Mental health and access to care among refugee mothers relocated to San Diego: a comparative study of Iraqi and Somali refugee communities

摘要

Background Mental illness is common amongst refugees and can differ depending on cultural background, experiences, and access to care. Given significant risk factors including high rates of exposure to sexual violence and different barriers to seeking adequate health care, refugee mothers are uniquely at risk. Methods In 2012–2013, surveys were administered to a convenience sample of Somali and systematic random sample of Iraqi refugee mothers to identify differences in mental health between the populations. The Hopkins Symptom Checklist (HSCL-25) identified respondents with major depression and emotional distress. We used multivariable logistic regression to compare these populations and identify variables associated with mental illness. Results 198 Somali and 219 Iraqi women were included. Most Iraqis (60.27%) had not seen a mental health provider while most Somalis (62.63%) had. On average, Iraqis scored 0.34 points higher (worse) on the HSCL-25 compared to Somalis (95% CI, 0.22–0.46; P 0.001). Iraqis were more likely to have major depression (OR = 2.62, 95% CI 1.50–4.57, P = 0.001). On multivariable analysis accounting for the country of origin, those who saw a mental health provider were less likely to have major depression or emotional distress (OR 0.42, 95% CI 0.22–0.82, P = 0.011; OR 0.43, 95% CI 0.22–0.85, P = 0.015, respectively). Discussion Iraqi refugee mothers were more likely to have depression compared to Somalis. Refugee mothers who saw a mental health provider were less likely to have depression or emotional distress. These results suggest the cultural background and access to health services among refugee mothers’ impact on mental health.