The use of diagnosis-specific rates of mental hospitalization to estimate underutilization by immigrants

Abstract

A survey of 2867 admissions in 1971 for non-toxic, non-organic psychiatric diagnoses to 21 hospitals serving the Toronto catchment area showed immigrants' rates for psychosis to be 84 and 79% of the native-born, for males and females respectively, while for non-psychotic disorders they were 35 and 46%. Rates for non-psychotic disorders were lowest in groups most culturally distant from Canadian society. Immigrants in general tended to stay in hospital longer. Our findings suggest that milder immigrant cases are less likely to be hospitalized, and that this “underutilization” is culturally determined. The possible significance of lay treatment networks and blocks in the immigrant's pathway to care are discussed, and a social indicator of an immigrant group's cultural integrity is proposed.