What you need to know
This study explored refugee parents’ experiences of resettlement stressors and mental health, the impacts of these stressors on their own and their family’s well-being, and parents’ methods of coping. Post-migration stressors can increase the risk of mental disorders among forcibly displaced individuals.
To address information gaps on the mental health and coping strategies of resettled refugee parents, the researchers conducted a mixed-methods study. They found that refugee parents experienced high levels of psychological distress associated with economic and social stressors. Risk factors such as ill-health, being a single parent, low levels of literacy and high levels of household conflict seemed to worsen parental distress. Despite daily hardships, most participants reported coping well and using strategies such as positive reframing, family support and turning to religion.
The findings suggest that refugee parents could benefit from programs incorporating culturally responsive and family-based mental health care models and providing comprehensive social and economic support beyond the first one to two years of arrival.
What is this research about?
Previous studies have shown that post-migration stressors increase the risk of mental disorders among forcibly displaced individuals, which can intensify the mental health impacts of pre-migration trauma. However, little is known about the mental health of resettled refugee parents, despite evidence indicating a higher risk of poorer mental health outcomes among this population. Additionally, there are few studies about the coping strategies used by refugee parents to adapt to their new environments.
This study integrates family systems and social determinants of refugee mental health frameworks to examine:
- refugee parents’ experiences of resettlement stressors and mental health
- perceived impacts of resettlement stressors on individual and family indicators of well-being
- refugee parents’ coping strategies and resources.
What did the researchers do?
The study team conducted a mixed-methods survey with 40 Government-Assisted Refugee parents who had resettled to Hamilton, Canada between 2018 and 2022. The study focused on Arabic-speaking refugees because of the large number of Syrian families that resettled in Canada since 2016 as part of the federal government’s humanitarian response. Case workers from an organization providing settlement services in Hamilton contacted eligible clients by telephone to introduce the study and seek consent.
Participant inclusion criteria were:
- arrived in Canada as a Government-Assisted Refugee since 2018
- fluent in Arabic
- primary caregiver to at least one child aged four to 17 years.
Each participant completed an interview in Arabic via web conference or telephone. Interviewers documented open-ended responses in the interviewees’ own words before translating them into English. The researchers analyzed quantitative and qualitative data separately before combining them at the results stage.
What did the researchers find?
The average age of study participants was 43 years old. 60% of respondents were female, and 85% were married. A majority of respondents (78%) had primary or secondary education, and more than half (58%) were unemployed and not seeking work due to illness, disability, being a full-time caregiver or inability to speak English. 90% relied on government assistance as their main source of income.
Daily-life resettlement stressors
A majority of participants reported that daily stressors such as concern for the safety and well-being of loved ones abroad, obtaining good quality housing, reuniting with family members outside Canada, paying back the immigration loan and paying the bills affected their family’s mental well-being. Certain challenges, such as difficulties learning and communicating in English, had on-going negative impacts on their ability to perform essential tasks such as accessing healthcare or seeking employment.
Parental distress and intersecting post-migration stressors
The daily challenges of language barriers, poor housing, inadequate income, family separation and difficulty accessing healthcare had a compounding and intersecting effect on the mental health of refugee parents. Half of the parents in the study screened positive for severe psychological distress.
The research team asked participants to complete two copies of a 5-point scale to rate their own health and that of a randomly selected child in their household. The researchers interpreted answers on the lower end of the scale (1 and 2 points) as indicating a poor health status. For the first scale, 65% of the participants answered that their health was “poor” (1 point) or “fair” (2 points). For the second scale, 28% of participants considered their child’s health to be “poor” or “fair”. These participants indicated that their own or their family member’s health condition added to their psychological burden.
COVID-19-related restrictions further increased parental distress and family conflicts by reducing opportunities for social interaction, learning the language or adjusting to the societal and cultural norms of their new environment. Inter-adult conflict in the household also appeared to be an important risk factor for refugee parents’ mental health.
The researchers noted that most participants attributed their distress to current resettlement-related stressors rather than pre-migration trauma. Single parents seemed to be particularly vulnerable to resettlement stressors given their increased sense of isolation and helplessness.
Coping strategies and family as a source of resilience
Despite high levels of psychological distress and resettlement stressors, the majority of parents (85%) rated themselves as coping “well” or “very well”. Participants mentioned several coping strategies including positive reframing, seeking support from service providers, problem-solving and turning to religion.
Interestingly, study participants did not describe the negative impact of daily stressors and psychological distress on family functioning and well-being. Participants reported 2–3 positive parent-child interactions per week and few parent-child or inter-adult conflicts (less than once a month). Many parents highlighted the importance of family as a source of emotional support and resilience that enabled them to cope with daily hardships.
Limitations of the research
The researchers note several limitations of the study. Since all respondents were Government-Assisted Refugees with a majority from Syria, the study sample may not be representative of the broader, diverse refugee population arriving in Canada. The findings should also be interpreted in the specific context of the COVID-19 pandemic as data collection took place during that time. Finally, the researchers assessed coping with a single self-rated item, which does not capture the range of coping strategies described by participants.
How can you use this research?
These findings suggest that refugee parents are at greater risk of poor mental health due to difficult post-migration social and economic conditions and specific caregiving stressors, highlighting the urgent need to address structural and social determinants of refugee mental health. The research team notes that policies and programs should provide comprehensive social and economic support to refugees beyond the first two years of arrival in order to lessen the psychological toll of resettlement. Additionally, these programs should incorporate culturally-responsive, family-based models of mental health care that acknowledge the family system as a source of resilience.
About the researchers
Amanda Sim1, Eve Puffer2, Afreen Ahmad1, Lina Hammad1 and Katholiki Georgiades1
- Department of Psychiatry and Behavioural Neurosciences, The Offord Centre for Child Studies, McMaster University, Hamilton, ON, Canada
- Department of Psychology and Neuroscience, Duke Global Health Institute, Duke University, Durham, NC, USA