Immigrants 'face higher health risks'

South Asian immigrants are worst affected

Immigrant populations in the UK are at higher risk from mental and physical illness, a study commissioned by the Department of Health has suggested.

Problems with access to facilities, an inability to speak the language, and racism within the adopted country all contribute to the relatively poor health of minority groups, researchers say.

"Out of six ethnic minority groups, there was only one which had a health equivalent to the general population, which was the Irish group," James Nazroo, a reader in sociology at University College London, which was asked to produce the survey.

"All of the other groups have worse health."

However, the health of immigrant populations varied from group to group, with those from South Asia worst off.

Mr Nazroo told BBC World Service's Health Matters programme:"The poorest groups - the Pakistani and Bangladeshi groups - had really very poor health in comparison with everybody else.

"The other groups had worse health, but nowhere near as bad."

Trouble fitting in

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.

For some, the UK is far from welcoming

One example is schizophrenia.

As far back as 1932, Norwegian psychiatrists were studying the rates of schizophrenia amongst Norwegians, Americans, and the US Norwegian immigrant population.

They found that the immigrants had much higher rates. The causes were described as being due to "alienation and vulnerability."

The Centre for Mental Health Services Development (CMHSD) at King's College, London, has been trying to establish the factors that cause immigrants to feel this way.

"People who are classed as refugees and asylum seekers come to Britain - and they may have been victims of torture, they may have been threatened or experienced distress in a number of ways - this is exacerbated when they come to a new country," the CMHSD's Melba Wilson told Health Matters.

"They 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.

They are afraid to approach people in positions of authority because often their status is very precarious Melba Wilson, King's College London

"That all leads to increased isolation and a sense of increased vulnerability."

She added that often by the time any symptoms were recognised it was too late.

"By the time people are able to access service - for example through their GPs, if they are lucky enough to be able to get one - they are then in a very advanced state of crisis," she said.

"Issues that may have been dealt with in very straightforward ways are exacerbated and therefore the stress and distress that people experience is made worse."

Misdiagnosis

However, Ms Wilson added that she felt there was "a lack of cultural understanding in the mental health system" that could lead to patients being misdiagnosed.

"For example schizophrenia is a very common diagnosis for people who are African-Caribbean," she said.

Asylum seekers' problems are often not seen until too late

"There is a raging debate - and has been for a number of years now - as to whether that is an accurate diagnosis, because a schizophrenia diagnosis is more a kind of catch-all phrase for when professionals are not quite sure."

But Robin Murray, professor of psychiatry at the Maudsley hospital in London, denied that the system was to blame.

"We would expect the same rates of delusions and hallucinations between Caribbean immigrants and their children as the white population - we actually have six times more," he conceded.

But he said it was society that was causing the problems for immigrants that were adversely affecting their health.

"Probably five out of the six individuals presenting with these kind of symptoms from the Caribbean community have major factors of social adversity in their lives, which are propelling them to develop psychotic symptoms," he said.

He added that surveys had proved doctors were actually more, not less, reluctant to diagnose a patient as schizophrenic if they were black, aware of cultural factors in some ethnic populations.

"We can exclude the possibility that this [difference] is due to racial prejudice, or bias or misdiagnosis, on the part of psychiatrists.

"What we cannot do is exclude the possibility that this high rate is a consequence of discrimination and prejudice in the general population.

"I think that this is quite a probable reason."