Journal ArticleDOI
Predisplacement and postdisplacement factors associated with mental health of refugees and internally displaced persons: a meta-analysis.
Matthew Porter,Nick Haslam +1 more
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TLDR
The extent of compromised mental health among refugees (including internally displaced persons, asylum seekers, and stateless persons) using a worldwide study sample is meta-analytically established.Abstract:
ContextThe global refugee crisis requires that researchers, policymakers, and
clinicians comprehend the magnitude of the psychological consequences of forced
displacement and the factors that moderate them. To date, no empirical synthesis
of research on these issues has been undertaken.ObjectiveTo meta-analytically establish the extent of compromised mental health
among refugees (including internally displaced persons, asylum seekers, and
stateless persons) using a worldwide study sample. Potential moderators of
mental health outcomes were examined, including enduring contextual variables
(eg, postdisplacement accommodation and economic opportunity) and refugee
characteristics.Data SourcesPublished studies (1959-2002) were obtained using broad searches of
computerized databases (PsycINFO and PILOTS), manual searches of reference
lists, and interviews with prominent authors.Study SelectionStudies were selected if they investigated a refugee group and at least
1 nonrefugee comparison group and reported 1 or more quantitative group comparison
on measures of psychopathology. Fifty-six reports met inclusion criteria (4.4%
of identified reports), yielding 59 independent comparisons and including
67 294 participants (22 221 refugees and 45 073 nonrefugees).Data ExtractionData on study and report characteristics, study participant characteristics,
and statistical outcomes were extracted using a coding manual and subjected
to blind recoding, which indicated high reliability. Methodological quality
information was coded to assess potential sources of bias.Data SynthesisEffect size estimates for the refugee-nonrefugee comparisons were averaged
across psychopathology measures within studies and weighted by sample size.
The weighted mean effect size was 0.41 (SD, 0.02; range, −1.36 to 2.91
[SE, 0.01]), indicating that refugees had moderately poorer outcomes. Postdisplacement
conditions moderated mental health outcomes. Worse outcomes were observed
for refugees living in institutional accommodation, experiencing restricted
economic opportunity, displaced internally within their own country, repatriated
to a country they had previously fled, or whose initiating conflict was unresolved.
Refugees who were older, more educated, and female and who had higher predisplacement
socioeconomic status and rural residence also had worse outcomes. Methodological
differences between studies affected effect sizes.ConclusionsThe sociopolitical context of the refugee experience is associated with
refugee mental health. Humanitarian efforts that improve these conditions
are likely to have positive impacts.read more
Citations
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Association of Torture and Other Potentially Traumatic Events With Mental Health Outcomes Among Populations Exposed to Mass Conflict and Displacement: A Systematic Review and Meta-analysis
TL;DR: A systematic review and meta-regression of the prevalence rates of PTSD and depression in the refugee and postconflict mental health field found nonrandom sampling, small sample sizes, and self-report questionnaires were associated with higher rates of mental disorder.
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Resources for mental health: scarcity, inequity, and inefficiency
TL;DR: Scarcity of available resources, inequities in their distribution, and inefficiencies in their use pose the three main obstacles to better mental health, especially in low-income and middle-income countries.
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War exposure, daily stressors, and mental health in conflict and post-conflict settings: Bridging the divide between trauma-focused and psychosocial frameworks
TL;DR: An integrative, sequenced approach to intervention is proposed in which daily stressors are first addressed, and specialized interventions are then provided for individuals whose distress does not abate with the repair of the social ecology.
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Common mental health problems in immigrants and refugees: general approach in primary care
Laurence J. Kirmayer,Lavanya Narasiah,Marie Munoz,Meb Rashid,Andrew G. Ryder,Jaswant Guzder,Ghayda Hassan,Cécile Rousseau,Kevin Pottie +8 more
TL;DR: Systematic inquiry into patients’ migration trajectory and subsequent follow-up on culturally appropriate indicators of social, vocational and family functioning over time will allow clinicians to recognize problems in adaptation and undertake mental health promotion, disease prevention or treatment interventions in a timely way.
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