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Unmet need for mental health medication within the migrant population of Northern Ireland: a record linkage study
  1. Kishan Patel1,2,
  2. Tania Bosqui1,3,
  3. Anne Kouvonen1,4,5,
  4. Michael Donnelly1,2,
  5. Ari Väänänen6,7,
  6. Justyna Bell8,
  7. Dermot O’Reilly1,2
  1. 1 Administrative Data Research Centre - Northern Ireland, Belfast, UK
  2. 2 Centre for Public Health, Queen's University Belfast, Belfast, Northern Ireland
  3. 3 Department of Psychology, American University of Beirut, Beirut, Lebanon
  4. 4 Faculty of Social Sciences, University of Helsinki, Helsinki, Finland
  5. 5 SWPS University of Social Sciences and Humanities in Wroclaw, Wroclaw, Poland
  6. 6 Finnish Institute of Occupational Health, Helsinki, Finland
  7. 7 School of Social Policy, Sociology and Social Research, University of Kent, Canterbury, UK
  8. 8 Norwegian Social Research (NOVA), Oslo Metropolitan University, Oslo, Norway
  1. Correspondence to Kishan Patel, Centre for Public Health, Royal Victoria Hospital, Grosvenor Road, Belfast BT12, 6BA, UK; kpatel05{at}


Background Migrant populations are particularly at risk of not receiving the care for mental ill-health that they require for a range of reasons, including language and other barriers to health service access. This record linkage study compares, for migrant and settled communities, the likelihood that a person in Northern Ireland with poor mental health will receive psychotropic medication.

Methods A cohort of 78 267 people aged 16–64 years (including 1736 migrants) who reported chronic poor mental health in the 2011 Census records was followed for 15 months by linkage to a centralised prescribing data set to determine the rates of pharmacological treatment. Logistic regression analyses quantified the relationship between psychotropic medication uptake and migrant status, while accounting for relevant demographic and socioeconomic factors.

Results Overall, 67% of the migrants with chronic poor mental health received at least one psychotropic medication during the study period, compared to 86% for the settled population; this equates to an OR of 0.32 (95% CI 0.29 to 0.36) in the fully adjusted models. Adjustment for English proficiency did not significantly alter these models. There was also considerable variation between individual migrant groups.

Conclusion Although this study suggests substantial unmet need for treatment of poor mental health among the migrant population of Northern Ireland, further qualitative studies are required to better understand how different migrant groups respond to mental ill-health.

  • Public health
  • Migration
  • Mental health
  • Record linkage
  • Access to hlth care

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  • Contributors KP, TB, AK, DƠR and AV contributed to the study design. KP drafted the manuscript. All authors contributed to data interpretation and revising the manuscript content, and approved the final version of the manuscript.

  • Funding The study was funded as part of an Administrative Data Research Centre Northern Ireland (ADRC-NI) research programme, funded by the Economic and Social Research Council (ESRC) (grants ES/L007509/1 and ES/S00744X/1). DƠR, MD and AK were also supported by the Medical Research Council (MRC) (grant MR/K023241/1). AK was additionally supported by the Academy of Finland (grant 312310 for the Centre of Excellence for Research on Ageing and Care, RG 3 Migration, Care and Ageing).

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data may be obtained from a third party and are not publicly available.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.