A systematic review of resilience and mental health outcomes of conflict-driven adult forced migrants

Abstract

BackgroundThe rising global burden of forced migration due to armed conflict is increasingly recognised as an important issue in global health. Forced migrants are at a greater risk of developing mental disorders. However, resilience, defined as the ability of a person to successfully adapt to or recover from stressful and traumatic experiences, has been highlighted as a key potential protective factor. This study aimed to review systematically the global literature on the impact of resilience on the mental health of adult conflict-driven forced migrants.MethodologyBoth quantitative and qualitative studies that reported resilience and mental health outcomes among forcibly displaced persons (aged 18+) by way of exploring associations, links, pathways and causative mechanisms were included. Fourteen bibliographic databases and seven humanitarian study databases/websites were searched and a four stage screening process was followed.ResultsTwenty three studies were included in the final review. Ten qualitative studies identified highlighted family and community cohesion, family and community support, individual personal qualities, collective identity, supportive primary relationships and religion. Thirteen quantitative studies were identified, but only two attempted to link resilience with mental disorders, and three used a specific resilience measure. Over-reliance on cross-sectional designs was noted. Resilience was generally shown to be associated with better mental health in displaced populations, but the evidence on this and underlying mechanisms was limited.DiscussionThe review highlights the need for more epidemiological and qualitative evidence on resilience in forcibly displaced persons as a potential avenue for intervention development, particularly in resource-poor settings.

Immigrants’ Pathways to Outpatient Mental Health: Are there Differences with the Native Population?

“…Nonetheless, it is likely that the outpatient treatment is similar in natives and immigrants as far as number and frequency of contacts are concerned, but that it may show differences regarding the type of intervention delivered, mainly as far as psychotherapeutic interventions is concerned, as suggested by Spinogatti et al [6]. In our sample, the time elapsed between migration and referral to the CMHC was consistent with the literature [27,28]. It is not clear whether its duration depends on the presence of socio-cultural barriers that hinder immigrants' access to psychiatric facilities, or instead on the accumulation of stressful events through the years, eventually leading to the onset of psychiatric symptoms and disorders.…”

The Relationship Between Mental Health and Resilience: A Systematic Review and Meta-Analysis

“…This finding is compatible with that of Siriwardhana et al (2014) and Hartley (2011) (44,45). Resilience is the capacity of an individual to demonstrate psychological health in a situation in which society views it as aversive (46).…”

Improving access to and engagement with mental health services among young people from refugee backgrounds: service user and provider perspectives

“…The rising global burden of forced migration is increasingly recognised as an important issue in global and international public health (Siriwardhana, Sheik Ali, Roberts, & Stewart, 2014). There is some degree of evidence that children and young people from a refugee background have greater vulnerability to the development of mental health problems and to suicidal behaviour (Vijayakumar & Jotheeswaran, 2010).…”

“…Low or 'lower than expected' levels of service use may in part reflect reduced levels of need for service and a great degree of resilience (e.g. (Siriwardhana et al, 2014;Steel, Silove, Chey, Bauman, & Phan, 2005;Weine et al, 2000)). Nevertheless, studies that have measured mental health needs and service utilisation levels have found that the majority of young refugees who have significant mental health needs do not access services (e.g., (Bean, Eurelings-Bontekoe, Mooijaart, & Spinhoven, 2006;Ziaian, 2013).…”