Risk and protective factors for common mental disorders among populations during migration. A pilot cohort study among migrants and asylum seekers in Mexico

流动人口中常见精神障碍的危险因素及保护因素

• 批准号: 10730324
• 负责人: Martha Claire Greene
• 金额: $ 62.68万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-08-14 至 2026-08-13
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10730324
• 关键词: Address; Adolescent; Adult; Area; Capital; Caribbean region; Child; Cities; Climate; Cohort Studies; Collaborations; Communities; Complex; Country; Data; Data Analyses; Data Collection; Destinations; Development; Distress; Economics; Emergency Situation; Employment Opportunities; Enrollment; Epidemiology; Ethics; Face; Family; Generalized Anxiety Disorder; Goals; Health; Human; Human Rights; Incidence; Individual; Intention; International; Intervention; Investigation; Latin America; Legal; Legal Status; Literature; Location; Longitudinal Studies; Longitudinal cohort; Major Depressive Disorder; Measures; Mental Health; Mental disorders; Methods; Mexico; Migrant; Monitor; National Institute of Mental Health; Natural History; Outcome; Participant; Phase; Policies; Population; Post-Traumatic Stress Disorders; Preparation; Prevalence; Prevention; Procedures; Prospective cohort; Prospective, cohort study; Psychosocial Assessment and Care; Public Health; Research; Resources; Risk; Risk Factors; Risk Reduction; Safety; Sampling Studies; Services; Shelter facility; Social Protection; Specific qualifier value; Symptoms; Time; Underrepresented Populations; United States National Institutes of Health; Universities; Violence; Woman; Work; acceptability and feasibility; data quality; design; displaced person; experience; follow-up; gender-based violence; improved; innovation; insight; interest; member; men; mental disorder prevention; migration; modifiable risk; novel; population migration; prevent; preventive intervention; programs; protective factors; psychologic; recruit; response; retention rate; risk mitigation; service utilization; social; social determinants; structural determinants; traumatic event; violence prevention

PROJECT SUMMARY Forced displacement has reached unprecedented levels and is becoming increasingly protracted with over 75% of the estimated 100 million displaced persons globally expected to live in exile for over five years. Latin America has experienced the greatest proportional increase in forced displacement across international borders since 2017. Due to delays in processing asylum applications and policies permitting the widespread expulsion of migrants and asylum seekers, many migrants and displaced persons are temporarily residing in northern Mexico near the US border awaiting safety and more durable solutions in another destination. Displaced populations face significant adversity, human rights violations, and potentially traumatic events that increase their risk for common mental disorders (CMDs) during their migration journey. The point prevalence of CMDs is more than three times higher in displaced populations relative to global averages. Despite this elevated burden, migrants without legal status in the transit or destination country face significant barriers in accessing basic needs and services, further contributing to distress and the risk of CMDs. Most available data on mental health among migrants is cross-sectional due to practical and ethical challenges following mobile populations over time. Longitudinal data are needed to identify modifiable risk and protective factors that could serve as targets for CMD prevention interventions in this population. Our study team, which represents an established academic-humanitarian partnership, has expertise conducting mental health research among displaced populations and providing community-based mental health and psychosocial support to these communities, including in Mexico. We aim to further this partnership by piloting feasible, effective, and ethical strategies for recruiting and retaining a prospective cohort of 300 migrants in transit to clarify the factors that contribute to prevention of CMDs. Using data from this cohort this study aims to: 1) identify risk and protective factors for CMDs; 2) Estimate the short-term effect of economic services, social protection, legal assistance, and mental health interventions on reducing the risk of CMDs; and 3) evaluate the feasibility and acceptability of conducting a fully powered prospective cohort study of migrants in transit in Mexico followed over three years. This research is the first longitudinal investigation of mental health among migrants in transit, including underrepresented groups (women, children, separated families), and will innovatively measure the impact of multisectoral services on mental health outcomes among migrants during this critical phase of migration. Results from this study will provide critical and novel insights into the epidemiology of CMDs and will enable the development of targeted and efficient strategies to reduce the incidence of CMDs among migrants in transit in humanitarian emergencies.

项目概要 被迫流离失所已达到前所未有的水平，并且日益旷日持久 全球估计有 1 亿流离失所者，其中 75% 预计将流亡海外五年以上。拉丁 美国是国际上被迫流离失所人数增幅最大的国家 自 2017 年以来，由于处理庇护申请的延误以及允许广泛庇护的政策，边境 驱逐移民和寻求庇护者，许多移民和流离失所者暂时居住在 靠近美国边境的墨西哥北部正在等待另一个目的地的安全和更持久的解决方案。 流离失所者面临严重的逆境、侵犯人权行为和潜在的创伤事件， 增加他们在移民过程中患常见精神障碍（CMD）的风险。点流行率 流离失所者的 CMD 是全球平均水平的三倍多。尽管如此 由于负担加重，在过境国或目的地国没有合法身份的移民在 获得基本需求和服务，进一步加剧痛苦和 CMD 风险。最可用的数据 由于流动人口带来的实际和道德挑战，对移民心理健康的影响是跨部门的。 随着时间的推移人口。需要纵向数据来识别可改变的风险和保护因素 作为该人群 CMD 预防干预措施的目标。我们的研究团队代表了 建立了学术与人道主义伙伴关系，拥有开展心理健康研究的专业知识 流离失所者并为他们提供基于社区的心理健康和社会心理支持 社区，包括墨西哥。我们的目标是通过试点可行、有效和道德的方式进一步推进这种伙伴关系 招募和留住 300 名过境移民的潜在群体的战略，以澄清影响移民的因素 有助于预防 CMD。使用该队列的数据，本研究旨在：1）识别风险和保护措施 CMD 因素； 2) 估计经济服务、社会保护、法律援助、 降低 CMD 风险的心理健康干预措施； 3）评估可行性和可接受性 对墨西哥过境移民进行了一项全面的前瞻性队列研究，随后超过三个 年。本研究是首个针对过境移民心理健康状况的纵向调查，包括 代表性不足的群体（妇女、儿童、失散家庭），并将以创新方式衡量 在这一移徙的关键阶段，针对移徙者心理健康结果提供多部门服务。 这项研究的结果将为 CMD 的流行病学提供重要且新颖的见解，并使 制定有针对性的有效战略，减少过境移民中 CMD 的发生率 在人道主义紧急情况下。