Psychiatric and social problems among immigrants

High rates of mental morbidity among migrants are common but not universal. Differences in rates may reflect factors in: (a) the country of origin; (b) the actual move; (c) the country of settlement. About 1.8 million people came to Britain in 1950–1970 from the West Indies and Indian subcontinent. They resembled Gastarbeiters in other European countries, except that as Commonwealth citizens they had the right of permanent residence. With their children (many of whom are now adults) they are 3.5% of Britain's population. Britain does not have a liberal compolitan culture in which newcomers are welcomed, and the situation has deteriorated in response to high unemployment, constrained public expenditure, and widening gulfs between income‐groups. Minority groups are scapegoated, and racial prejudice is more apparent than ever. Black people face obstacles in education and employment. Immigration laws which curtail the right to live in Britain have created insecurity, which is aggravated by insensitive policing and irresponsible press reporting. Institutions and authorities have been slow to respond to the different needs of new cultures. Riots receive more publicity than the daily violence which black people experience, which includes implicit contempt expressed as negative stereotypes, and explicit physical harassment. In this situation a high incidence of stress‐related disporders might be predicted. There has been insufficient community‐based research but one study of Indian and Pakistani samples showed them to have less mental and emotional disorder than indigenous controls. Research using mental hospital admission data gives conflicting results, but generally seems to show high admission rates among people of Caribbean background: they are more often admitted compulsorily, or detained in high security units. This does not apply to Asians. The difference between Asian and Afrocaribbean groups raises questions, since they arrived at about the same time and for similar reasons. Asians having their own languages, religions and culture, might have expected more adaptational difficulty than the Afro‐Caribbeans who understood English, were Christians, and had an education and culture modelled on an English pattern. Both are victims of racist hostility and discrimination. If the relationship between adaptation and mental illness were simple we might expect Asians to be more vulnerable than Afrocaribbeans: not the reverse. Perhaps variables in the country of settlement (see (c) above) are less important than was supposed, and more attention should be paid to variables (a) and (b).