MARKKULA NIINA, KATARIINA
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MARKKULA NIINA, KATARIINA
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kmarkkula@udd.cl
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54994163500

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Purchases of psychotropic drugs among the migrant population in Finland: a nationwide register-based cohort study

2020 , Venla Lehti , Jaana Suvisaari , Mika Gissler , MARKKULA NIINA, KATARIINA

Abstract Background Migrant populations may have different mental health service needs when compared with native populations. One indicator of service use is the use of psychotropic medication. The aim of this study was to compare the purchases of psychotropic drugs among different migrant populations with the native population in Finland. Methods Foreign-born participants (n = 184 805) and their Finnish-born controls (n = 185 183) were identified from the Finnish Central Population Register. Information on their purchases of psychotropic drugs in 2011–15 was collected from the National Prescription Register. A washout period of 2009–10 was used to define incident purchases. Cox regression analysis was the statistical method used. Results At least one incident purchase of a psychotropic drug was identified for 11.1% of migrant women, 11.4% of Finnish-born women, 8.7% of migrant men and 9.8% of Finnish-born men. When controlled for age, sex, marital status, socioeconomic status and social assistance, migrants were less likely to purchase psychotropic drugs (adjusted hazard ratio 0.96, 95% confidence interval 0.93–0.98), but there was variation between different drug categories. Recent migrants and migrants from Asia and Sub-Saharan Africa were least likely to purchase drugs. Migrants from Nordic countries and other Western countries most closely resembled the Finnish-born controls. Conclusions Recent migrants in Finland appear to use fewer psychotropic drugs than native Finns. It is important to analyze the reasons for this pattern, as they may indicate delays in access to care or benefits. The heterogeneity of migrant populations must also be considered when developing services to better address their needs.

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Incidence and prevalence of mental disorders among immigrants and native Finns: a register-based study

2017 , MARKKULA NIINA, KATARIINA , Venla Lehti , Mika Gissler , Jaana Suvisaari

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The Impact of Universal Health Care Programmes on Improving 'Realized Access' to Care for Depression in Chile

2018 , Ricardo Araya , Pedro Zitko , Niina Markkula

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Effectiveness of non-medical health worker-led counselling on psychological distress: a randomized controlled trial in rural Nepal

2019 , C. A Decosimo , J. Hanson , M. Quinn , P. Badu , E. G. Smith , MARKKULA NIINA, KATARIINA

Background.This paper reviews the efficacy of a community psychosocial arts program focused on building mental health capacity within post-Ebola Liberia. The aim of this paper was to evaluate the outcome effects of two groups using pre- and post-treatment data. We hypothesized that there would be a difference in symptoms pre- and post-treatment, and the longer program would yield more significant results.Methods.There was a total of 870 child participants. Of 40 sites, 24 were selected for a 5-month treatment (TG1) while the remaining 16 sites received 3 months of treatment (TG2). Pairedttests and a mixed-model analysis of variance (ANOVA) were used to analyse pre- and post-psychological stress symptoms (PSS) for samples from both groups.Results.Separately, treatment group 1 (TG1) and treatment group 2's (TG2) pairedttest yielded significant results (p< 0.001) for the decrease of PSS. The mixed-model ANOVA found that there were significant differences in total pre- and post-test PSS and a significant difference in PSS means over time.Conclusions.Results indicated that there was a statistically significant decrease in reported symptoms in both treatment groups pre- to post-intervention and a significant difference in total symptoms over time. However, the findings do not indicate that the longer programming was statistically different compared to the shorter programming. The study presented had gaps in data, largely due to limits in research during the crisis. However, this paper provides a unique case study for challenges that can be faced for project evaluation in emergency settings.

