|Year : 2022 | Volume
| Issue : 1 | Page : 10-12
Migration to High-Income Countries: A Panacea for Social Deprivation in Low- and Middle-Income Countries: A Mental Health Perspective
Abolaji Paul Adekeye
Department of Mental Health, Federal Teaching Hospital, Ido-Ekiti, Ekiti State, Nigeria
|Date of Submission||01-Mar-2022|
|Date of Decision||06-Mar-2022|
|Date of Acceptance||08-Mar-2022|
|Date of Web Publication||27-Apr-2022|
Dr. Abolaji Paul Adekeye
Department of Mental Health, Federal Teaching Hospital, Ido-Ekiti, Ekiti State
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Adekeye AP. Migration to High-Income Countries: A Panacea for Social Deprivation in Low- and Middle-Income Countries: A Mental Health Perspective. World Soc Psychiatry 2022;4:10-2
|How to cite this URL:|
Adekeye AP. Migration to High-Income Countries: A Panacea for Social Deprivation in Low- and Middle-Income Countries: A Mental Health Perspective. World Soc Psychiatry [serial online] 2022 [cited 2022 Jul 1];4:10-2. Available from: https://www.worldsocpsychiatry.org/text.asp?2022/4/1/10/344121
| Introduction|| |
Migration is the movement of people to a new country or area to find work or better living conditions. According to the World Bank, low-income economies are defined as those with a gross national income (GNI) per capita, calculated using the World Bank Atlas More Details method, of $1045 or less in 2013; middle-income economies are those with a GNI per capita of more than $1045 but <$12,746; high-income economies are those with a GNI per capita of $12,746 or more. Lower-middle-income and upper-middle-income economies are separated at a GNI per capita of $4125.
Social deprivation is a broad and somewhat poorly defined umbrella term that refers to the combination of factors that prevent a person from having easy and frequent access to the many different aspects of their culture and society. The World Health Organization (WHO) defines mental health as a state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community.
| Social Deprivation and Mental Health|| |
The relationship between social deprivation and mental health has long been established to be bimodal. On the one hand, social deprivation can increase the risk for poor mental health as it is one of its social determinants. On the other hand, experiencing poor mental health could be an avenue for being socially deprived. In the low- and middle-income countries, due to political instability and pronounced insincerity, high level of unemployment, corruption, poverty, and the risk of social deprivation is heightened due to defective management of funds, infrastructures, and resources. For instance, in Nigeria, apart from the fact that there is a rising trend of unemployment, the majority of those employed are underemployed with a national minimum wage of less than a 100 US dollars.
Studies have shown that low income, not living with a partner, lack of social support, female gender, low level of education, low socioeconomic status, unemployment, financial strain, and perceived discrimination are factors hinged on social deprivation that is associated with poor mental health. It was reported by the WHO that systemic inequalities and inequities in the purview of gender, age, education, ethnicity, income, and place of residence are major determinants of mental health, and there is an association between economic disadvantage and common mental disorders (CMDs) (depression and anxiety) among low- and middle-income countries.
Besides, studies have also found the disproportionate rates of mental illness among people living in the poorest parts of cities, and with the distribution of income in the low- and middle-income countries, the overrepresentation of this may not be farfetched. Social deprivation has been found to increase the risk for psychological distress among adolescents moving toward adulthood, thereby increasing their vulnerability for subsequent mental illness. Poor social support, discrimination, and stress from multiple deprivations have been found to increase the risk of poor mental health.
Furthermore, poor mental health may be a precursor to social deprivation. It has been reported that social exclusion from deprivation is a notable consequence of mental health difficulties, and this is due to the effects of discrimination, unfair detention, stigma, and constructions of the difference attached to the mentally ill. Sometimes, people with mental health problems are excluded from consuming health services, such as health promotion and health improvement programs that are available to others, leading to unequal health outcomes and increased mortality among these populations. Similarly, people with mental health problems experience exclusion as a result of their low employment rates and inequalities in the chance to adequately contribute to the society.
