Why is compulsory psychiatric care more common amongst migrants than the Swedish-born population?

Research problem and specific questionsThe proportion individuals admitted to compulsory psychiatric care is higher amongst migrants (defined here as a person born abroad and settled in Sweden) when compared with the majority Swedish population.

The purpose of this project is to study compulsory psychiatric care use within different migrant groups as compared with the Swedish majority population, and to explore possible reasons for any differences.

This will be achieved by answering the following questions: What are the differences in likelihood of compulsory psychiatric care use in the total population by migrant status (i.e. by migrants, descendants of migrants, and the majority Swedish population) and amongst migrants by migration related factors such as country-of-origin, reason for migration, duration of stay in Sweden and age of migration?

Are there differences regarding age, gender, socioeconomic factors and/or geographical regions in Sweden?What could explain the differences?

The following possible explanations will be studied: Variations in prevalence of psychiatric disorders and suicide attemptsLower use of voluntary psychiatric care amongst those with higher use of compulsory psychiatric careFactors in the health care setting that increase the risk of a patient being perceived as a risk to themselves or others Data and methodWe will use a mixed methods approach.

For the longitudinal epidemiological studies, we plan to use our register-linkage to create a total population cohort of all individuals born 1944-1988 with a follow-up during 2006-2020.

In the qualitative study, we will use focus groups and results will be analysed using Thematic analysis.Societal relevance and utilisationIn cases of immediate danger to a patient or others, physicians have a difficult dual mandate when deciding if compulsory psychiatric care is needed; requiring them to balance the patient’s right to autonomy with the protection of the patient’s and others’ lives.

The project will highlight inequities in the use of compulsory psychiatric care and explore potential factors influencing these patterns, paving the way for more equitable psychiatric care.Plan for project realisationThe project will be carried out by a team with extensive research experience in psychiatric epidemiology, and in clinical and transcultural psychiatry.

The total budget for the three years will be 4,9 million SEK, including salaries and social security contributions of 3,9 million SEK.