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Refugee Mental Health and Wellbeing: Innovations, Ethics and New Directions

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Mental Health".

Deadline for manuscript submissions: closed (1 October 2022) | Viewed by 14610

Special Issue Editors

School of Social Sciences, Australian Human Rights Institute, University of New South Wales (UNSW), Sydney 2031, Australia
Interests: social health; arts-health research; participatory research; trauma-informed approaches; gender-sensitive research
Special Issues, Collections and Topics in MDPI journals
Psychosomatic and Psychotherapeutic Department, University Hospital Erlangen, 91054 Erlangen, Germany
Interests: psychosomatics; immigrant and refugee mental health; psychooncology and psychosocial aspects of transplantation; psychotherapy research

Special Issue Information

Dear Colleagues, 

This Special Issue entitled “Refugee Mental Health and Wellbeing: Innovations, Ethics and New Directions” is timely. As we take stock of the vast health and socioeconomic impacts of the COVID-19 pandemic, people from refugee and asylum-seeking backgrounds have continued to experience complex circumstances. The uncertainty of the past few months has presented significant challenges alongside new and creative opportunities to advance research on refugee mental health and wellbeing. We are now thinking about new ways of addressing enduring issues by focusing on strengths-based, interdisciplinary approaches. This Special Issue presents a selection of this exciting, innovative research.

We are particularly interested in papers that directly address diversity and intersectional issues with particular attention paid to the impacts of gender, age, language, sexual orientation, ethnicity, religion, educational, political and socioeconomic backgrounds or (dis)ability to dispel the myth that people from refugee and asylum-seeking backgrounds constitute one uniform group.

Since the last major migration movement associated with the Syrian war, international organisations such as WHO and European authorities have supported major projects for the psychosocial care of refugees and asylum seekers. It is very gratifying to see the first results of these projects being published. On the other hand, there is a lack of work that presents how innovative solutions may become sustainable.

Post-migratory concerns such as social exclusion and discrimination are significant concerns for the integration of refugees in host countries. We would therefore like to invite reports from the health care and community sector, as well as urban authorities and municipalities.

We encourage submissions from academic researchers co-written with people with lived experiences, as well as research that is explicitly decolonial. The field of refugee studies is still plagued by outsider views, especially from Global North countries. Let us ensure that this new decade marks a significant turning point in that respect.

Dr. Caroline Lenette
Prof. Dr. Yesim Erim
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • refugee mental health and wellbeing;
  • asylum-seeker health and wellbeing;
  • trauma-informed research;
  • ethics;
  • intersectionality.

Published Papers (6 papers)

