Migration background and unmet care needs for depression and anxiety among young adults in Sweden

Background

Depression and anxiety are common in young adulthood, yet many affected individuals do not receive adequate care. It remains unclear if and how unmet care needs for these conditions differ across migration backgrounds. This study examines unmet care needs for depression and anxiety and explores differences by migration background among young adults in Sweden.

Methods

Data came from a national Swedish survey (Futura01) of 21-year-olds conducted in 2022, with linked registry information from 2022–2025 (n = 3,037). Depression and anxiety symptoms were measured using the Patient Health Questionnaire-4 (PHQ-4; 0–12), categorised as no/mild (0–5), moderate (6–8), and severe (9–12). Care receipt was defined using registry data on diagnoses from specialised care (ICD-10 F chapter). Migration background was categorised into five groups: (1) native Swedes; (2) born in the Global North; (3) born in the Global South; (4) Swedish‑born with at least one parent from the Global North; and (5) Swedish‑born with at least one parent from the Global South. Covariates included sex and parental education. Descriptive statistics and adjusted multinomial logistic regression models were performed.

Results

In the total sample, 23.7% reported moderate or severe symptoms, and among these, only a minority (24.3%) received diagnoses from specialised mental care. Compared with native Swedes, the relative risk of unmet care needs was higher among young adults born in the Global South (RRR 2.09, 95% CI 1.19–3.66) and among those with parents born there (RRR 1.65, 95% CI 1.08–2.53). No significant differences were observed for individuals born in the Global North or with parents born there.

Conclusions

In Sweden, young adults with a Global South migration background have substantially higher levels of unmet care needs for depression and anxiety, as defined in the present study. Addressing these disparities is critical to ensuring equitable access to mental health services.

Key messages

• Unmet care needs for depression and anxiety are higher among young adults who were born in the Global South or whose parents were born there.

• Addressing these disparities is essential for advancing equitable mental health policy, and future research should investigate the social, cultural, and systemic factors that contribute to them.