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“If I get sick here, I will never see my children again”: The mental health of international migrants during the COVID-19 pandemic in Chile

2022 , Alice Blukacz , CABIESES VALDES, BALTICA BEATRIZ , Kate E. Pickett , OBACH KING, ALEXANDRA ALICE , Paula Madrid , CARREÑO CALDERON, ALEJANDRA ANGELICA , MARKKULA NIINA, KATARIINA , Cesar Infante Xibille

Background The COVID-19 pandemic has had an impact on the mental health of international migrants globally. Chile has managed its response to the pandemic in an ongoing context of social unrest and combined regional migratory and humanitarian crisis. The country’s population presents a high prevalence of common mental disorders and a high suicide rate, with limited access to mental healthcare. International migrants in Chile represent 8% of the total population, and although a socioeconomically heterogenous group, they face social vulnerability, a range of mental health stressors and additional barriers to access mental healthcare. This study describes the mental health outcomes, stressors, response, and coping strategies perceived by international migrants during the COVID-19 pandemic in Chile. Methods and findings A qualitative case study was carried out through individual online interviews to 30 international migrants living in Chile during the pandemic and 10 experts of the social and health care sectors. An inductive content analysis was carried out, a process during which the researchers sought to identify patterns and themes derived from the data. Participants experienced mainly negative mental health outcomes, including anxiety and depression symptomatology. Stressors included the virus itself, work, living and socioeconomic conditions, discrimination, fear for their family and distance caring. Institutional responses to address the mental health of international migrants during the pandemic in Chile were limited and participants relied mainly on individual coping strategies. Conclusions The pandemic can represent an important opportunity to strengthen mental health systems for the general population as well as for population groups experiencing social vulnerability, if the issues identified and the lessons learned are translated into action at national, regional, and international level. Promoting the mental health of international migrants means recognising migration as a social determinant of mental health and adopting a cross-cultural as well as a Human Rights approach.

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Inequities in mental health and mental healthcare between international immigrants and locals in Chile: a narrative review

2020 , Alice Blukacz , CABIESES VALDES, BALTICA BEATRIZ , Niina Markkula

Abstract Mental health in a context of international migration is a particularly pressing issue, as migration is recognised as a social determinant of physical and mental health. As Chile is increasingly becoming a receiving country of South-South migration, immigrants face mental health inequities, with regards to outcomes and access to care. In order to identify and synthetize mental healthcare inequities faced by international migrants with regards to locals in Chile, a narrative review of the literature on national mental healthcare policies in Chile and a narrative review of the literature on migrants’ mental healthcare in Chile were conducted, with a focus on describing mental health outcomes, policy environment and persisting gaps and barriers for both topics. The existing literature on mental healthcare in Chile, both for the general population and for international migrants, following the social determinant of health framework and categorised in terms of i) Inequities in mental health outcomes; ii) Description of the mental health policy environment and iii) Identification of the main barriers to access mental healthcare. Despite incremental policy efforts to improve the reach of mental healthcare in Chile, persisting inequities are identified for both locals and international migrants: lack of funding and low prioritisation, exacerbation of social vulnerability in the context of a mixed health insurance system, and inadequacy of mental healthcare services. International migrants may experience specific layers of vulnerability linked to migration as a social determinant of health, nested in a system that exacerbates social vulnerability. Based on the findings, the article discusses how mental health is a privilege for migrant populations as well as locals experiencing layers of social vulnerability in the Chilean context. International migrants’ access to comprehensive and culturally relevant mental healthcare in Chile and other countries is an urgent need in order to contribute to reducing social vulnerability and fostering mechanisms of social inclusion. International migration, social determinants of mental health, mental health inequities, social vulnerability, review.

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An evaluation of the absolute and relative stability of alexithymia over 11 years in a Finnish general population

2017 , A Hiirola , S Pirkola , M Karukivi , N Markkula , RM Bagby , M Joukamaa , A Jula , E Kronholm , S Saarijärvi , JK Salminen , J Suvisaari , G Taylor , AK Mattila , MARKKULA NIINA, KATARIINA

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Changes in prevalence and correlates of alcohol-use disorders in Finland in an 11-year follow-up

2019 , Sebastián Peña , Jaana Suvisaari , Tommi Härkänen , Niina Markkula , Suoma Saarni , Janne Härkönen , Pia Mäkelä , Seppo Koskinen

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Use of health services among international migrant children – a systematic review

2018 , Niina Markkula , CABIESES VALDES, BALTICA BEATRIZ , Venla Lehti , Eleonora Uphoff , Sofia Astorga , Francisca Stutzin

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Predictors of new-onset depressive disorders - Results from the longitudinal Finnish Health 2011 Study

2017 , Niina Markkula , Niko Marola , Tarja Nieminen , Seppo Koskinen , Samuli I. Saarni , Tommi Härkänen , Jaana Suvisaari

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