Acute psychiatric care for immigrants

Are admission rates to acute psychiatric care higher for immigrants from non-Western countries than for the traditional Norwegian population?

Immigrants from non-Western countries occupy a fifth of the beds in an acute psychiatric department. There is a prevailing clinical impression that they have higher morbidity than the traditional Norwegian population.

Material. A one-year cohort of patients, n = 415, was retrospectively investigated, 80 of whom had a non-Western background.

Results. The proportion of immigrant patients from the department’s catchment area was 49 in 10 000, compared to 52 in 10 000 for traditional Norwegian patients, p = 0.72. Significantly more of the immigrants were men, they were younger, they got more compulsory treatment, and more often a diagnosis of psychosis, but they had less substance abuse problems. Suicidality was evenly distributed in both groups.

Interpretation. Our clinical impression of a higher frequency of referral of immigrants was not substantiated. However, it is suggested that immigrants have greater difficulties in presenting their psychiatric problems to a general practitioner; hence they probably develop more severe symptoms before referral. The low incidence of referral of female immigrants could indicate a higher level of functioning, or cultural barriers to exhibiting problems.