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Research

18 pages, 771 KiB  
Article
Exploring Syrian Refugees’ Access to Medical and Social Support Services Using a Trauma-Informed Analytic Framework
by Neda Moayerian, Max Stephenson, Jr., Muddather Abu Karaki and Renad Abbadi
Int. J. Environ. Res. Public Health 2023, 20(3), 2031; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph20032031 - 22 Jan 2023
Viewed by 1680
Abstract
Even after arrival in new countries, refugees may be exposed to traumatic events. This state is exacerbated by contextual stressors, including the resettlement process, asylum proceedings and threats of deportation. This paper is rooted in a trauma-informed framework. We interviewed 16 male Syrian [...] Read more.
Even after arrival in new countries, refugees may be exposed to traumatic events. This state is exacerbated by contextual stressors, including the resettlement process, asylum proceedings and threats of deportation. This paper is rooted in a trauma-informed framework. We interviewed 16 male Syrian refugee migrant workers employed on a Jordanian farm during crop harvesting season to explore the quality and level of medical care and mental health services they received in light of the framework’s principal dimensions (e.g., safety, trust, intersectionality). We found that this vulnerable group of individuals is living a marginal and marginalized existence and depends on the goodwill of the growers for whom they work to treat them with a modicum of dignity and respect. Second, their itinerancy makes it difficult for this population to take advantage of available medical and mental health services at the nation’s major refugee camps. Finally, our interlocutors preferred their current lives, as isolating and limiting as they are, as superior to full-time residence in the camps, because they perceive their present way of life as according a measure of dignity, self-direction and autonomy they could not enjoy in the camps. Full article
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18 pages, 571 KiB  
Article
The Importance of Local and Global Social Ties for the Mental Health and Well-Being of Recently Resettled Refugee-Background Women in Australia
by Kate E. Murray, Caroline Lenette, Mark Brough, Katherine Reid, Ignacio Correa-Velez, Lyn Vromans and Robert D. Schweitzer
Int. J. Environ. Res. Public Health 2022, 19(17), 10917; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph191710917 - 01 Sep 2022
Cited by 3 | Viewed by 1710
Abstract
Social connections are foundational to the human condition and are inherently disrupted when people are forcibly displaced from their home countries. At a time of record high global forced migration, there is value in better understanding how refugee-background individuals engage theirsocial supports or [...] Read more.
Social connections are foundational to the human condition and are inherently disrupted when people are forcibly displaced from their home countries. At a time of record high global forced migration, there is value in better understanding how refugee-background individuals engage theirsocial supports or ties in resettlement contexts. A mixed methods research design aimed to understand the complexities of how 104 refugee-background women experienced their social networks in the first few months of resettlement in Australia. One of the research activities involved participants completing a survey with both quantitative and qualitative components. The quantitative analyses identified the impact of post-migration living difficulties that represented social stressors (worry about family, loneliness and boredom, feeling isolated, and racial discrimination) on the women’s mental health outcomes in the months following resettlement. The qualitative data highlighted the complexities of social relationships serving as both stressors and sources of support, and the importance of recognizing extended families and supports around the globe. The findings point to the need for nuanced accounts of the social contexts surrounding refugee resettlement as important influences able to promote trauma-informed and gender sensitive practices to support mental health and well-being in new settings. Full article
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17 pages, 373 KiB  
Article
Impact of and Coping with Post-Traumatic Symptoms of Refugees in Temporary Accommodations in Germany: A Qualitative Analysis
by Irja Rzepka, Catharina Zehetmair, Emma Roether, David Kindermann, Anna Cranz, Florian Junne, Hans-Christoph Friederich and Christoph Nikendei
Int. J. Environ. Res. Public Health 2022, 19(17), 10893; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph191710893 - 01 Sep 2022
Cited by 1 | Viewed by 1287
Abstract
Due to pre-, peri- and post-migratory stress factors, refugees often experience higher levels of psychological stress than the general population. Post-traumatic stress disorder, in particular, has an increased prevalence in the refugee population. However, living conditions in the early post-migratory phase are characterized [...] Read more.
Due to pre-, peri- and post-migratory stress factors, refugees often experience higher levels of psychological stress than the general population. Post-traumatic stress disorder, in particular, has an increased prevalence in the refugee population. However, living conditions in the early post-migratory phase are characterized by many challenges. In the present qualitative study, 14 refugees with symptoms of PTSD from temporary accommodations in Germany were interviewed in semi-structured interviews about their individual experiences of the impact of their trauma sequelae symptoms on their current living conditions and interactions. Participants reported dealing with post-traumatic symptoms primarily through distraction strategies, such as working or learning the language or social interaction. Many reported a sense of mistrust as a result of traumatic experiences. Current stress factors cited included uncertain asylum status, worry about family members and lack of ability to influence living situations. The interactions between the post-traumatic symptoms and the living conditions of the refugees were highlighted. The effects of the symptomatology of trauma sequelae and the framework conditions under which refugees live can lead to aggravated psychological distress. Therefore, special attention must be paid to refugee mental health care. Full article
10 pages, 327 KiB  
Article
The Effect of Postmigration Factors on Quality of Life among North Korean Refugees Living in South Korea
by Jung Eun Shin, Jung-Seok Choi, Soo-Hee Choi and So Young Yoo
Int. J. Environ. Res. Public Health 2021, 18(21), 11036; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182111036 - 20 Oct 2021
Cited by 4 | Viewed by 1873
Abstract
