The mental healthcare needs of undocumented migrants: an exploratory analysis of psychological distress and living conditions among undocumented migrants in Norway

Abstract

Aims and objectives: To explore undocumented migrants' mental healthcare needs and more specifically to explore how undocumented adults living in Norway perceive psychological distress, to gather insight on their living conditions and to explore associated living condition risk factors.

Background: Undocumented migrants are defined both nationally and internationally as an especially vulnerable group with regard to their health status, living conditions and barriers to access to health care and social welfare.

Design: An exploratory mixed-methods design using primarily quantitative data with a qualitative component was implemented.

Methods: Socio-demographic data on 90 undocumented migrants were obtained, and self-report questionnaire on psychological distress was completed, supplemented by qualitative data obtained through interviews.

Results: The level of psychological distress was extremely high in our group of undocumented migrants. Leaving their home country because of war or persecution, economic strain, homelessness, hunger and having experienced abuse was significantly positively associated with psychological distress. Contrary to what was predicted, having family and work was not significantly associated with the reduction of psychological distress. Additional qualitative data indicate that having family entails great responsibilities and work implies exploitation to such an extent that any potential positive influence this has on mental health, such as a sense of belonging and a reasonable standard of living, is outweighed.

Conclusions: The high level of psychological distress indicates a need of additional diagnostic evaluation and mental health care. The living conditions were so marginal that their day-to-day existence was threatened.

Relevance to clinical practice: We recognised a need for an interdisciplinary and dynamic approach to mental health care. Undocumented migrants are in need of a minimum of psychological and material support assuring basic needs such as shelter and appropriate food and access to health care and social welfare.

Keywords: Hopkins Symptom Checklist - 25; living conditions; mental health; psychological distress; public health; relevance to clinical practice for nurses; undocumented adults in Norway.