Charles Watters

Migration and mental health care in Europe: Report of a preliminary mapping exercise

This paper offers an examination of mental health services for migrant groups in a number of European countries. It draws on a range of recent studies to highlight some of the key and emerging issues in relation to the provision of mental health services within an increasingly multi-ethnic and multicultural Europe. The results of a preliminary mapping exercise of mental health services for migrant groups are presented and their broader implications are considered. The aim of the mapping exercise was to collect and examine information on mental health services for migrant groups against a backdrop of broad policy developments in the mental health field and the emergence of multicultural approaches in public policy. The results of a questionnaire survey of service providers in 16 European countries are summarised, with special attention to three of the participating countries, Sweden, the Netherlands and Spain. The information from it is placed in a context of current research in the field of race, culture and mental health. In examining the results of the preliminary mapping exercise, key areas for policy development and service provision are identified and an agenda for future research in this area is suggested.

Migration experiences, employment status and psychological distress among Somali immigrants: a mixed-method international study

BackgroundThe discourse about mental health problems among migrants and refugees tends to focus on adverse pre-migration experiences; there is less investigation of the environmental conditions in which refugee migrants live, and the contrasts between these situations in different countries. This cross-national study of two samples of Somali refugees living in London (UK) and Minneapolis, Minnesota, (USA) helps to fill a gap in the literature, and is unusual in being able to compare information collected in the same way in two cities in different countries.MethodsThere were two parts to the study, focus groups to gather in-depth qualitative data and a survey of health status and quantifiable demographic and material factors. Three of the focus groups involved nineteen Somali professionals and five groups included twenty-eight lay Somalis who were living in London and Minneapolis. The quantitative survey was done with 189 Somali respondents, also living in London and Minneapolis. We used the MINI International Neuropsychiatric Interview (MINI) to assess ICD-10 and DSM-IV mental disorders.ResultsThe overall qualitative and quantitative results suggested that challenges to masculinity, thwarted aspirations, devalued refugee identity, unemployment, legal uncertainties and longer duration of stay in the host country account for poor psychological well-being and psychiatric disorders among this group.ConclusionThe use of a mixed-methods approach in this international study was essential since the quantitative and qualitative data provide different layers and depth of meaning and complement each other to provide a fuller picture of complex and multi-faceted life situations of refugees and asylum seekers. The comparison between the UK and US suggests that greater flexibility of access to labour markets for this refugee group might help to promote opportunities for better integration and mental well-being.

Refugees at Europe's borders: the moral economy of care.

In recent years the treatment of those seeking asylum in industrialized countries has been a matter of increasing international concern. Human rights organizations have documented instances of ill treatment and the summary expulsion of those trying to cross borders in the hope of a more secure existence. This article focuses on the treatment of asylum seekers and undocumented migrants at Europes borders, presenting examples from Europes southern border, Belgium and the UK. The idea of a moral economy of care is invoked which provides an overarching context in which legitimate and illegitimate asylum seekers and refugees are identified. The implications of a moral economy of care are explored in relation to the provision of mental health and social care services to refugees.

Acculturation Attitudes and Social Adjustment in British South Asian Children A Longitudinal Study

A 1-year longitudinal study with three testing points was conducted with 215 British Asian children aged 5 to 11 years to test hypotheses from Berry’s acculturation framework. Using age-appropriate measures of acculturation attitudes and psychosocial outcomes, it was found that (a) children generally favored an “integrationist” attitude, and this was more pronounced among older (8-10 years) than in younger (5-7 years) children and (b) temporal changes in social self-esteem and peer acceptance were associated with different acculturation attitudes held initially, as shown by latent growth curve analyses. However, a supplementary time-lagged regression analysis revealed that children’s earlier “integrationist” attitudes may be associated with more emotional symptoms (based on teachers’ ratings) 6 months later. The implications of these different outcomes of children’s acculturation attitudes are discussed.

Inequalities in Mental Health: the Inner City Mental Health Project

This paper draws on the evidence of a 3-year evaluation study of an inner city mental health project. Innovative service developments aimed at Afro-Caribbean and Asian communities are described, as are the reactions of providers of mainstream mental health services to these initiatives. The structural position of special projects aimed at Black communities is explored in relation to mainstream mental health services, as are the difficulties which may be encountered by service users and project staff when the project is integrated into mainstream mental health services.

