The association between visa insecurity and mental health, disability and social engagement in refugees living in Australia

Nickerson, Angela; Byrow, Yulisha; O’Donnell, Meaghan; Mau, Vicki; McMahon, Tadgh; Pajak, Rosanna; Li, Susan; Hamilton, Amber; Minihan, Savannah; Liu, Candy; Bryant, Richard A.; Berle, David; Liddell, Belinda J.

doi:10.1080/20008198.2019.1688129

Cited by 69 publications

(84 citation statements)

References 35 publications

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“…Indeed, financial strain experienced by asylum seekers [ 38 ] has been suggested to adversely affect mental health by creating conditions in the host country that make accessing social support difficult. Similarly, perceived discrimination not only affects mental health negatively [ 12 ], but may also decrease social engagement [ 21 , 39 ]. Additionally, the experience of social exclusion and isolation related to asylum seekers being confined in housing facilities and lacking citizenship can be detrimental, not only to mental health [ 10 ], but also decrease the perceived levels of social support.…”

Section: Discussionmentioning

confidence: 99%

Exploring Social and Financial Hardship, Mental Health Problems and the Role of Social Support in Asylum Seekers Using Structural Equation Modelling

Sengoelge

Solberg

Tatarko

et al. 2020

IJERPH

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Asylum seekers are exposed to a range of social and financial difficulties suggested to adversely impact mental health. Uprooted social networks and living conditions during the asylum seeking process potentially predispose this population to low access to social support. The aim of this study was to examine the relationship between social and financial hardship and mental health problems, and assess the potential mediating role of social support among asylum seekers. Cross sectional survey data from a cohort of asylum seekers in Sweden (N = 455) were subjected to structural equation modelling for examining hypothesized pathways between social and financial hardship, common mental health problems (CMHPs) and social support. Fit indices showed adequate to excellent fit of the examined models with CMHPs as the outcome (all CFI ≥ 0.951, RMSEA < 0.05, SRMR < 0.056). CMHPs were positively regressed on social and financial hardship (B = 0.786, S = 0.102, p < 0.001) and negatively regressed on social support (B = −0.103, SE = 0.032, p = 0.001). Social support mediated the association between social and financial hardship and CMHPs (effect estimate = 0.075, 95% CI = 0.032–0.136). The results point to the importance of social and living conditions of asylum seekers and indicate that social support is both socially patterned and may act as a mitigating resource to inform interventions and policies.

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Section: Discussionmentioning

confidence: 99%

Exploring Social and Financial Hardship, Mental Health Problems and the Role of Social Support in Asylum Seekers Using Structural Equation Modelling

Sengoelge

Solberg

Tatarko

et al. 2020

IJERPH

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“…Individuals in each of the trauma-exposed classes were also more likely to have travelled to Australia by boat, likely reflecting high exposure to trauma during the journey (e.g. witnessing drownings at sea, and lack of food and water (Hauff and Vaglum, 1993;Nickerson et al, 2019)). In addition, Australian immigration policy dictated that all refugees who travelled by boat to Australia without a valid visa during the data collection phase of the study were subsequently held in immigration detention or offshore processing centres (Parliament of Australia, 2013-2014), with this experience being associated with exposure to adverse events such as witnessing selfharm and physical assault, discrimination and lack of access to medical care (Steel et al, 2006).…”

Section: Discussionmentioning

confidence: 99%

“…In addition, Australian immigration policy dictated that all refugees who travelled by boat to Australia without a valid visa during the data collection phase of the study were subsequently held in immigration detention or offshore processing centres (Parliament of Australia, 2013 –2014), with this experience being associated with exposure to adverse events such as witnessing self-harm and physical assault, discrimination and lack of access to medical care (Steel et al ., 2006 ). These findings extend on past research that has documented greater PTE exposure in refugees with insecure visas, many of whom had arrived in Australia by boat (Steel et al ., 2006 ; Nickerson et al ., 2019 ), to suggest that these individuals also experience a greater diversity of PTE exposure. Membership in the trauma-exposed classes was also associated with greater ongoing stressors in the post-displacement environment.…”

Section: Discussionmentioning

confidence: 99%

“…Facebook) and snowball sampling, which has been found to be effective for difficult-to-access populations (Sadler et al ., 2010 ). Participants in this study had entered Australia via two pathways (Nickerson et al ., 2019 ). Approximately three-quarters of the sample ( n = 826, 76.1%) had applied for and been granted refugee status prior to arriving in Australia (via the United Nations High Commissioner for Refugees or Australia's humanitarian programme).…”

