The circumstances involved in becoming a refugee are enough to test the mental wellbeing of anyone forced to go through it, but new research from the University of Toronto highlights that the stresses can be especially challenging for older refugees.
The authors highlight how much of the focus on the mental health of refugees is focused on their first few years of resettlement, but there remains a gap in our understanding of their long-term mental health. The study examined people aged between 45-85, and found that refugees were around 70% more likely to have depression than native Canadians of a similar age, with this still true decades after they immigrated.
“Our findings indicate that the refugee experience casts a long shadow across an individual’s lifespan,” the researchers say. “While our data did not capture reasons for the high levels of depression among refugees, we believe it may be influenced by exposure to pre-migration traumas such as genocide, forced displacement, human trafficking, sexual assault, famine, and separation from family.”
A depressing situation
The researchers attempted to distinguish between the stress refugees suffered from before their migration and that suffered after they migrated. They did this by exploring the mental health of immigrants who were not arriving to Canada as refugees, and therefore were not saddled with the stresses associated with leaving extremely challenging circumstances.
“Our results suggest that post-migration challenges are less important than pre-migration traumas when it comes to depression,” the researchers say. “The greater prevalence of depression among refugees — half of whom arrived more than four decades ago — underlines the importance of providing mental health resources for our refugee community both immediately after arrival, but also in the ensuing decades.”
A number of factors were explored to try and understand these high levels of depression, including income, health, education or marital status, but even when all of these factors were accounted for, refugees still experienced significantly higher rates of depression than native Canadians.
The need for support
What did appear to be key, however, was the level of social support people could tap into. A lack of support network was strongly linked with high rates of depression among refugees, and this lack of support was sadly all too common. Refugees were, for instance, twice as likely to say they lacked someone who they could confide in, or who could give them advice in a crisis. Indeed, when such social support was available, depression rates were comparable to that of native Canadians.
“Our study indicates that the quality of relationships, rather than the quantity of social connections, matters most for refugees’ mental health.” the researchers explain. “This highlights the importance of investigating ways to promote powerful positive social relations among refugees and asylum seekers in their families, neighbourhoods, and communiies.”
The authors believe their work has a number of clear policy implications. In Canada today, there are a couple of sponsorship programs in place. The first of these is Government-assisted refugees (GARS), which provides basic financial assistance to refugees, while the second is Privately-sponsored refugees (PSRs), whereby refugees are helped by a network of volunteers, often wrapped around religious groups.
In an analysis of Syrian refugees in Canada, it seems like PSRs were more useful than GARs, with the authors suggesting that this is largely because such an approach helps to develop the social support networks that are so vital to wellbeing.
Of course, this was in addition to more obvious stress-related factors, such as poverty, chronic illnesses and various co-morbid health conditions, all of which are common in people with depression.
“It is not surprising that Canadians who have household incomes under $25,000 per year have double the odds of distress compared to those with incomes above $75,000. Struggling to pay the rent and feed one’s family can be extremely distressing,” the authors conclude.