However, social exclusion can also lead to an increase in the risk of poor mental health through isolation, loneliness, and low levels of self-esteem, for example, while social capital can act as a protective factor. In all, social exclusion, which refers to a person being shunned by his or her community or culture because of certain circumstances, traits, or characteristics, can complicate social deprivation if the deprivation becomes long-term.
| Migration and Mental Health|| |
Migration is the process of social change whereby an individual moves from one cultural setting to another for the purpose of settling down either permanently or for a prolonged period. The process of migration is inevitably stressful, and stress can increase the risk for mental illness. Migration is a global phenomenon and it occurs due to a range of factors such as conflict, unemployment, and poverty. Available research has shown a higher prevalence of CMDs and higher psychiatric admission rates in migrant communities compared to the majority of the settled population. Apart from the stress involved in the pre- and intra-migration processes, the postmigration phase, characterized by culture shock, which is exemplified by assimilation, acculturation, and deculturation, appears to be a significant period of outrageous risk. In the quest for obtaining more optimal socioeconomic status, migrants sometimes face the harsh realities of life-threatening events such as poor living conditions, social isolation, unemployment, and deportation even in the new countries and these are important psychosocial stressors that can increase the risk for mental illness. In a notable research done on Schizophrenia among Norwegians migrating to the USA, it was observed that the inception rate for schizophrenia among the migrating Norwegians was twice that of those residents in Norway. The possible explanations for this finding were higher rates of schizophrenia in the emmigrating country, people with schizophrenia are predisposed to migrate, migration increases stress that may increase the risk for schizophrenia, migrants are misdiagnosed with schizophrenia, increased population density and diversity of ethnic migrant groups can show elevated rates of schizophrenia.
Although many immigrants cherish the fact that there are improved amenities and better socioeconomic opportunities which make for better quality of life in high-income countries, these are rather toppled with the menace of ethnic discrimination, racism, and limitation for advancement in certain paradigms. Furthermore, sometimes, the migrants have feelings of detachment from their families in their native countries and the intense drive to make it up by working extra hard to send money to them. All these are important substrates for social exclusion, which is a psychosocial stressor for mental illness, even in the new environment.
Furthermore, because migration to high-income countries may be like a safe haven to some individuals due to the optimal socioeconomic status they attain, it may be a protective factor for them, thereby reducing their vulnerability for mental illness.
| Conclusion|| |
Social deprivation is a major reason for migration from low- and middle-income countries to high-income countries globally. Social deprivation and the process of migration may reduce the resilience and increase the vulnerability of migrants to mental illness. The sociocultural milieu of the new environment may either be protective or precipitating for mental illness.
| References|| |
Hudson CG. Socioeconomic status and mental illness: Tests of the social causation and selection hypotheses. Am J Orthopsychiatry 2005;75:3-18.
World Health Organization. Social Determinants of Mental Health. Geneva: World Health Organization; 2014. p. 1-54.
Wickham S, Taylor P, Shevlin M, Bentall RP. The impact of social deprivation on paranoia, hallucinations, mania and depression: The role of discrimination social support, stress and trust. PLoS One 2014;9:e105140.
Stansfeld SA, Haines MM, Head JA, Bhui K, Viner R, Taylor SJ, et al.
Ethnicity, social deprivation and psychological distress in adolescents: School-based epidemiological study in east London. Br J Psychiatry 2004;185:233-8.
Gudino AG, Lau AS. Immigration and mental health. In: Encyclopedia of Mental Health. 2nd
ed. Waltham, MA: Academic Press; 2016.
Payne S. Mental Health, Poverty and Social Exclusion. Vol. 9. UK: PSE; 2012. p. 1-4.
Bhugra D, Jones P. Migration and mental illness. Adv Psych Treat 2001;7:216-23.
Close C, Kouvonen A, Bosqui T, Patel K, O'Reilly D, Donnelly M. The mental health and wellbeing of first generation migrants: A systematic-narrative review of reviews. Global Health 2016;12:47.
Virupaksha HG, Kumar A, Nirmala BP. Migration and mental health: An interface. J Nat Sci Biol Med 2014;5:233-9.
Harrison P, Cowen P, Burns T, Fazel M. Shorter Oxford Textbook of Psychiatry. 7th
ed. Oxford: Oxford University Press; 2018.
World Health Organization. Mental Health Promotion and Mental Health Care in Refugees and Migrants. Geneva: World Health Organization; 2018. p. 1-40.