Psychopathology and resident status – comparing asylum seekers, refugees, illegal migrants, labor migrants, and residents

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Abstract

Purpose

This study aimed to describe, compare, and predict mental health outcomes of different migrant groups and native residents in Switzerland.

Subjects and methods

Asylum seekers (n = 65); refugees holding permanent protection visas (n = 34); illegal migrants (n = 21); labor migrants (n = 26); and residents (n = 56) completed an assessment by questionnaire. Main outcome variables were symptoms of posttraumatic stress, anxiety and depression. It was tested whether resident status predicted psychopathology over and above the influence of control variables including social desirability, traumatic event types and post-migration resources.

Results

Asylum seekers (54.0%) and refugees (41.4%) fulfilled criteria of PTSD most frequently. Clinically relevant symptoms of anxiety and depression were most frequently reported by asylum seekers (84.6% and 63.1%, resp.) and illegal migrants (both 47.6%). Resident status contributed to psychopathology over and above the influence of control variables.

Conclusions

Overall, asylum seekers, refugees, and illegal migrants showed high psychiatric morbidity. Differences in resident status appear to be specifically associated with mental health outcomes. This association persists even when controlling for social desirability, post-migration resources and traumatic events. This emphasizes the importance of current socio-political living conditions for mental health, even with respect to the psychopathological sequelae of past traumatic experiences.

Introduction

Generally speaking, the term ‘migrant’ applies to all persons having left their home country either due to ‘push’ factors in the country of origin (i.e. asylum seekers and refugees; 1) or due to ‘pull’ factors of the immigration country (i.e. economic incentives, as in the case of labor migrants). Illegal migrants may be found in both groups. As Carta et al. [2] state, it is not possible to consider migrants as one homogeneous group, as conditions of migration differ widely, e.g. with regard to motivation for migration, distance from home and residence status.

With respect to migrants' mental health, high rates of psychiatric morbidity and mental health problems have been consistently reported. Asylum seekers and refugees in particular were found to suffer from symptoms of posttraumatic stress, depression and anxiety (e.g. [3], [4], [5]). Several studies report associations of psychopathology not only with traumatic experiences prior to migration but also with the living situation in exile [5], [6], [7]. Less is known about the mental health of labor migrants and illegal migrants. According to a recent meta-analysis [8], labor migrants appear to suffer less depression and anxiety as compared to refugees, but the authors point out that many of the included studies did not consider the duration of stay in the immigrant nation, which may contribute to variations in symptoms. Regarding illegal migrants, a lack of knowledge about their mental health is reported [9].

Whereas isolated comparisons of different migrant groups have been conducted, these results cannot be merged into an overall picture of migrant mental health: Comparisons between different studies are hindered by methodological differences as well as inequalities in socio-political and economical characteristics of immigrant nations [8], [9]. There is a lack of studies comparing the mental health of different groups of migrants including illegal migrants to that of residents and identifying different migrant conditions specifically associated with mental health problems. Moreover, existing studies are frequently limited by methodological shortcomings such as disregard of length of residency in the immigrant nation or failure to consider differential exposure to violence and other traumatic events in the nation of origin [8].

This study aimed to describe, compare, and predict mental health outcomes in four different migrant groups and in residents in Switzerland. For the assessment of mental health, a multifaceted approach considering general as well as trauma-specific markers of psychopathology was chosen. In order to overcome shortcomings of previous studies, variables such as length of stay in the receiving country or post-migration resources, trauma history, and potentially confounding variables such as social desirability were considered.

Section snippets

Participants and procedure

Five groups of subjects residing in the Swiss canton of Zurich were recruited for assessment: (1) Asylum seekers (AS; n = 65) still waiting for their claim to be processed and living in asylum centers at the time of assessment; (2) refugees (RE; n = 34) whose claims for asylum had been accepted and who now held permanent resident visas; (3) illegal migrants (IM; n = 21) having entered Switzerland without visas and living in illegality at the time of assessment. Former asylum seekers whose claims had

Demographic characteristics

Demographic variables are summarized in Table 1. 52.0% of all participants were females, without between-group differences. About half of the participants were married, with RE being married more frequently than AS, IM and SR. AS were less frequently employed than all other groups and SR more frequently. RE, IM and LM did not differ in employment status. The mean length of education was 10.8 years, without significant between-group differences. AS and RE more frequently originated from Asia

Discussion

This study described psychopathological outcomes and their predictors in four different migrant groups and Swiss residents. In order to overcome shortcomings of previous research, all migrant groups were assessed simultaneously in the scope of the same study. Moreover, migrant groups included those who had rarely been examined up to this point (i.e. illegal migrants and labor migrants). Trauma-specific as well as trauma-unspecific psychopathology was assessed, and factors such as length of

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