Persistence of the association between mental health and resource access: A longitudinal reciprocal model in a diverse refugee sample.

Abstract

Stress associated with resource deprivation is an active social determinant of mental health. However, mixed findings around the strength of this association and its persistence over time obscure optimal interventions to improve mental health in forcibly displaced populations. A reciprocal model was analyzed between resource access and measures of depression, anxiety and posttraumatic stress (PTSD) symptoms at three different assessments conducted 6 months apart (Time [T] 1, T2, and T3). Participants included resettled refugees (N = 290) from three geocultural regions (i.e., Afghanistan, the Great Lakes Region of Africa, and Iraq/Syria). The results showed that although limited resource access at T1 was related to depressive and anxiety symptoms, B = 0.26, SE = 0.16, p = .023, r2 = 0.55; posttraumatic stress disorder (PTSD) symptoms, B = 0.20, SE = 0.10, p < .001, r2 = .56; and culturally specific depression and anxiety at T2, B = 0.22, SE = 0.16, p < .001, r2 = 0.65, these were not reciprocally related to resource access at T3. The results help clarify the strength and direction of effects between resource deprivation and depression, anxiety , and PTSD sympotms over time. Although resource deprivation is predictive of depression, anxiety, and PTSD symptoms among recently resettled refugees, the effect may not persist in the long term. These findings have critical implications, including the urgency of ensuring initial access to resources for resettled refugees to stave off the development of depression, anxiety and PTSD symptoms, as delaying immediate resource access may result in the development of chronic, hard-to-treat mental health disorders.