From trauma to resilience: a mixed methods study of negative and positive mental health in young Australian refugees from different cultures
Creators: name: Lau, Winnie
Publisher: name: RMIT University
Year: 2024

description: Refugees endure a range of war related traumatic events and subsequent resettlement stressors, prompting concern about their emotional impact. Youth refugees are particularly vulnerable because development is often incomplete, and responsibilities and expectations are high. Most refugee mental health research has used a psychiatric epidemiological approach to explore trauma related negative mental health outcomes such as PTSD or depression. This literature has enhanced understanding of emotional difficulties faced by refugees. However, not all refugees exposed to trauma develop mental health problems. This has led to the examination of alternative psychosocial and positive mental health variables such as quality of life and resilience.<br><br>Using an integrated theoretical ecological perspective, taking into account factors across pre-, peri- and post-migration phases, and a mixed quantitative and qualitative methodology, the aims of this research were to: (i) explore mental health and wellbeing in young refugees (aged 12-27; N=82) resettled in Australia, including refugees from Sudan, the Horn of Africa, and newer refugees from Togo and the Karen State; (ii) explore the relationship between negative mental health factors (PTSD, anxiety, depression, and somatisation) and positive and psychosocial mental health factors (resilience and quality of life); and (iii) examine cultural differences in these outcomes.<br><br>Almost all participants endorsed multiple traumatic events, including separation, loss, bereavement, deprivation of basic necessities, and (re)settlement stressors including language difficulties, racism, discrimination and worries about loved ones back home. Mental health problems were observed in almost 30% of the sample, though a proportion also displayed partial mental health symptomatology. Regression analyses confirmed the role of multiple pre-, peri-, and post-migration experiences, particularly trauma, in influencing PTSD, anxiety, depression and somatisation. However, different factors across the stages influenced different disorders. Trauma uniquely predicted PTSD and somatisation, while post-migration factors predicted anxiety and depression.<br><br>An inverse relationship was observed between the negative mental health outcomes and resilience and quality of life. Regression analyses also showed resilience predicted PTSD, anxiety, depression and somatisation, however different types of resilience were important in predicting different disorders. Community resilience uniquely predicted PTSD, peer resilience predicted anxiety, and individual resilience predicted depression and somatisation.<br><br>No cultural differences were found in resilience and quality of life, but Karen and Sudanese refugees scored greater on symptomatology than other cultures. Qualitative themes revealed narratives in journeys of flight, traumas, deprivation, loss, hardships, environmental contrasts, few opportunities for education and employment, cultural and community distance, developmental and intergenerational changes, homesickness, loneliness, social exclusion, racism, mental health constructs, anger and forgiveness, coping, strength and resilience.<br><br> In conclusion, youth refugees represent multiple and diverse cultures with complex negative mental health issues as well as strength factors. While psychopathology is relatively high, this thesis supports resilience as a salient construct among this group. As there is no unitary theory or discipline to explain mental health and well-being, an inter-disciplinary approach, comprised of psychiatric epidemiology and ecological approaches is necessary to advance knowledge and practice in this field to enable young refugees to move from trauma towards resilience. Theoretical, research, policy and clinical implications are discussed.