Exploring community capacity: Karen refugee women’s mental health

Abstract

PurposeThe purpose of this paper is to describe Karen refugee women’s experience of resettlement and the factors which structured community capacity to support their mental health and well-being.Design/methodology/approachA postcolonial and feminist standpoint was used to bring Karen women’s voice to the knowledge production process. Data were collected through ethnographic field observation, in-depth semi-structured individual and focus group interviews with Karen women as well as healthcare and social service providers.FindingsThree interrelated themes emerged from the data: Karen women’s construction of mental health as “stress and worry”; gender, language and health literacy intersected, shaping Karen women’s access to health care and social resources; flexible partnerships between settlement agencies, primary care and public health promoted community capacity but were challenged by neoliberalism.Research limitations/implicationsKaren women and families are a diverse group with a unique historical context. Not all the findings are applicable across refugee women.Practical implicationsThis paper highlights the social determinants of mental health for Karen women and community responses for mitigating psychological distress during resettlement.Social implicationsPublic health policy requires a contextualized understanding of refugee women’s mental health. Health promotion in resettlement must include culturally safe provision of health care to mitigate sources of psychological distress during resettlement.Originality/valueThis research brings a postcolonial and feminist analysis to community capacity as a public health strategy.

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“…The centrality of gender in determining health-seeking behavior was reflected in the way women often de-prioritized their own health, leisure and self-care, and healthcare-seeking in favor of their partners’ and children’s [ 3 , 32 , 35 ]. Another common experience during resettlement was the inability to care for one’s own health and wellbeing due to childcare roles and responsibilities [ 32 , 36 , 37 ]. Women found it challenging to find time to access medical services [ 36 ] or practice self-care through leisure or physical activity [ 38 ] as the absence of extended family limited options for childcare, a responsibility seemingly borne largely by women.…”

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“…However, a considerable amount of literature has been published on the extensive limitations of physical refugee camps which have outweighed the perceived benefits. These limitations include but are not limited to: mental health such as psychological distress [12,15,30], greater domestic violence towards women, illnesses amongst children under 5 [14], lack of dignity and normalcy [27], and poor health conditions such as chronic illness and spread of infectious diseases [18,36]. The UNHCR has published policies and standards for designing and implementing refugee camps or settlements, however, UNHCR prefers alternatives to camps, provided they protect and assist people of concern effectively [2].…”

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