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People have migrated from one place to another since the start of human existence, for all kinds of reasons and varying durations. The process of migration can be divided into three stages: pre-migration, migration and post-migration. The impact of migration on an individual's mental health is multifaceted and affects different aspects of the individual, whether it is biological, social or psychological. Migration involves a series of losses, such as the family and the familiar society; both emotional and structural losses are experienced. The relationship between social inequalities and mental health is well known and it is inevitable that if migrants suffer from social and economic inequalities they are also likely to suffer from mental ill-health, though the mediating factors may well vary. In cultures where Cartesian mind-body dualism is not a prevalent model, the interaction between somatic symptoms and psychological distress will be significant.
This chapter emphasises the role of social and economic inequalities in the production of both ethnic/racial differences in risk of mental illness, and in constructing the experience of ethnic/racial minorities in psychiatric care. It discusses the ethnic minority people's experiences of mental health services and the implications this has for healthcare provision and practice. Ethnic differences in risk of psychotic illnesses have been the primary focus of research in the mental health field, and most of this work has been based on studies of treatment rates. The chapter discusses non-health service-related factors: migration, genetics, culture, social and economic inequalities. One of the central problems with work on ethnicity and mental illness arises from the reliance of most work on data based on contact with treatment services. Generally, regardless of their ethnic background, people with mental health problems are critical of the services they receive.
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