Abstract
PurposeThe purpose of this paper is to describe Karen refugee women’s experience of resettlement and the factors which structured community capacity to support their mental health and well-being.Design/methodology/approachA postcolonial and feminist standpoint was used to bring Karen women’s voice to the knowledge production process. Data were collected through ethnographic field observation, in-depth semi-structured individual and focus group interviews with Karen women as well as healthcare and social service providers.FindingsThree interrelated themes emerged from the data: Karen women’s construction of mental health as “stress and worry”; gender, language and health literacy intersected, shaping Karen women’s access to health care and social resources; flexible partnerships between settlement agencies, primary care and public health promoted community capacity but were challenged by neoliberalism.Research limitations/implicationsKaren women and families are a diverse group with a unique historical context. Not all the findings are applicable across refugee women.Practical implicationsThis paper highlights the social determinants of mental health for Karen women and community responses for mitigating psychological distress during resettlement.Social implicationsPublic health policy requires a contextualized understanding of refugee women’s mental health. Health promotion in resettlement must include culturally safe provision of health care to mitigate sources of psychological distress during resettlement.Originality/valueThis research brings a postcolonial and feminist analysis to community capacity as a public health strategy.
Highlights
The process of migration and the context of resettlement are determinants for the mental health and overall well-being of refugee women
Purposeful sampling occurred through recruitment posters and information letters distributed by community j j PAGE 246 INTERNATIONAL JOURNAL OF HUMAN RIGHTS IN HEALTHCARE VOL. 11 NO. 4 2018 leaders working with an Early Years Refugee Project (EYRP), a non-profit service organization aimed to support early childhood education for refugee women with children between the ages of zero to six
Three dominant themes emerged from the data and include: Karen women’s construction of mental health as “stress and worry”; gender, language and health literacy intersected, shaping Karen women’s access to health care and social resources; community capacity was promoted through collaboration across settlement agencies, primary care and public health but challenged by neoliberalism
Summary
The process of migration and the context of resettlement are determinants for the mental health and overall well-being of refugee women. Resettlement is recognized as a key protection tool for refugee women and girls at risk to ensure protection and well-being, but only if their gendered specific needs are recognized and addressed (United Nations High Commissioner for Refugees, 2013). Refugee women’s mental health is impacted by resettlement factors related to complex gender role strain, lack of social support, low literacy and education, domestic violence and discrimination (Kirmayer et al, 2011; Raphael et al, 2012; Beiser, 2009). Functional health literacy requires ability to utilize health resources, such as making medical appointments and navigating health care systems (Mitschke et al, 2013; United Nations High Commissioner for Refugees, 2013; Williams and Meadows, 2017; Zanchetta et al, 2012)
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