There are over 200 million international migrants, people who live in a country other than the one in which they were born, in the world today, the vast majority moving from middle- and low-income countries to high-income countries in North America, Europe and Oceania. Intra-national migrants, people who move large distances within the country in which they were born, may be an even larger population, with massive rural to urban migration continuing in many countries and a recent memory in most others. The chapters of this edited volume attempt a comprehensive overview of the many implications of these massive movements of people for population mental health and mental health treatment.
The volume contains 26 chapters, divided into five major sections covering the epidemiology of migration and mental health, consequences of migration, challenges that migrations pose to mental healthcare systems, needs of special populations and several country-level case studies. The authors are with few exceptions non-researchers and the chapters are for the most part selective literature reviews that explicate concepts and highlight themes of interest. Although the content is not unavailable elsewhere, the book fills a niche by bringing together discussion of a broad range of topics of interest to practitioners and policy makers who work with migrant populations into a single volume.
The epidemiology chapters go into considerable depth in describing mental health concerns corresponding to the several stages of migration, from pre-migration experiences, the experience of transit, and experiences in the receiving country both in the short and long term. The papers take a broad view of migration, including epidemiological patterns that extend across generations of descendants of migrants born in the receiving countries. The careful delineation of the distinct factors affecting migrant populations at each stage of the migration process is a strength of the collection. The papers also take a broad view of mental health, with some chapters focusing on psychosis, others on common mental disorders and others on distress.
The sections that are most likely to be useful to students are those that cover consequences of migration within the receiving countries and the challenges of taking care of socially disadvantaged culturally ‘other’ populations. These chapters open doors into the lives of migrants and ethnic minority patients that may otherwise remain shut to clinicians. They provide introductions to a variety of social and health science frameworks for thinking about the distinctive conditions of migrants and ethnic minorities that may affect mental health, including acculturation theory, collective trauma, social stress, and idioms of distress. In addition chapters devoted to circumstances of migrant elderly, child, female and lesbian, gay, bisexual, and transgender (LGBT) populations highlight issues that are likely to be overlooked. There are separate chapters devoted to inter-cultural communication, ethno-psychopharmacology, and culturally sensitive mental health services.
The book has some shortcomings. There is a great deal of repetition of some topics across the chapters, with no cross-referencing. For instance, the literature on migration and psychosis in Europe is reviewed multiple times with no attempt to synthesize the varying accounts or even bring them into contrast. At the same time the large literature on migration and mental health in the USA is hardly mentioned despite the long history of research on this topic in the USA and the large expansion of this work over the past decade with the fielding of large epidemiological surveys focused on immigrants and ethnic minorities.
Readers and instructors interested in a broad introduction to issues concerning mental healthcare for migrant and ethnic minority populations will find this a useful volume.
