Impact of language proficiency on mental health service use, treatment and outcomes: "Lost in Translation".

Coercive Treatment Language Proficiency Mental Health Treatment Outcomes

Journal

Comprehensive psychiatry
ISSN: 1532-8384
Titre abrégé: Compr Psychiatry
Pays: United States
ID NLM: 0372612

Informations de publication

Date de publication:
31 Jan 2022
Historique:
received: 19 08 2021
revised: 19 12 2021
accepted: 12 01 2022
pubmed: 28 2 2022
medline: 28 2 2022
entrez: 27 2 2022
Statut: aheadofprint

Résumé

Mastery of a language is bound to place of origin; low language proficiency is thus related to migration and cultural differences, all of which influence access to mental health care, treatment and outcomes. Switzerland, being multilingual, allows the disentangling of language proficiency from migration and, to some extent, culture. This study uses propensity score matching to explore how language proficiency relates to help-seeking behaviour, service use, treatment and outcomes in patients with mental health disorders. We used the first admission of patients admitted to and discharged from an academic psychiatric hospital in Switzerland between January 1st, 2013 and December 31st, 2019, with an observation period of one-year post-discharge (until December 31st, 2020). We paired 2101 patients with low language proficiency to 2101 language proficient patients, balancing baseline sociodemographic and clinical characteristics using propensity score matching. Patients with low language proficiency had a higher probability of compulsory admission (OR: 1.79, 99%CI: 1.60-2.02); which remained after adjustment for confounders (OR: 1.51; 99%CI: 1.21-1.89). Whilst in treatment, they had higher rates of compulsory medication (OR: 1.73, 99%CI: 1.16-2.59) and seclusion/restraint (OR: 1.87, 99%CI: 1.25-2.79). Furthermore, patients initially admitted voluntarily had a higher probability of being compulsorily retained (OR: 1.74, 99%CI: 1.24-2.46). Both groups showed similar clinical improvement rates and service use parameters. Our results demonstrate that low language proficiency constitutes a risk factor for coercive measures throughout hospitalisation. The results demonstrate the need for an increase in language sensitivity in psychiatric care.

Sections du résumé

BACKGROUND BACKGROUND
Mastery of a language is bound to place of origin; low language proficiency is thus related to migration and cultural differences, all of which influence access to mental health care, treatment and outcomes. Switzerland, being multilingual, allows the disentangling of language proficiency from migration and, to some extent, culture. This study uses propensity score matching to explore how language proficiency relates to help-seeking behaviour, service use, treatment and outcomes in patients with mental health disorders.
METHODS METHODS
We used the first admission of patients admitted to and discharged from an academic psychiatric hospital in Switzerland between January 1st, 2013 and December 31st, 2019, with an observation period of one-year post-discharge (until December 31st, 2020). We paired 2101 patients with low language proficiency to 2101 language proficient patients, balancing baseline sociodemographic and clinical characteristics using propensity score matching.
RESULTS RESULTS
Patients with low language proficiency had a higher probability of compulsory admission (OR: 1.79, 99%CI: 1.60-2.02); which remained after adjustment for confounders (OR: 1.51; 99%CI: 1.21-1.89). Whilst in treatment, they had higher rates of compulsory medication (OR: 1.73, 99%CI: 1.16-2.59) and seclusion/restraint (OR: 1.87, 99%CI: 1.25-2.79). Furthermore, patients initially admitted voluntarily had a higher probability of being compulsorily retained (OR: 1.74, 99%CI: 1.24-2.46). Both groups showed similar clinical improvement rates and service use parameters.
CONCLUSIONS CONCLUSIONS
Our results demonstrate that low language proficiency constitutes a risk factor for coercive measures throughout hospitalisation. The results demonstrate the need for an increase in language sensitivity in psychiatric care.

Identifiants

DOI: 10.1016/j.comppsych.2022.152299 PMID: 35220037
pubmed: 35220037
pii: S0010-440X(22)00005-0
doi: 10.1016/j.comppsych.2022.152299
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

152299

Informations de copyright

Copyright © 2022 The Author(s). Published by Elsevier Inc. All rights reserved.

Auteurs

Dimitrina Miteva (D)

Faculty of Medicine, Department of Psychiatry, Psychotherapy and Psychosomatics, University of Zurich, Zurich, Switzerland.

Foivos Georgiadis (F)

Faculty of Medicine, Department of Psychiatry, Psychotherapy and Psychosomatics, University of Zurich, Zurich, Switzerland.

Lorna McBroom (L)

Faculty of Medicine, Department of Psychiatry, Psychotherapy and Psychosomatics, University of Zurich, Zurich, Switzerland.

Vanessa Noboa (V)

Faculty of Medicine, Department of Psychiatry, Psychotherapy and Psychosomatics, University of Zurich, Zurich, Switzerland; Faculty of Medicine, San Francisco de Quito University, Quito, Ecuador.

Boris B Quednow (BB)

Faculty of Medicine, Department of Psychiatry, Psychotherapy and Psychosomatics, University of Zurich, Zurich, Switzerland.

Erich Seifritz (E)

Faculty of Medicine, Department of Psychiatry, Psychotherapy and Psychosomatics, University of Zurich, Zurich, Switzerland.

Stefan Vetter (S)

Faculty of Medicine, Department of Psychiatry, Psychotherapy and Psychosomatics, University of Zurich, Zurich, Switzerland.

Stephan T Egger (ST)

Faculty of Medicine, Department of Psychiatry, Psychotherapy and Psychosomatics, University of Zurich, Zurich, Switzerland; Faculty of Medicine, Department of Psychiatry, University of Oviedo, Oviedo, Spain. Electronic address: stephan.egger@pukzh.ch.

Classifications MeSH