase of migration. Results from this study will provide critical and novel insights into the epidemiology of CMDs and will enable the development of targeted and efficient strategies to reduce the incidence of CMDs among migrants in transit in humanitarian emergencies.

项目摘要 强迫流离失所已达到前所未有的程度，而且随着人口的增加， 在全球1亿流离失所者中，75%的人预计将流亡五年以上。拉丁 美国在国际上被迫流离失所的比例增加最大。 自2017年以来的边界。由于处理庇护申请的拖延和政策允许广泛的 由于驱逐移民和寻求庇护者，许多移民和流离失所者暂时居住在 靠近美国边境的北方墨西哥，在另一个目的地等待安全和更持久的解决方案。 流离失所人口面临着重大的逆境、侵犯人权行为和潜在的创伤性事件， 增加了他们在移民过程中患上常见精神疾病的风险。时点患病率 相对于全球平均水平，流离失所人口的CMD高出三倍以上。尽管如此 由于负担加重，在过境国或目的地国没有法律的地位的移徙者在以下方面面临重大障碍： 获得基本需求和服务，进一步加剧了痛苦和CMD的风险。现有数据 由于在移动的人口流动之后的实际和道德挑战， 人口随着时间的推移。需要纵向数据来确定可改变的风险和保护因素， 作为该人群中CMD预防干预的目标。我们的研究小组，代表了一个 建立了学术-人道主义伙伴关系，拥有在以下群体中开展心理健康研究的专门知识： 为流离失所者提供心理健康和社会心理支持， 社区，包括墨西哥。我们的目标是通过试点可行的，有效的和道德的进一步合作伙伴关系， 招募和留住预期的300名过境移徙者的战略，以澄清 有助于预防CMD。使用该队列的数据，本研究旨在：1）识别风险和保护性 （2）估计经济服务、社会保障、法律的援助、 评估干预措施的可行性和可接受性 对墨西哥过境移民进行了一项全面的前瞻性队列研究， 年这项研究是第一次对过境流动人口的心理健康进行纵向调查，包括 代表性不足的群体（妇女、儿童、离散家庭），并将创新地衡量 在移徙的这一关键阶段，为移徙者提供多部门心理健康服务。 这项研究的结果将为CMD的流行病学提供关键和新颖的见解，并将使 制定有针对性的有效战略，减少过境移民中的CMD发病率 人道主义紧急情况。