Section: Methodsmentioning

confidence: 99%

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Profiles of exposure to potentially traumatic events in refugees living in Australia

Nickerson

Byrow

Rasmussen

et al. 2021

Epidemiol Psychiatr Sci

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Aims Refugees and asylum-seekers are typically exposed to multiple potentially traumatic events (PTEs) in the context of war, persecution and displacement, which confer elevated risk for psychopathology. There are significant limitations, however, in extant approaches to measuring these experiences in refugees. The current study aimed to identify profiles of PTE exposure, and the associations between these profiles and key demographics, contextual factors (including ongoing stressors, method of travel to Australia and separation from family), mental health and social outcomes, in a large sample of refugees resettled in Australia. Methods Participants were 1085 from Arabic, Farsi, Tamil and English-speaking refugee backgrounds who completed an online or pen-and-paper survey in their own language. Constructs measured included PTE exposure, demographics, pre-displacement factors, ongoing stressors, post-traumatic stress disorder symptoms, depression symptoms, anger reactions, plans of suicide and social engagement. Results Latent class analysis identified four profiles of PTE exposure, including the torture and pervasive trauma class, the violence exposure class, the deprivation exposure class and the low exposure class. Compared to the low exposure class, participants in the trauma-exposed classes were more likely to be male, highly educated, from Farsi and Tamil-speaking backgrounds, have travelled to Australia by boat, experience more ongoing stressors and report both greater psychological symptoms and social engagement. Conclusions This study found evidence for four distinct profiles of PTE exposure in a large sample of resettled refugees, and that these were associated with different demographic, psychological and social characteristics. These findings suggest that person-centred approaches represent an important potential avenue for investigation of PTE exposure in refugees, particularly with respect to identifying subgroups of refugees who may benefit from different types or levels of intervention according to their pre-migration PTE experiences.

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“…Past research in asylum-seeking and refugee populations from Africa found PTSD rates of up to 79% (19)(20)(21). Individuals without secure residency status-be it pending cases (22,23), rejected asylum seekers (24,25), or undocumented migrants (26)-appear to be at a particularly high risk for ongoing mental health problems and post-migration stress (25,27).…”

Section: Introductionmentioning

confidence: 99%

Relational Spirituality and Transgenerational Obligations: The Role of Family in Lay Explanatory Models of Post-traumatic Stress Disorder in Male Cameroonian Asylum Seekers and Undocumented Migrants in Europe

et al. 2021

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Context: Diasporic Cameroonians are increasingly leading a transnational life in which family members are sustained through networks of relations and obligations. However, before arriving in Europe, the vast majority of African migrants who take the Mediterranean route are exposed to trauma and hardship. Moreover, the joint occurrence of forced displacement, trauma, and extended separation from families has a significant impact on mental health.Objectives: This study explores the role of culture-specific conceptualizations of family structures and transnationalism in explanatory models of post-traumatic stress disorder (PTSD) among male Cameroonian asylum-seekers and undocumented migrants in Europe.Methods: An in-depth study of two samples of Cameroonian migrants with a precarious residency status in Europe was conducted. Focus group discussions and interviews were carried out with asylum seekers in Germany (n = 8) and undocumented migrants and failed asylum seekers in France (n = 9). The verbatim transcripts of these interviews served as the data for interpretative phenomenological analyses.Results, Analysis, and Discussion: Family was conceptualized in religious and spiritual terms, and relational spirituality appeared to be a crucial element of family cohesion. Explanatory models of PTSD were mainly based on an intersection of family and spirituality. The disrespect of transgenerational, traditional, and spiritual obligations toward parents and ancestral spirits represented a crucial causal attribution for post-traumatic symptoms.Conclusions: Conceptualizations of post-traumatic stress were based on a collective family and spiritual level instead of an individualized illness-centered perception. The Western psychological and psychiatric perspective on post-traumatic stress might conflict with traditional, religious, and spiritual practices in the context of family conceptualizations of Cameroonian forced migrants with a precarious residency status.

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The association between visa insecurity and mental health, disability and social engagement in refugees living in Australia

Cited by 69 publications

References 35 publications

Exploring Social and Financial Hardship, Mental Health Problems and the Role of Social Support in Asylum Seekers Using Structural Equation Modelling

Exploring Social and Financial Hardship, Mental Health Problems and the Role of Social Support in Asylum Seekers Using Structural Equation Modelling

Profiles of exposure to potentially traumatic events in refugees living in Australia

Relational Spirituality and Transgenerational Obligations: The Role of Family in Lay Explanatory Models of Post-traumatic Stress Disorder in Male Cameroonian Asylum Seekers and Undocumented Migrants in Europe

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