The epidemiology of schizophrenia among Caribbean-born and first- and second-generation migrants in Britain

The study of migrants in their new environments is often a useful means of investigating environmental influences on health. Migrants have been found to develop higher rates of mental illness compared to their counterparts who remain at home. These deleterious effects of migration have been attributed to selection factors and stressful life experiences. Migration from an agricultural and traditional society to an urban industrial society where value systems can be demanding, often leads to role strain and role conflict. These kinds of incongruities are the beginning of a series of stressful experiences that contribute to poor health/mental health status. The extent to which one experiences stress is dependent on a number of factors. First, it depends on the perceived difference between home and the new environment. Second, it depends on the cultural homogeneity of the new environment, that is, the extent to which the migrant is readily assimilated into the new culture or is able to maintain a traditional lifestyle by living in an ethnic enclave, and the psychological resources available to successfully access services in the new environment. This paper examines the rates, incidence, and prevalence of schizophrenia found in Caribbean-born immigrants to Britain, and first- and second-generation people of Caribbean background born in Britain. It is argued that Afro-Caribbean people in England are overrepresented in the diagnosis of schizophrenia. Factors that may contribute to this finding range from unemployment, social disadvantage status, social adversity, racism in the health and criminal justice systems, and misdiagnosis.This paper was completed when the author served as Distinguished Visiting Professor-William Patterson College, Wayne, New Jersey.