Migration and mental health over the past 20 years: how has the situation evolved?

BACKGROUND: Poor mental health is heavily stigmatized, even more when it comes to migrant and ethnic minority groups (MEM). Belgium, with its long history of immigration, is a good case study for analysing mental illness (MI) prevalence and how it has evolved over time across ethnic groups. This paper aims to shed light on the prevalence of MI among MEM in Belgium, between 1997 and 2018. Its objective is to describe the potential disparities in MI prevalence over time by ethnicity. METHODS: The study used data from the six cross-sectional waves of the Belgian Health Interview Survey from 1997 to 2018 to assess the prevalence of MI among five major ethnic groups in Belgium, and to analyse potential disparities over time using logistic and linear regression models. The 12-item General Health Questionnaire was used to measure mental illness (score≥4), and the minimal clinically important difference (MID) was also calculated for MI severity. RESULTS: From 1997 to 2008, the proportion of people with MI was similar across ethnic groups. However, in 2013 and 2018, there was a significant increase in MI prevalence among Moroccan and Turkish respondents compared to Belgians. The study also found that Turkish respondents had a higher score of mental distress than Belgians from 2013 onwards. In 2018, having a mother born in a non-EU country was found to increase the risk of MI (β = 1.38, CI95%= 0.71;2.05), even after controlling for age, sex and education level. CONCLUSIONS: Mental health inequalities between ethnic groups are on the rise in Belgium, particularly among the Moroccan and Turkish populations. Specific interventions and policies must be implemented to prevent the increase of MI among MEM, and ensure that high-quality mental health care is accessible to all, regardless of ethnicity. Additionally, we recommend better data collection in future research on ethnic mental health, especially on the country of birth of respondents and their parents. KEY MESSAGES: • This study describes the evolution of the prevalence of mental health risk among the migrant population in comparison with the native population in Belgium. • The results of this study can help us to understand the evolution of mental health risk since 1997 and to develop appropriate policies and interventions.