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

项目总结 强迫流离失所已经达到了前所未有的水平，并且正变得越来越持久， 全球估计有1亿流离失所者，其中75%的人预计将流亡五年以上。拉丁语 美国经历了国际上被迫流离失所的最大比例增长。 自2017年以来的边界。由于在处理庇护申请方面的延误，以及允许广泛 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 墨西哥北部靠近美国边境，在另一个目的地等待安全和更持久的解决方案。 流离失所的人口面临严重的逆境、侵犯人权和潜在的创伤性事件 增加他们在迁徙过程中患常见精神障碍(CMD)的风险。时点流行率 相对于全球平均水平，流离失所人口的CMDS高出三倍多。尽管如此 负担加重，在过境国或目的地国没有合法身份的移民在以下方面面临重大障碍 获得基本需求和服务，进一步增加了慢性精神疾病的痛苦和风险。最可用的数据 由于流动人口带来的实际和道德挑战，关于流动人口心理健康的研究是跨部门的 随着时间的推移种群数量。需要纵向数据来确定可修改的风险和保护因素，这些因素可能 在这一人群中作为CMD预防干预的目标。我们的研究团队，代表着一个 建立学术-人道主义合作伙伴关系，拥有开展心理健康研究的专业知识 并为这些人提供社区心理健康和心理社会支持 社区，包括在墨西哥。我们的目标是通过试行可行、有效和合乎道德的方式来促进这种伙伴关系 招募和保留300名过境移民预期队列的战略，以澄清以下因素 有助于预防慢性精神疾病。使用来自该队列的数据，本研究的目的是：1)识别风险和保护措施 CMD的因素；2)估计经济服务、社会保护、法律援助、 和心理健康干预，以降低慢性精神疾病的风险；以及3)评估可行性和可接受性 对在墨西哥过境的移民进行了一项全面的前瞻性队列研究 好几年了。这项研究是第一次对过境移民的心理健康进行纵向调查，包括 代表不足的群体(妇女、儿童、离散家庭)，并将创新性地衡量 在移徙的这一关键阶段，提供关于移徙者心理健康结果的多部门服务。 这项研究的结果将为慢性精神分裂症的流行病学提供关键和新的见解，并将使 制定有针对性和有效的战略，以减少过境移民中慢性精神疾病的发病率 在人道主义紧急情况下。

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.