Living a frozen life: a qualitative study on asylum seekers’ experiences and care practices at accommodation centers in Sweden

Abstract

Background Forced migrants fleeing conflict and violence face a high risk of mental health problems due to experiences before displacement, perilous journeys, and conditions in the new host societies. Asylum seekers seem to be in particularly vulnerable situations, indicated by higher prevalence rates of mental health problems compared to resettled refugees. Asylum seekers’ mental health is highly influenced by the conditions they face in host countries while awaiting a decision on their case. In Sweden, 40% of asylum seekers reside in state-provided accommodation centers during the asylum process. Collective accommodation centers for asylum seekers have been said to impose restrictive social conditions and to be associated with poorer mental health outcomes than other housing forms (e.g., self-organized housing). However, there seems to be a scarcity of qualitative studies exploring the experiences of asylum seekers in different contexts. The aim of this study was therefore to explore the experiences of asylum seekers and how they manage their mental wellbeing while living at accommodation centers in Sweden. Methods Fourteen semi-structured interviews with asylum seekers were conducted at two accommodation centers in Sweden. Participants were recruited using purposeful sampling and represented a diverse group of asylum seekers regarding age, background, and gender. The data was analyzed using content analysis. Results Three overarching categories were identified; 1) Frozen life, 2) Constant worrying and “overthinking”, and 3) Distractions and peer support. Participants experienced a state of being that could be characterized as a frozen life, which was associated with intense feelings of psychological distress, mostly described as manifesting itself in consuming patterns of ruminative thoughts, for instance overthinking and constant worrying. However, despite high levels of distress, participants demonstrated agency in managing negative mental health outcomes through self-care practices, peer support, and the development of care practices in caring for others in need. Conclusion This study offers new insights into the everyday challenges that asylum seekers at accommodation centers face. Furthermore, it offers valuable observations of how asylum seekers at accommodation centers cope through self-care practices, peer support, and care practices in caring for peers in need. In order to enable sustainable and empowering support, mental health and psychosocial support services must identify and address both challenges and strengths, be grounded in the lived reality of asylum seekers, and build on existing resources. Moreover, further policy work needs to be done to enable faster asylum processes.

(Over)crowded house: exploring asylum seekers’ experiences of the COVID-19 pandemic while living at accommodation centers in Sweden

“…Already prior to the pandemic, a large body of research had described asylum seekers’ situation as precarious and as potentially harmful to their health, both physical and mental [ 29 , 30 ]. Scholars have depicted it as a life in limbo [ 31 ] or as living a frozen life [ 9 ]. Thus, the effects of the COVID-19 pandemic added to already existing challenges and can be understood based on the concept of a crisis within a crisis , which has been aptly used to describe the situation of other vulnerable refugee groups during the pandemic [ 32 ].…”

“…This study was part of larger ongoing project focusing on asylum seekers’ experiences, and the data collection was conducted for the purpose of two different studies, one previously described elsewhere [ 9 ]. Hence, the interviews were divided into two parts with two different aims in mind.…”

“…Asylum seekers, individuals who have applied for asylum (protection) in another country but have not yet been granted refugee status, were already a vulnerable group in society prior to the COVID-19 pandemic, with higher levels of both physical and mental ill health than among host populations [ 5 – 7 ]. Studies have highlighted risk factors for ill health such as the unpredictable and uncertain asylum process, potentially traumatic experiences from before migration, the vulnerable socioeconomic situation, and a lack of healthcare rights in countries of asylum [ 8 , 9 ]. Furthermore, the type of housing, such as collective accommodation centers or self-organized housing in the community, has also been highlighted as a determinant of health among asylum seekers [ 10 , 11 ], with collective institutional accommodations being shown to be related to a higher increase in psychological distress [ 12 ].…”

Patient Safety and People Who Are Incarcerated

“…Even for people without a prior mental illness, the experience of incarceration can act to facilitate these conditions. One high profile example of this is the rapid mental deterioration of many asylum seekers incarcerated while they await a review of their situation, in detention centres around the world [27,28]. Commonly reported mental health issues experienced by long term detainees included "Depression and demoralisation, concentration and memory disturbances, and persistent anxiety … Standardised measures found high rates of depression, anxiety, PTSD and low quality of life scores" [29: 2070].…”

Accommodation centres for asylum seekers as sites of conflict and collaboration: Strategies for the prevention of violence

“…In recent years, growing political and scholarly attention has been paid to the issue of conflict and violence in asylum seekers' accommodation centres (Christ et al, 2017;van Eggermont Arwidson et al, 2022;Lorenz et al, 2023). The literature predominantly focuses on violent acts in the centres involving accommodation residents and staff, leading to descriptions of centres as dangerous sites of conflict and violence.…”