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Abstract
Despite the frequency that refugees suffer bereavement, there is a dearth of research into the prevalence and predictors of problematic grief reactions in refugees. To address this gap, this study reports a nationally representative population-based study of refugees to determine the prevalence of probable prolonged grief disorder (PGD) and its associated problems. This study recruited participants from the Building a New Life in Australia (BNLA) prospective cohort study of refugees admitted to Australia between October 2013 and February 2014. The current data were collected in 2015-2016, and comprised 1767 adults, as well as 411 children of the adult respondents. Adult refugees were assessed for trauma history, post-migration difficulties, probable PGD, post-traumatic stress disorder (PTSD) and mental illness. Children were administered the Strengths and Difficulties Questionnaire. In this cohort, 38.1% of refugees reported bereavement, of whom 15.8% reported probable PGD; this represents 6.0% of the entire cohort. Probable PGD was associated with a greater likelihood of mental illness, probable PTSD, severe mental illness, currently unemployed and reported disability. Children of refugees with probable PGD reported more psychological difficulties than those whose parents did not have probable PGD. Probable PGD was also associated with the history of imprisonment, torture and separation from family. Only 56.3% of refugees with probable PGD had received psychological assistance. Bereavement and probable PGD appear highly prevalent in refugees, and PGD seems to be associated with disability in the refugees and psychological problems in their children. The low rate of access to mental health assistance for these refugees highlights that there is a need to address this issue in refugee populations.
Highlights
The current refugee crisis has resulted in over 22 million refugees across the globe, and over 40 million internally displaced persons (UNHCR, 2017)
We measured (a) the association of Prolonged grief disorder (PGD) with probable post-traumatic stress disorder (PTSD) because of the increased risk for PTSD resulting from repeated exposure to traumatic events (Steel et al, 2009), (b) psychological distress because of the ongoing stressors experienced by refugees (Li et al, 2016) and (c) self-reported
The analysis is based on the Building a New Life in Australia (BNLA) study undertaken by the Australian Government Department of Social Services (DSS) (Edwards et al, 2018)
Summary
The current refugee crisis has resulted in over 22 million refugees across the globe, and over 40 million internally displaced persons (UNHCR, 2017). Rates of probable PGD in refugees have varied between 8 and 54% (Craig et al, 2008; Schaal et al, 2010), but these have been in small, clinical or non-representative studies. These rates do not provide accurate estimates of the occurrence of PGD in refugees. We measured (a) the association of PGD with probable PTSD because of the increased risk for PTSD resulting from repeated exposure to traumatic events (Steel et al, 2009), (b) psychological distress because of the ongoing stressors experienced by refugees (Li et al, 2016) and (c) self-reported
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