BACKGROUND The fast-growing migrant population in Japan and globally poses challenges in mental healthcare, yet research addressing migrants' mental health treatment engagement remains limited. OBJECTIVE This study examined language proficiency, demographic and clinical characteristics as predictors of early treatment discontinuation among migrants. METHODS Electronic health record data from 196 adult migrants, identified from 14 511 patients who received mental health outpatient treatment during 2016 and 2019 at three central hospitals in the Tokyo-Yokohama metropolitan region of Japan, were used. We conducted multivariable regression models to identify predictors of early discontinuation within 3 months. FINDINGS The study cohort (65% women, age range: 18-90 years, from 29 countries or regions) included 23% non-Japanese speakers. Japanese and non-Japanese speakers had similar discontinuation rates (26% vs 22%). Multivariable models revealed younger age (OR=0.97; 95% CI: 0.95, 0.99; p=0.016) and those with a primary diagnosis other than a schizophrenia spectrum disorder (OR=3.99; 95% CI: 1.36, 11.77; p=0.012) or a neurotic, stress-related and somatoform disorder (OR=2.79; 95% CI: 1.14, 6.84; p=0.025) had higher odds of early discontinuation. These effects were more pronounced among the Japanese speakers with significant language-by-age and language-by-diagnoses interactions. CONCLUSION Younger age and having a primary diagnosis other than a schizophrenia spectrum disorder or a neurotic, stress-related and somatoform disorder increased vulnerability for discontinuing mental health treatment early in Japanese-speaking migrants but not for migrants with limited Japanese proficiency. CLINICAL IMPLICATIONS Understanding language needs within a context of mental health treatment should go beyond assumed or observed fluency. Unmet language needs might increase vulnerability for treatment disengagement among migrants. Targeted clinical efforts are crucial for enhancing early treatment engagement and informing health practices in Japan and countries with growing migrant populations.

中文翻译：

---

探索心理健康门诊治疗的早期终止：日本移民人群的语言、人口统计和临床特征。


背景日本和全球快速增长的移民人口给心理保健带来了挑战，但针对移民心理健康治疗参与度的研究仍然有限。目的 本研究考察了语言能力、人口统计学和临床​​特征作为移民早期停止治疗的预测因素。方法 使用 196 名成年移民的电子健康记录数据，这些数据来自 2016 年和 2019 年在日本东京-横滨大都市区的三家中心医院接受心理健康门诊治疗的 14 511 名患者。我们进行了多变量回归模型来确定 3 个月内提前停药的预测因素。结果 研究队列（65% 为女性，年龄范围：18-90 岁，来自 29 个国家或地区）包括 23% 的非日语使用者。日语和非日语使用者的停药率相似（26% vs 22%）。多变量模型显示年龄较小（OR=0.97；95% CI：0.95, 0.99；p=0.016）和主要诊断为精神分裂症谱系障碍以外的患者（OR=3.99；95% CI：1.36, 11.77；p=0.012 ) 或神经质、压力相关和躯体形式障碍 (OR=2.79; 95% CI: 1.14, 6.84; p=0.025) 早期停药的可能性较高。这些影响在说日语的人中更为明显，并且语言与年龄之间以及语言与诊断之间存在显着的相互作用。结论 对于讲日语的移民来说，年龄较小且初步诊断为精神分裂症谱系障碍或神经质、压力相关和躯体形式障碍以外的疾病的人较早停止心理健康治疗的可能性更大，但日语水平有限的移民则不然。 临床意义 在心理健康治疗的背景下理解语言需求不应超出假设或观察到的流利程度。未满足的语言需求可能会增加移民脱离治疗的脆弱性。有针对性的临床工作对于提高日本和移民人口不断增长的国家的早期治疗参与度和宣传健康实践至关重要。