People who have migrated to a country from their homeland are much more vulnerable to mental illness. Between 1993 and 2014 the foreign-born population in the UK more than doubled from 3.8 million to around 8.3 million. Studies carried out in various countries have long indicated that migrants often have higher rates of mental illness that either the native-born people or the population of their country of origin.
Immigrants have much higher rates of schizophrenia for example, possibly due to their increased sense of alienation and vulnerability in society. They may suffer from depression, and PTSD, particularly if they are asylum seekers and victims of torture.
Adapting to a new culture brings its own issues. If newcomers don’t speak the language, they don’t know how to access services. They are afraid to approach people in positions of authority because often their status is very precarious.
Many will not be registered with a GP and their symptoms may go undiagnosed.
In recent years there has been a concerted effort by organisations, such as Mind, to highlight the growing concerns that have arisen within the Black and minority ethnic communities regarding racism within the mental health system.
Amnesty International has also flagged up what it sees as institutionalised exacerbation of the problem. In 2015, 32,400 people entered immigration detention compared to approximately 30,4000 in 2014.
Incarceration at these centres can damage mental health further. Studies show that for those who have already been tortured, the damage is massive and long-term.
Older immigrant people, who may have lived in the UK for decades, have their own mental health challenges. About 6 per cent of people aged 65 and over were born outside the country and there is a greater concentration of pensioners from ethnic minorities in deprived inner-city areas. Numbers are also increasing rapidly, as those who immigrated to the UK after the Second World War reach retirement age. Cultural, language and educational differences cause problems in studying this group’s mental health. Idioms of distress may affect presentation, help-seeking behaviour and acceptability of treatment. Ethnic elders may be considered vulnerable to depression because of socio-economic deprivation, immigrant status and old age but studies are contradictory and may use inappropriate screening instruments. Relatively few consider immigrant status and dementia.