Public defence: Kamila Angelika Hynek

An increasing number of individuals live with a mental disorder, yet not everyone has the same risk of developing one. Studies indicate that young women as well as migrants may be at particular risk.

Thus, being a young woman and a migrant may result in a double burden. Despite this, knowledge of the differences in risk factors for, and consequences of, mental disorders between women with and without migrant background is limited.

Aim

This thesis aims to shed light on whether potential risk factors such as persistent low parental income (PLI) and early marriage are associated with mental disorders.

Additionally, the thesis examines whether mental disorders are associated with upper-secondary school completion and income. Uniquely, in this thesis, I focus on whether these associations vary between women with and without migrant background. 

Materials and methods

This thesis builds on data extracted from five national registries. Outpatient mental healthcare (OPMH) service use is applied as a proxy for mental disorder. Data were analysed by use of descriptive statistics and various regression analyses, depending on the research question of interest.

Differences in the associations of interest between migrant and non-migrant women were analysed by inclusion of an interaction term between the exposure variable and migrant background. Four independent studies, focusing on different stages of the life course, constitute the foundation of this thesis. 

Results

The findings indicated that PLI is a risk factor for mental disorder for young non-migrants, but it does not appear to be a risk factor for young migrants. Furthermore, although early marriage may increase the odds of mental disorder compared to on-time marriage, the differences are attributed to poorer educational attainment among those who marry early rather than the timing of marriage.

No differences between migrant and non-migrant women were found, thus, migrant background plays a limited role in the association between marital timing and mental disorder. Further, mental disorders were found to be associated with lower probability of upper-secondary school completion and loss of income regardless of migrant background.

However, some groups such as majority and descendant women are more adversely affected by mental disorder in terms of both school completion and income loss, while women from Eastern Europe appear less affected.

Conclusions

Mental disorders, defined by OPMH service use, can negatively influence young women's lives, regardless of their migrant background. However, there are significant differences between young non-migrants and some groups of migrants.

These findings could indicate that some migrant groups may be more resilient both in terms of exposure to potential risk factors for, but also to the negative consequences of, mental disorders.

Yet, based on existing knowledge regarding the barriers to care faced by migrants, the results could alternatively indicate that the application of OPMH service use is a poorer proxy of mental disorder for migrants than for non-migrants.

Future research should therefore aim to investigate the mechanisms behind the rather weak association between PLI and mental disorder, or less adverse consequences of mental disorders among some migrant groups.  Further, it is important to prevent mental disorders during vulnerable life stages to hinder the negative consequences on the accumulation of socioeconomic resources.

When already affected by mental disorders, young women should be supported to stay in and complete their education and enter or remain in the workforce. This is important as disruption of education or loss of income may influence future dependency on social welfare services and other health outcomes, as well as contribute to maintaining or even increasing inequality in the society.