A recent comprehensive review has discovered various influential protective and supportive elements linked to improved mental health outcomes among adult refugees.
A recent thorough review led by Professor Angela Nickerson from UNSW has uncovered numerous significant protective and favorable factors associated with enhanced mental health results in refugee adults.
“Although a history of persecution, conflict, and displacement correlates with elevated rates of mental health disorders like PTSD and depression, it’s noteworthy that most refugees, despite facing severe challenges, do not end up developing these disorders,” states Professor Nickerson, who is the Director of the Refugee Trauma and Recovery Program at UNSW’s School of Psychology.
Nonetheless, past studies have primarily aimed at understanding factors that lead to psychological distress or disorders, rather than those that contribute to well-being or resilience.
“Recently, there has been a shift towards a strengths-based perspective in mental health, especially concerning refugees, and we aimed to explore existing research in this area,” explains Professor Nickerson.
The article published this week in Nature Mental Health is the first to concentrate on elements that foster better mental health among refugees.
For their review, the researchers examined four databases for relevant studies, evaluating thousands of articles, of which 174 met the inclusion criteria. Of these, 81% were conducted among refugees in high-income countries (HICs) and 19% in lower- and middle-income countries (LMICs).
“The scarcity of studies focused on predictors of positive mental health emphasizes the predominant deficit-oriented approach in refugee mental health research,” notes Professor Nickerson. She also pointed out that although 75% of the global refugee population resides in LMICs, much of the research originates from HICs.
“This highlights a significant gap in refugee research,” she adds.
What were the researchers investigating?
“Our systematic review encompassed studies examining the mental health of refugees or asylum seekers, focusing on factors we categorized as either protective or promotive of mental health. Protective factors help lessen unfavorable mental health outcomes, while promotive factors contribute positively to mental health,” explains Professor Nickerson.
The aim was to explore how to strengthen individual or community capacities to reduce or prevent distress.
“We were interested in a range of aspects, from demographic and social factors to environmental and psychological influences,” Professor Nickerson mentions.
“Our goal was to articulate various implications and recommendations for the field of refugee mental health—everything from strategies that psychologists or social workers could implement with clients to broader policy considerations that can be established in countries hosting refugees to help individuals heal and progress after traumatic experiences.”
Study Findings
The review revealed that the refugee experience is marked by prolonged exposure to uncertainty and danger. Factors relating to stability and predictability displayed some of the strongest connections with positive mental health in refugees.
“It stands to reason that to help individuals who have endured significant hardships to overcome these challenges and flourish, it is essential to establish conditions that meet their fundamental safety needs,” states Professor Nickerson.
The research revealed that a secure immigration status, stable employment, adequate income, quality housing, and control over one’s environment were linked to favorable mental health outcomes in both HICs and LMICs.
People differ in their ability to handle tough situations, with resilience indicating how well an individual can recover or maintain good mental health amidst adversity.
The findings indicated that psychological factors such as cognitive strategies, self-efficacy, and a sense of control are protective and promotive of well-being.
Enhancing individual skills and abilities to cope and thrive is a vital aim for promoting mental health within refugee populations.
“When we seek to understand how to best assist individuals, we often focus on the negatives, leading our interventions to be centered around those aspects. This study highlights the importance of developing strategies linked to resilience, self-efficacy, and psychological adaptability,” adds Professor Nickerson.
However, the experiences of war, persecution, and displacement operate on a societal level, necessitating that approaches to fostering mental health post-trauma extend beyond the individual to encompass community-wide strategies.
“There is a strong correlation between social engagement and support and positive mental health outcomes for refugees, especially those in wealthier countries,” Professor Nickerson points out.
“Factors such as the ability to speak the host country’s language, social support, interaction with both their own and the host community, as well as religious coping methods, were associated with improved well-being.”
The Way Forward
This review proposes a clear research agenda with at least three significant pathways to enhance understanding of refugee mental health well-being, according to Professor Nickerson.
“First, there is a need to intentionally investigate factors linked to well-being and positive mental health outcomes, rather than solely concentrating on elements that lead to psychological distress. Refugee communities demonstrate remarkable resilience, providing valuable lessons from individuals who have triumphed over adversity in their new environments.
“Secondly, it is crucial to address the research gap in LMICs. The bulk of the refugee population resides in temporary settings outside HICs. To deliver effective support, we must explore factors that enhance well-being in those contexts.
“Finally, adopting an interdisciplinary research approach is vital. By uniting researchers, psychologists, social workers, and policymakers, we can develop a deeper understanding of protective and promotive factors. Prioritizing refugee voices in this process is essential to identify key research areas and utilize findings effectively. This approach will assist in shaping policies and initiatives that enable refugee communities to flourish.”
This research received support from the Social Policy Group.
