Mechanisms underlying the mental health impact of family separation on resettled refugees

Abstract

Objective: Many refugees experience prolonged separation from family members, which research suggests has adverse effects on mental health and post-displacement outcomes in refugee populations. We examine mental health differences in refugees separated and not separated from their families, and key post-migration factors and cultural mechanisms that may underlie this impact. Methods: A sample of 1085 refugees resettled in Australia, of which 23.3% were separated from all of their immediate family, took part in an online battery of survey measures indexing pre- and post-migration refugee experiences, mental health symptoms, disability and individualistic/collectivistic self-identity. Family separation was used as a predictor of mental health outcomes in a series of linear regressions, and the separated and non-separated groups were compared in multigroup path analysis models to examine group-specific indirect effects. Results: The separated group reported greater exposure to pre-migration potentially traumatic events and higher levels of post-migration living difficulties compared to the non-separated group. Family separation predicted higher post-traumatic stress and depression symptoms, but not disability, after controlling for potentially traumatic event exposure, age and sex. Path analyses revealed distinct indirect effects for separated and non-separated groups. Principally, higher collectivistic self-identity was associated with elevated post-traumatic stress, depression and disability symptoms via social-related post-migration living difficulties such as isolation and loneliness in the separated group; whereas collectivism was linked with increased depression symptoms via economic-related post-migration living difficulties in the non-separated group. Conclusion: These findings indicate that family separation powerfully influences mental health outcomes, but that its effect may be mediated by the type of post-migration stress experienced in the settlement environment and culturally bound differences in how the sense of self is interconnected with family.

The association between COVID-19 related stressors and mental health in refugees living in Australia

“…While refugees were concerned with being personally infected, they also demonstrated high levels of fear for family and worry about infecting others. This might reflect the fact that many refugees come from collectivistic cultural backgrounds, which cultivate a sense of self that is interdependent with others, particularly their families (Liddell et al, 2021 ). High prevalence of this particular stressor may also reflect the fact that many refugees may be concerned about their family members living in their home countries or other contexts (e.g.…”

“…Indeed, factors that contribute to increased social inclusion have been associated with stronger psychological adaptation in refugees settled in Germany (von Haumeder, Ghafoori, & Retailleau, 2019 ). The combination of pre-existing isolation, elevated depression symptoms which engenders social withdrawal (Nickerson et al, 2019 ), the inability to engage in crucial social-based coping strategies due to COVID-19 restrictions and ongoing separation from family (Liddell et al, 2021 ), may have particularly potent consequences for the mental health and functioning in refugee populations during COVID-19.…”

Activating the attachment system modulates neural responses to threat in refugees with PTSD

“…, 2013 ), an effect that is independent from overall trauma exposure ( Miller et al. , 2018 ; Liddell et al. , 2021 ).…”

Inclusive Settlement of Young Asylum Seekers in a Rural Region: The Role of Informal Support and Mentoring

“…Firstly, we highlight the ability of mentoring to provide companionship and social support to those people who were experiencing their rooting process alone. Lack of social support and separation from family members were aspects that, as different authors have highlighted [45], generate discomfort in the mental health of refugees and asylum seekers, mainly because of feelings of isolation and discriminatory or exclusionary experiences in the new environment. The young asylum seekers in this study highlight how the presence of mentors in their lives generated a sense of "family" or, at least, meant a safe space in which to share an activity that allowed them to put aside concerns related to the migratory process they were experiencing and thus reducing feelings of isolation and loneliness.…”