Towards a new paradigm in migrant health research: integrating entitlement, access and appropriateness

This paper explores the prevalence and methodological approaches of migrants entitlement and access to health care. It also demonstrates an alternative approach involving a conceptual and analytical framework that integrates these perspectives as levels of analysis within a holistic model. Consisting of three brief case studies demonstrating difficulties in adopting either policy oriented entitlement approaches or practice driven orientations examining migrants access to health care, The paper examines the policy and legal frameworks within which health care is delivered to immigrants. The case studies presented encompass the phenomenon of hidden immigrant children in Sweden, migrants crossing the Spanish border from North Africa, and asylum seekers in the UK. The case studies form a basis for presenting an integrated model encompassing a multi-level framework for examining the health care of migrant populations. Implications for the European Union immigrant health and social care are discussed.

Education, migration and the ‘failure’ of multiculturalism

The attack on the World Trade Centre in 2001 and the London tube bombings in 2005 heralded an intense public debate on migration and integration. Within the United Kingdom, the 7/7 tube bombings have been seen as evidence of a general failure of multiculturalism and have led to calls for an increasing emphasis to be placed on the ‘integration’ of migrants into British society. These calls were not confined to the United Kingdom and were reflected widely across Europe, North America and Australia. In October 2010 the German Chancellor Angela Merkel added her voice, declaring the death of multiculturalism in Germany by saying that it had ‘failed utterly’ in what has been interpreted as a startling shift from her previous views (The Guardian, 18 October 2010). Instead of realizing a vision of communities living harmoniously side by side, commentators confronted the public with a spectre of migrant communities turning in upon themselves and maintaining and developing identities and affiliations often antagonistic to those predominant in host societies. Multicultural policies were, in this context, often seen as, at best, naïve and at worst contributing significantly to a breakdown in social cohesion. As a consequence of this reaction, multicultural policies have been often

Crossing Thresholds: Acculturation and Social Capital in British Asian Children

This chapter draws on a longitudinal study of identity transitions among young children from migrant and host society backgrounds in schools in England. The research included a quantitative study of involving just fewer than 400 schoolchildren aged between 5 and 11 and a qualitative study based on interviews with 32 children who participated in the main study. We outline below some of the key reasons for studying issues of identity and social action among young children from migrant backgrounds and salient theoretical issues and orientations. The chapter includes a brief description of the research project and an examination of the key findings from the quantitative and qualitative studies. We conclude with reflections on the implications of the research for the formulation of educational policies and for developing further theoretical frameworks for work in this area.

Social capital, ethnicity and children’s well-being: Aspects of social capital in the everyday lives of British Punjabi children

This paper discusses the relationship between minority ethnicity, well‐being and childrens social capital in the light of data from a qualitative study on social capital among 32 British Punjabi primary school children. Through a broad overview of social capital literature on ethnic minorities and childrens welfare, the case is made for placing childrens well‐being in a contextual framework that acknowledges the variety and wealth of childrens everyday experiences. Looking at the childrens social networks and future aspirations, the discussion will draw out ways in which social capital processes interact with other aspects of childrens identity, including ethnicity and gender, from a child‐centred perspective. Finally, some exploratory ideas are offered as to how bonding processes may affect childrens psychological well‐being, and how they may be viewed through the concept of ‘emotional capital’.

Children and War: Cultures of Mistrust and the Moral Economy of Care

In this paper I examine the plight of children who have experienced war and seek protection by crossing international borders. I argue that these asylum seeking children routinely face a prevalent culture of mistrust manifest in various attitudes and practices: child specific forms of persecution are not recognised, age is disputed and the acceptance rates for refugee status is relatively low compared to adults. Within this context, children may achieve a degree of legitimacy and protection under humanitarian provisions but in severely circumscribed contexts. Overwhelmingly children affected by war are either rejected and excluded from host societies or embedded in discourses of vulnerability and mental ill-health.