North Korean refugees have not only endured traumatic experiences in North Korea and during defection but have also undergone an adaptation process after arrival in South Korea. Their quality of life (QoL) is likely to be affected by these traumatic life events, leading [...] Read more.
North Korean refugees have not only endured traumatic experiences in North Korea and during defection but have also undergone an adaptation process after arrival in South Korea. Their quality of life (QoL) is likely to be affected by these traumatic life events, leading to subsequent posttraumatic stress disorder (PTSD), or postmigration adaptation-related stress, which involves a sense of dislocation with the culture, language, and people in South Korea. We investigated which aspects predicted the QoL of refugees from North Korea. Fifty-five participants currently living in South Korea completed a checklist about personal characteristics and traumatic experiences before, during and after migration. Diagnosis and symptom severity of PTSD, depressive mood, anxiety, and QoL were also assessed. A multiple regression analysis was performed to evaluate associations between QoL and other variables of interest. Overall, QoL was associated with previous economic status in North Korea, present occupation in South Korea, difficulty interacting with South Koreans, depressed mood, and state–trait anxiety. Finally, QoL was explained by having difficulty interacting with South Koreans, depressed mood, and state anxiety, with the model accounting for 51.3% of the variance. Our findings suggest that QoL among North Korean refugees in South Korea is influenced by the current level of their anxiety and depressed mood, and post-migration adaptation-related stress resulting from trying to integrate with South Koreans after settlement. Full article
15 pages, 825 KiB  
Article
The Role of Coping Strategies in Post-Traumatic Growth among Syrian Refugees: A Structural Equation Model
by Busra Acar, İbrahim H. Acar, Omar A. Alhiraki, Ola Fahham, Yesim Erim and Ceren Acarturk
Int. J. Environ. Res. Public Health 2021, 18(16), 8829; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18168829 - 21 Aug 2021
Cited by 9 | Viewed by 3166
Abstract
The Syrian conflict has led to a mass migration of Syrians to other countries and exposed them to many possible traumatic events and stressors in their country of origin and in the resettlement process. The possibility of positive psychological effects of adverse life [...] Read more.
The Syrian conflict has led to a mass migration of Syrians to other countries and exposed them to many possible traumatic events and stressors in their country of origin and in the resettlement process. The possibility of positive psychological effects of adverse life events is less documented among Syrian refugees. Thus, the current study aimed to develop preliminary evidence for the identifying factors: traumatic experiences, post-migration stressors and coping strategies that are associated with post-traumatic growth (PTG) of Syrian refugees residing in Turkey. Structural equation modeling (SEM) was used in the current study to assess the associations among these factors. Data were obtained from Syrian refugees residing in the governorates of Hatay and Mardin. A total of 528 Syrians, aged between 18–77 years (M = 35.60, SD = 11.65) participated in this cross-sectional study. Results from the SEM indicated that past traumatic experiences and post-migration stressors were indirectly related to PTG. The results from the current study provide support for that the association between refugees’ traumatic experiences, post-migration stressors and PTG appear to be explained through the presence of coping strategies which could be addressed in the psychotherapies and psychosocial interventions for refugees to promote positive psychological change. Future studies should address the effects of post-migration stressors on PTG in detail. Full article
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13 pages, 352 KiB  
Article
Traumatized Syrian Refugees with Ambiguous Loss: Predictors of Mental Distress
by Anna Renner, David Jäckle, Michaela Nagl, Anna Plexnies, Susanne Röhr, Margrit Löbner, Thomas Grochtdreis, Judith Dams, Hans-Helmut König, Steffi Riedel-Heller and Anette Kersting
Int. J. Environ. Res. Public Health 2021, 18(8), 3865; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18083865 - 07 Apr 2021
Cited by 8 | Viewed by 3216
Abstract
Refugees from war zones often have missing significant others. A loss without confirmation is described as an ambiguous loss. This physical absence with simultaneous mental persistence can be accompanied by economic, social or legal problems, boundary ambiguity (i.e., uncertainty about who belongs to [...] Read more.
Refugees from war zones often have missing significant others. A loss without confirmation is described as an ambiguous loss. This physical absence with simultaneous mental persistence can be accompanied by economic, social or legal problems, boundary ambiguity (i.e., uncertainty about who belongs to the family system), and can have a negative impact on mental health. The aim of this study was to identify sociodemographic and loss-related predictors for prolonged grief, anxiety, depression, post-traumatic stress disorder (PTSD) and somatization in treatment-seeking Syrian refugees with post-traumatic stress symptoms in Germany experiencing ambiguous loss. For the present study, data were based on the treatment-seeking baseline sample of the “Sanadak” randomized-controlled trial, analyzing a subsample of 47 Syrian refugees with post-traumatic stress symptoms in Germany experiencing ambiguous loss. Sociodemographic and loss-related questions were applied, along with standardized instruments for symptoms of prolonged grief (ICG), anxiety (GAD-7), depression (PHQ-9), PTSD (PDS-5) and somatization (PHQ-15). Linear regression models were used to predict mental health outcomes. Having lost a close family member and higher boundary ambiguity showed a statistically significant association with higher severity in prolonged grief. The overall model for somatization reached statistical significance, while no predictor independently did. Boundary ambiguity showed a statistically significant positive association with depression, while the overall model showed no statistically significant associations. Boundary ambiguity and missing family members seemed to be important predictors for prolonged grief. These findings support the importance of reunification programs and suggest an inclusion of the topic into psychosocial support structures, e.g., including psychoeducational elements on boundary ambiguity in support groups for traumatized individuals and families experiencing ambiguous loss. Further research is needed for a more detailed understanding of the impact of ambiguous loss on refugee populations. Full article
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