Mental health service use by Chinese immigrants with severe and persistent mental illness

Abstract

Objective: To investigate whether recent Chinese immigrants in British Columbia diagnosed with severe and persistent mental illness used mental health services at a lower rate than a similar group of nonimmigrants and longer-term immigrants.

Method: Subjects were selected from linked immigration and health administrative databases. Their health service use records for the years 1992 to 2001 were extracted. Rates and rate ratios of use for severe psychiatric disorders for Chinese immigrants and the comparison group were calculated for 4 types of health services: mental health visits to general practitioners (GPs), visits to psychiatrists, psychiatric hospitalizations, and use of psychiatric medications. Rates and rate ratios of use for any mental health condition were calculated for the above 4 types of services, plus community mental health service and nonmental health visits to GPs.

Results: The Chinese immigrants (n = 786) and comparison subjects (n = 3962) having severe and persistent mental illness were identified. For serious mental disorders, Chinese immigrants were more likely to visit psychiatrists (RR = 1.36) but less likely to use the other types of services, with rate ratios ranging from 0.51 to 0.81. Including all mental health conditions, Chinese immigrants were less likely to use all 6 types of services, with rate ratios ranging from 0.41 to 0.90.

Conclusions: Except for psychiatric visits for serious disorders, recent Chinese immigrants diagnosed with severe and persistent mental illness used fewer mental health services than subjects from the comparison group. Seriously ill Chinese immigrants may experience problems with access to mental health services.