Residential mobility and associated factors as predictors of psychological well-being among Somali refugees in London

Abstract

Background: Previous research has consistently documented that residential mobility creates stress, of various degrees, on the individuals involved. However, when the process of mobility compounds other stressful postmigration events such as poor housing, lack of relocation choice, deprivation and disruption to the social support networks, it may have more devastating health impact on vulnerable groups. Objective: To explore the relationship between residential mobility and mental health of Somali refugees and whether mobility across primary care trust (PCT) boundaries, choice over move and distances moved are associated with higher risk of mental disorder. Methods: Of the 150 individuals planned, 143 (95.3%) were successfully interviewed. 100 subjects were recruited from qualitatively mapped non-health community venues and 43 from General Practitioners’ (GP) registers in two boroughs of London. The present study assessed the mental status of the study participants using culturally adopted Mini Neuro-psychiatric Interview (MINI). Modified Accommodation Record Questionnaire collected information on their residential movements and choice of relocation in the preceding five and half years. Results: Overall, 108 (75.5%) of the participants made one or more moves in the last 5.5 years. Of these, 60 (55.6%) were females and 48 (44.4%) males; (χ2 = 4.8, df =1, p<0.03). The majority of the movers 71 (65.7%) were recruited from non-health community venues while the remaining 37 (34.3%) were recruited from the General Practice (GP) registers; χ2 = 3.7, df =1, p<0.05. In logistic regression analysis, when fully adjusted for age, gender, marital status, social network beyond household, insult because of race or religion, immigration status, tenure current and period of stay in the UK; risk of mental disorder was associated with residential mobility (Odds Ratio [OR], 3.8; 95% 5 CI: 1.2 – 9.9, P < 0.02), Crossing Primary Care Trust Boundaries (OR, 4.0; 95%CI = 1.4 – 11.5; p = 0.005), lack of choice over move (OR, 4.3; 95% CI = 1.5 – 12.4; p = 0.008), most recent move (5.1; 95%CI = 1.6 – 16.1; p = 0.005) and moving longer distances than 10.2km (OR, 4.6; 95% CI = 1.4 – 15; p = 0.01). Men who were cases were more likely to change address (OR, 4.9; 95%CI: 1.3 – 19; p < 0.02) than women (OR, 2.0; 95%CI: 0.5 - 11.1; p < 0.2) even after adjusting for all possible confounding variables. Conclusion: In addition to documented post-migration difficulties, residential mobility, lack of choice in the process of moving and longer distances moved were all associated with mental disorders in Somali refugees and asylum seekers living in London. Involving clients in the decision making during the relocation process and also taking into account the practical social support network may lessen the burden of mental disorders of the study population.