High level of undetected post-traumatic stress found in psychiatric clients

Study of migrants and Irish users of inner city Dublin service also finds levels of sexual trauma to be of concern

Consultant psychiatrist Prof Brendan  said  the research represented ‘the tip of the iceberg’ in terms of mental illness and trauma among migrants.

Consultant psychiatrist Prof Brendan said the research represented ‘the tip of the iceberg’ in terms of mental illness and trauma among migrants.

 


A newly published Irish study has found a high level of undetected post-traumatic stress disorder (PTSD) among both migrant and native-born psychiatric service users.

The study of 178 individuals at a mental health service in inner city Dublin – Trauma and PTSD rates in an Irish psychiatric population – was conducted by researchers at the School of Psychiatry at UCD and the Department of Adult Psychiatry at the Mater Misericordiae University Hospital. It has just been published in the research journal Disaster Health.

Some 114 native Irish individuals and 64 migrants (from a total of 35 countries and with 29 different first languages) were included in the study.

The researchers believe it to be the most detailed study to date of the current mental health and past trauma experiences of migrants in Ireland who are attending adult mental health services.

Overall 71.3 per cent of the service users had experienced at least one major lifetime traumatic event that would meet the criteria for PTSD, the study found. Some 67 per cent of Irish users and 80 per cent of migrants had experienced at least one significant traumatic event in their lives. The researchers found both rates “notably high”.

Three of the five most common events reported by both groups were similar – lack of shelter, beatings or lack of food/water.

The top reported traumatic event for the Irish group was sexual abuse/humiliation, while for the migrant group it was the murder of a family member or a friend.

Within the migrant group, 94 per cent of forced migrants had experienced at least one such event. Of the voluntary migrants, 65.6 per cent had experienced a traumatic event.

Many war-related or torture-related events were only experienced by the forced migrants – these included kidnapping, forced labour, being forced to find and bury bodies, forced to witness rape or sexual abuse.

The rate of sexual trauma, including rape, any sexual abuse and humiliation was higher in the native Irish people studied (32.4 per cent) than in the migrants (28.1 per cent).

One of the authors, senior lecturer and consultant psychiatrist Prof Brendan Kelly, said this was a “new and deeply concerning finding – for both groups”.

Some 31 per cent of migrants and 3.5 per cent of native Irish users had formally defined, current PTSD.

The researchers found this was broadly consistent with international findings, although they said there was very limited Irish research with which to compare it. They said the study had improved practice further with regard to the issue of under-diagnosis of PTSD.

Prof Kelly said the research represented “the tip of the iceberg” in terms of mental illness and trauma among migrants because all of those in the study were already attending adult mental health services when they agreed to take part.

“There is strong evidence from other countries that, compared to native populations, migrants are substantially less likely to access mental health services in any of these ways, so the magnitude of this issue is likely very much greater than even this study suggests,” he added.