Social Resilience and Mental Health Among Eritrean Asylum-Seekers in Switzerland

Abstract

Eritreans comprise the largest group of asylum-seekers in Switzerland. Gaining recognized refugee status can take up to 36 months, during which time asylum-seekers live in a state of legal limbo, intensifying threats to their well-being. Resilience and mental health among this population is poorly understood. We interviewed 10 asylum-seekers residing in Switzerland using qualitative, in-depth interviews. Data were analyzed using the Framework Method. Results indicated that mental health was understood as a binary state rather than a continuum and that trusted friends and family were responsible for recognizing and attempting to treat mental health problems. Pathways to care were potentially interrupted for asylum-seekers. Capital building, considered through the lens of social resilience, consisted of language learning, establishing of new individual- and community-level social networks, and proactive symbolic capital building through volunteering. We contextualize the asylum-seekers' experience into a resilience framework and offer practical recommendations for improving mental health care access.

‘Only God can promise healing.’: help-seeking intentions and lay beliefs about cures for post-traumatic stress disorder among Sub-Saharan African asylum seekers in Germany

“…Seeking treatment can therefore be interpreted as a social act that involves the affected person's social environment and needs to be initiated by parents, relatives, or community elders. This corresponds to previous research reporting that Eritrean and Somali refugees perceive trusted friends and family to be responsible for recognizing and attempting to find treatment for mental health problems (Bettmann, Penney, Clarkson Freeman, & Lecy, 2015;Melamed et al, 2019). Community and family cohesion should therefore be considered as crucial elements of recovery (Schnyder et al, 2016) and should be taken into account when treating immigrant and refugee populations from Sub-Saharan Africa (Baubet & Moro, 2013;Ehntholt & Yule, 2006;Murray, Davidson, & Schweitzer, 2010).…”

“…Community and family cohesion should therefore be considered as crucial elements of recovery (Schnyder et al, 2016) and should be taken into account when treating immigrant and refugee populations from Sub-Saharan Africa (Baubet & Moro, 2013;Ehntholt & Yule, 2006;Murray, Davidson, & Schweitzer, 2010). However, as Melamed et al (2019) point out, the reliance on friends and family for initiating treatment might also pose a barrier to treatment seeking for asylum seekers, who may be living far away from their families and may not yet have trusting relationships around them.…”

“…Moreover, Ethiopian refugees and asylum seekers in the UK reported relying more on interpersonal solutions or religious treatment when experiencing mental health problems (Papadopoulos, Lees, Lay, & Gebrehiwot, 2004). Eritrean refugees in Switzerland considered mental health to be related to faith, and described spiritual or church support as a first-line treatment for mental health issues and trips to holy waters as a cure for mental health problems (Melamed, Chernet, Labhardt, Probst-Hensch, & Pfeiffer, 2019). Studies on the help-seeking preferences of Somali refugees living in Western resettlement countries found a reliance on family, friends, and the ethnic and religious community, and a preference for religious sources of help (Ellis et al, 2010;Markova & Sandal, 2016).…”

Availability, Accessibility, Acceptability, and Quality of Interpreting Services to Refugee Women in New Zealand

“…More opportunity to learn English would not only provide them with confidence to communicate with others and become independent, but it might also open up opportunities for employment and social integration. As Melamed et al (2019) suggest, continued language learning opportunity enhances refugees' ability to communicate, widen social support networks, and strengthen their social resilience toward migration related mental health threats. Furthermore, Bhutanese women experienced difficulties in communicating issues related to reproductive health with male service providers and male interpreters due to their sociocultural norms.…”

(Mis)recognition in the Therapeutic Alliance: The Experience of Mental Health Interpreters Working With Refugees in U.K. Clinical Settings

“…Alongside language barriers (Shrestha-Ranjit et al, 2020), much of this research attributes problems of access (and compliance with treatment) to cultural differences and unfamiliarity with the Western conception of mental health (e.g., Maier & Straub, 2011;Morris et al, 2009). Other research has been more equivocal about reliance on "cultural difference" explanations, drawing attention to professionals' (and researchers') cultural stereotypes (Kerbage et al, 2020;Kirmayer, 2006) and biases that privilege essentialized individual-and cultural-level explanations and solutions for distress over social, economic, and political ones (Melamed et al, 2019;Premji, 2019;Shannon et al, 2015;Tippens, 2017). Regardless of the explanatory framework, what is clear is that refugees themselves express fear about being misunderstood and offered unhelpful advice and support from professionals of different cultural or experiential backgrounds (Behnia, 2003;Bernardes et al, 2011;De Anstiss & Ziaian, 2010;Kerbage et al, 2020;Majumder et al, 2015), and have greater confidence in expressing themselves and being understood in the presence of an interpreter (Hadziabdic & Hjelm, 2014).…”