Unmet need for mental health medication within the migrant population of Northern Ireland: a record linkage study

Kishan Patel*, Tania Bosqui, Anne Kouvonen, Michael Donnelly, Ari Väänänen, Justyna Bell, Dermot O'Reilly

*Corresponding author for this work

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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.

Original languageEnglish
Pages (from-to)245-250
Number of pages6
JournalJournal of Epidemiology and Community Health
Issue number3
Early online date31 Oct 2020
Publication statusPublished - 10 Feb 2021

Bibliographical note

Funding Information:
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).

Funding Information:
1Administrative Data Research Centre - Northern Ireland, Belfast, UK 2Centre for Public Health, Queen's University Belfast, Belfast, Northern Ireland 3Department of Psychology, American University of Beirut, Beirut, Lebanon 4Faculty of Social Sciences, University of Helsinki, Helsinki, Finland 5SWPS University of Social Sciences and Humanities in Wroclaw, Wroclaw, Poland 6Finnish Institute of Occupational Health, Helsinki, Finland 7School of Social Policy, Sociology and Social Research, University of Kent, Canterbury, UK 8Norwegian Social Research (NOVA), Oslo Metropolitan University, Oslo, Norway Acknowledgements The Administrative Data Research Network takes privacy protection very seriously. All information that directly identifies individuals will be removed from the data sets by trusted third parties, before researchers get to see it. All researchers using the Network are trained and accredited to use sensitive data safely and ethically, they will only access the data via a secure environment, and all of their findings will be vetted to ensure they adhere to the strictest confidentiality standards. The help provided by the staff of the Administrative Data Research Network Northern Ireland (ADRC-NI) and the Northern Ireland Statistics and Research Agency (NISRA) Research Support Unit is acknowledged. The ADRC-NI is funded by the Economic and Research Council (ESRC). The authors alone are responsible for the interpretation of the data and any views or opinions presented are solely those of the author and do not necessarily represent those of the ADRC-NI. The BSO data have been supplied for the sole purpose of this project.

Publisher Copyright:
© Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.

Copyright 2021 Elsevier B.V., All rights reserved.


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

ASJC Scopus subject areas

  • Epidemiology
  • Public Health, Environmental and Occupational Health


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