Until now, much of the research on mental health among refugees understandably focuses on the first few years after their arrival in Canada, says Dr. Hongmei Tong, but a new study led by the assistant professor of social work discovered that the psychological distress refugees experience can last even decades after resettlement.
In a study published in the International Journal of Social Psychiatry this month, Tong and her colleagues from universities across the country found that 24 per cent of refugees in the study’s sample were experiencing psychological distress compared to 13 per cent of their peers born in Canada.
Using data from the Canadian Longitudinal Study on Aging, Tong’s research team looked at a number of factors that might influence levels of distress among older adults aged 45 to 85: age, sex, marital status, income, education, health conditions and behaviours, chronic pain and frequency of social contact.
While non-refugee immigrants aged 45 to 85 shared a significant number of post-migration stressors with refugees – racial discrimination, higher levels of unemployment, language barriers and reduced social networks – they don’t appear to share the same prevalence of mental health issues.
"We believe the increased risks of being distressed among refugees may be highly influenced by pre-migration trauma and distress,” says Tong.
She explains that it’s most likely the cumulative and long-lasting effects of those traumas – political or religious oppression, war, genocide, forced displacement, human trafficking, sexual assault, famine, loss of family members and various forms of abuse – that play the most significant role in refugees’ mental health over the long term.
Tong says the ultimate goal is to use the study’s findings to create and support strategies that can address mental health issues among older adults who are refugees. Trauma-informed care and mental health resources, for example, could help improve resilience and reduce mental illness.
The study’s findings also emphasize the impact of social connectedness and physical health on refugees’ mental health.
When older adults who are refugees have someone to confide in, who shows them love and affection, and who can advise them if they experience a crisis, it lowers the odds that they will experience psychological distress, says the study’s senior author Dr. Esme Fuller-Thomson from the University of Toronto. The quantity of those relationships, according to this study, also matters far less than the quality.
“These findings underline the importance of finding effective interventions to help refugees integrate into their community and develop supportive relationships,” says Fuller-Thomson.
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Dr. Hongmei Tong is also part of a seven-year, $2.5 million research project funded by a Social Sciences and Humanities Research Council (SSHRC) Partnership Grant that is developing interventions to help reduce social isolation and promote connectedness among older immigrants in Canada.
Physical health, gender and other factors
Chronic pain and physical health conditions have a significant impact on refugees’ mental health experiences. Women, visible minorities and individuals with less education and who are struggling financially are also more likely to experience psychological distress.
Mental health programming and policies must consider each of these findings, says Tong’s co-researcher Dr. Karen Davison of Kwantlen Polytechnic University, who emphasizes the need to screen for depression and to provide trauma informed mental health interventions for those who are struggling.
This study is part of a larger research project that uses data from the Canadian Longitudinal Study on Aging, which includes information on 244 refugees, 4,765 non-refugee immigrants and 23,149 respondents born in Canada. Earlier studies showed a link between depression and nutrition in older adults.
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