Health Outcomes In Refugees Research Articles

Profiles of post-migration stressors and mental health in refugees: A latent class analysis

Studies have documented the mental health effects of pre-migration trauma on resettled refugees and identified distinct psychological symptom profiles using person centred statistical techniques (e.g., latent class analysis; LCA). These techniques have advanced our understanding of the complex presentation of trauma and psychopathology in refugees. The current study employs LCA to examine patterns of exposure to stressors including post-migration stressors, allowing us to identify patterns of post-migration stress exposure and their association with mental health outcomes. Participants were 1085 Arabic, Farsi, Tamil, or English speaking adult refugees. Pre-migration trauma, post-migration stressors, PTSD, depression, anger, and functional impairment was measured. LCA was conducted to identify distinct classes of post-migration stressors and associations with mental health and adjustment in the resettlement environment. Latent class analysis revealed 5 classes of participants: high difficulties class (7.2%), immigration fear class (14.4%), social disconnection class (17.3%), moderate difficulties class (28.9%) and a low difficulties class (32.3%). Each of the five classes shared commonalities in addition to key differences associated with specific demographic characteristics and psychopathology. Post-migration stressors appear to map onto distinct profiles, which uniquely contribute to functional impairment and mental health outcomes in refugees. These findings have substantial implications for public health and social services working with resettled refugee communities.

Access to health-care policies for refugees and asylum-seekers

Purpose The influx of refugees and asylum-seekers over the past decade into the European Union creates challenges to the health systems of receiving countries in the preparedness and requisite adjustments to policy addressing the new needs of the migrant population. This study aims to examine and compare policies for access to health care and the related health outcomes for refugees and asylum-seekers settling both in the UK and Germany as host countries. Design/methodology/approach The paper conducted a scoping review of academic databases and grey literature for studies within the period 2010-2017, seeking to identify evidence from current policies and service provision for refugees and asylum-seekers in Germany and the UK, distilling the best practice and clarifying gaps in knowledge, to determine implications for policy. Findings Analysis reveals that legal entitlements for refugees and asylum-seekers allow access to primary and secondary health care free of charge in the UK versus a more restrictive policy of access limited to acute and emergency care during the first 15 months of resettlements in Germany. In both countries, many factors hinder the access of this group to normal health care from legal status, procedural hurdles and lingual and cultural barriers. Refugees and asylum-seeker populations were reported with poor general health condition, lower rates of utilization of health services and noticeable reliance on non-governmental organizations. Originality/value This paper helps to fulfill the need for an extensive research required to help decision makers in host countries to adjust health systems towards reducing health disparities and inequalities among refugees and asylum-seekers.

Qualitative exploration of the impact of employment and volunteering upon the health and wellbeing of African refugees settled in regional Australia: a refugee perspective

BackgroundPeople from refugee backgrounds face various challenges after moving to a new country. Successfully securing employment has been linked to positive health outcomes in refugee populations; there is less research into the impact of volunteering on health outcomes in refugees, or the role of employment and volunteering in regional or rural communities. This study aims to explore how employment and volunteering influences the health and wellbeing of refugees settled in regional Australia, and identify areas for appropriate service provision.MethodsNine adults of refugee background in regional Australia were purposively sampled through community organisations using word-of-mouth referrals for semi-structured interviews. Interviews were transcribed. Thematic analysis was used to uncover emergent themes and identify relationships between themes. A strengths-based theoretical framework was adopted to inform further analysis.ResultsPaid work and volunteering engenders a sense of self-fulfillment and sense of belonging, facilitating successful integration into a new community. Employment further allows maintenance of an adequate standard of living, thus improving healthcare access and promoting healthy lifestyle behaviours. Adverse effects from employment include difficulties managing work-life balance, disconnect with family and loss of traditional heritage, but these were significantly outweighed by the positive effects. Volunteering provides no financial incentive, but similarly promotes community connections and positive self-worth, preparing refugees for the workforce. Both employment and volunteering held direct positive benefits for their physical and mental health, improved healthcare access and promoted cultural and social integration. These factors enabled successful settlement and subsequently improved overall wellbeing of participants. A strengths-based approach demonstrated how participants used employment as a tool for seeking purpose and ongoing self-development.ConclusionUnique experiences with employment and volunteering in a regional area amongst a refugee community were explored. Our results describe various ways in which meaningful employment and volunteering can facilitate positive health and wellbeing outcomes of refugees, and thus reinforces the importance of providing such opportunities to ensure successful settlement. The benefits of volunteering in this community have not been previously explored. Additionally, concerns expressed and recommendations suggested by participants could be used to inform future research, policy, interventions and health and employment service provision for refugee populations.

The Relationship Between Post-Migration Stress and Psychological Disorders in Refugees and Asylum Seekers.

Refugees demonstrate high rates of post-traumatic stress disorder (PTSD) and other psychological disorders. The recent increase in forcible displacement internationally necessitates the understanding of factors associated with refugee mental health. While pre-migration trauma is recognized as a key predictor of mental health outcomes in refugees and asylum seekers, research has increasingly focused on the psychological effects of post-migration stressors in the settlement environment. This article reviews the research evidence linking post-migration factors and mental health outcomes in refugees and asylum seekers. Findings indicate that socioeconomic, social, and interpersonal factors, as well as factors relating to the asylum process and immigration policy affect the psychological functioning of refugees. Limitations of the existing literature and future directions for research are discussed, along with implications for treatment and policy.

Adult attachment in the context of refugee traumatisation: the impact of organized violence and forced separation on parental states of mind regarding attachment

Starting from an outline of the refugee experience as a process of cumulative traumatisation, we review research literature on mental health outcomes in refugees. Next, an integration of findings on relational processes in refugee families documents the role of the family unit as a key interactive context patterning the impact of sequential traumatisation. Relating these trauma- and migration-specific family processes to their central dimension of provision or disruption of emotional availability in a context of chronic adversity, we aim to explore the development of unresolved and insecure parental states of mind regarding attachment during forced migration. Starting the research report, a method discussion on the administration of 11 Adult Attachment Interviews with adult refugees as part of an explorative multiple case study integrates deontological and technical reflections on the use of the Adult Attachment Interview in a context of ongoing traumatisation. The paper then presents findings on adult attachment in refugees and highlights representational processes involved in the potential disruption of caregiver availability during refugee traumatisation.