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BMC Pregnancy and Childbirth
Published in: BMC Pregnancy and Childbirth 1/2015

Open Access 01-12-2015 | Research article

Pregnant migrant and refugee women’s perceptions of mental illness on the Thai-Myanmar border: a qualitative study

Authors: Gracia Fellmeth, Emma Plugge, Moo Kho Paw, Prakaykaew Charunwatthana, François Nosten, Rose McGready

Published in: BMC Pregnancy and Childbirth | Issue 1/2015

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Abstract

Background

Mental illness is a significant contributor to the global burden of disease, with prevalence highest in low- and middle-income countries. Rates are high in women of childbearing age, especially during pregnancy and the first year post-partum. Migrant and refugee populations are at risk of developing mental illness due to the multiple stressors associated with migration. The Thai-Myanmar border area is home to large populations of migrants and refugees as a result of long-standing conflict, poverty and unemployment in Myanmar. This study aims to explore perceptions of mental illness among pregnant migrants and refugees and antenatal clinic staff living and working along the Thai-Myanmar border.

Methods

Thirteen focus group discussions were conducted with pregnant migrants, pregnant refugees and antenatal clinic staff. Focus groups were held in one large refugee camp and two migrant health clinics along the Thai-Myanmar border. Thematic analysis was used to identify and code themes emerging from the data.

Results

A total of 92 pregnant women and 24 antenatal clinic staff participated. Discussions centered around five main themes: symptoms of mental illness; causes of mental illness; suicide; mental illness during pregnancy and the post-partum period; and managing mental illness. Symptoms of mental illness included emotional disturbances, somatic symptoms and socially inappropriate behavior. The main causes were described as current economic and family-related difficulties. Suicide was frequently attributed to shame. Mental illness was thought to be more common during and following pregnancy due to a lack of family support and worries about the future. Talking to family and friends, medication and hospitalization were suggested as means of helping those suffering from mental illness.

Conclusions

Mental illness was recognized as a concept by the majority of participants and there was a general willingness to discuss various aspects of it. More formal and systematic training including the development of assessment tools in the local languages would enable better ascertainment and treatment of mental illness in this population.
Literature
1.
Whiteford HA, Degenhardt L, Rehm J, Baxter AJ, Ferrari AJ, Erskine HE, et al. Global burden of disease attributable to mental and substance use disorders: findings from the global burden of disease study 2010. Lancet. 2013;382:1575–86.CrossRefPubMed
2.
Moussavi S, Chatterji S, Verdes E, Tandon A, Patel V, Ustun B. Depression, chronic diseases, and decrements in health: results from the world health surveys. Lancet. 2007;370:851–8.CrossRefPubMed
3.
4.
Commission on the Social Determinants of Health. Closing the gap in a generation: health equity through action on the social determinants of health. Final report of the Commission on Social Determinants of Health. Geneva: World Health Orgnisation; 2008.
5.
6.
Stewart DE, Robertson E, Dennis CL, Grace SL, Wallington T. Postpartum depression: Literature review of risk factors and interventions. Toronto: University Health Network Women’s Health Programme, University of Toronto; 2003.
7.
Gavin NI, Gaynes B, Lohr K, Meltzer-Brody S, Gartlehner G, Swinson T. Perinatal depression: A systematic review of prevalence and incidence. Obstet Gynecol. 2005;106:1071–83.CrossRefPubMed
8.
Fisher J, Cabral de Mello M, Patel V, Rahman A, Tran T, Holton S. Holmes W Prevalence and determinants of common perinatal mental disorders in women in low- and lower-middle-income countries: a systematic review. Bulletin of the World Health Organization. 2012;90:139–149H. 10.2471/BLT.11.091850.CrossRef
9.
O’Hara MW, Swain AM. Rates and risks of post-partum depression – a meta-analysis. International Review of Psychiatry. 1996;8:37–54.CrossRef
10.
Ross LE, McLean LM. Anxiety disorders during pregnancy and the postpartum period: A systematic review. J Clin Psychiatry. 2006;67:1285–98.CrossRefPubMed
11.
Patel V, Lund C, Hatherill S, Plagerson S, Corrigall J, Funk M, et al. Mental disorders: equity and social determinants. In: Blas E, Sivasankara Kurup A, editors. Equity, social determinants and public health programmes. Geneva: World Health Organization; 2010. p. 115–34.
12.
Lund C, De Silva M, Plagerson S, Cooper S, Chisholm D, Das J, et al. Poverty and mental disorders: breaking the cycle in low-income and middle-income countries. Lancet. 2011;2011(378):1502–14.CrossRef
13.
14.
Zimmerman C, Kiss L, Hossain M. Migration and health: a framework for 21st century policy-making. PLoS Medicine. 2011;8(5):e1001034. doi:10.1371/journal.pmed.1001034. Epub 2011 May 24.CrossRefPubMedPubMedCentral
15.
16.
Collins C, Zimmerman C, Howard LM. Refugee, asylum seeker, immigrant women and postnatal depression: rates and risk factors. Archives of Women’s Mental Health. 2011;14:3–11.CrossRefPubMed
17.
Fazel M, Wheeler J, Danesh J. Prevalence of serious mental disorder in 7000 refugees resettled in western countries: a systematic review. Lancet. 2005;365:1309–14.CrossRefPubMed
18.
United Nations Population Division. International migrant stock: the 2008 revision. Geneva: United Nations Population Division; 2009.
19.
20.
Pearson R, Kusakabe K. Thailand’s hidden workforce: Burmese migrant women factory workers. London: Zed Books; 2012.
21.
22.
23.
24.
25.
Dunlop N. Invisible people: stories of migrant labourers in Thailand. Bangkok: Raks Thai Foundation; 2011.
26.
27.
O’Neill M. Asylum, migration and community. Bristol: The Policy Press; 2010.CrossRef
28.
29.
Carrara VI, Hogan C, De Pree C, Nosten F, McGready R. Improved pregnancy outcome in refugees and migrants despite low literacy on the Thai-Burmese border: results of three cross-sectional surveys. BMC Pregnancy Childbirth. 2011;11:45.CrossRefPubMedPubMedCentral
30.
McGready R, Ashley EA, Wuthiekanun V, Tan SO, Pimanpanarak M, et al. Arthropod borne disease: the leading cause of fever in pregnancy on the Thai-Burmese border. PLoS Negl Trop Dis. 2010;4(11), e888. 10.1371/journal.pntd.0000888.CrossRefPubMedPubMedCentral
31.
White AL, Carrara VI, Paw MK, Malika H, Dahbu C, Gross MM, et al. High initiation and long duration of breastfeeding despite absence of early skin-to-skin contact in Karen refugees on the Thai-Myanmar border: a mixed methods study. Int Breastfeed J. 2012;7(1):19.CrossRefPubMedPubMedCentral
32.
Rijken MJ GME, Thwin MM, Kajeechewa HML, Wiladpahingern J, Lwin KM, Jones C, et al. Refugee and migrant women’s views of antenatal ultrasound on the Thai Burmese border: a mixed methods study. PLoS One. 2012;7:4–e34018.
33.
34.
Cheah PY, Lwin KM, Phaiphun L, Maelankiria L, Parker M, Day NP, et al. Community engagement on the Thai-Burmese border: rationale, experience and lessons learnt. International Health. 2010;2(2):123–9.CrossRefPubMedPubMedCentral
35.
Hoogenboom G, Thwin M, Velink K, Baaijens M, Charrunwatthana P, Nosten F, et al. Quality of intrapartum care by skilled birth attendants in a refugee clinic on the Thai-Myanmar border: a survey using WHO safe motherhood needs assessment. BMC Pregnancy Childbirth. 2015;15(1):17.CrossRefPubMedPubMedCentral
36.
37.
Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3:77–101.CrossRef
38.
Power DV, Pratt RJ. Karen refugees from Burma: focus group analysis. International Journal of Migration, Health and Social Care. 2012;82(4):156–66.CrossRef
39.
Lopez-Cardozo B, Talley L, Burton A, Crawford C. Karenni refugees living in Thai-Burmese border camps: traumatic experiences, mental health outcomes, and social functioning. Soc Sci Med. 2004;58:2637–44.CrossRef
40.
Lim AG, Stock L, Oo EKS, Jutte DP. Trauma and mental health of medics in eastern Myanmar’s conflict zones: a cross-sectional and mixed methods investigation. Confl Heal. 2013;7:15.CrossRef
41.
Der Wang, P. Southeast Asian mental health from the perspective of the bicultural provider (PhD thesis). University of Minnesota, 2007. UMI 3292991.
42.
Kitzinger J. The methodology of focus groups: the importance of interaction between research participants. Sociology of Health and Illness. 1994;16:103–21.6.CrossRef
43.
Kitzinger J. Qualitative research: introducing focus groups. Br Med J. 1995;311:299–302.CrossRef
44.
Lindsay SW, Ewald JA, Samung Y, Apiwathnasorn C, Nosten F. Thanaka (limonia acidissima) and deet (di-methyl benzamid) mixture as a mosquito repellent for use by Karen women. Med Vet Entomol. 1998;12:295–301.CrossRefPubMed
45.
Patel V, Araya R, Chatterjee S, Chisholm D, Cohen A, De Silva M, et al. Treatment and prevention of mental disorders in low-income and middle-income countries. Lancet. 2007;370:991–1005.CrossRefPubMed
Metadata
Title
Pregnant migrant and refugee women’s perceptions of mental illness on the Thai-Myanmar border: a qualitative study
Authors
Gracia Fellmeth
Emma Plugge
Moo Kho Paw
Prakaykaew Charunwatthana
François Nosten
Rose McGready
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2015
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/s12884-015-0517-0

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