Refugees with insecure visas experience more trauma, depression and post-traumatic stress
A new study has revealed the association between refugees' visas and their mental health.
Refugees and people seeking asylum with insecure visas have significantly higher post-traumatic stress disorder (PTSD) symptoms and depression symptoms, and they're nearly 2.5 times more likely to report suicidal intent than those with secure visas—showing how the state of prolonged uncertainty that refugees often live in is associated with negative mental health outcomes.
The study of more than 1000 refugees and people seeking asylum—the first set of results of a three-year longitudinal online survey of people from a refugee background living in Australia—was published today in the European Journal of Psychotraumatology. The study is a partnership between UNSW Sydney, Australian Red Cross, Settlement Services International (SSI), and Phoenix Australia at the University of Melbourne.
"Most of the world's 23 million refugees and people seeking asylum live in a state of sustained uncertainty—but we don't know a lot about the mental health impact of that prolonged insecurity," says lead author Associate Professor Angela Nickerson, Director of the Refugee Trauma and Recovery Program at UNSW.
"That's why we wanted to understand how refugees adapted after coming to Australia, so we can build an evidence base that informs policy and service provision."
The team surveyed 1085 refugees from Arabic, Farsi, Tamil and English-speaking backgrounds who have arrived in Australia since January 2011 and have either secure (e.g. permanent residency or citizenship) or insecure visas (e.g. asylum seeker, temporary protection visa or bridging visa).
"Refugees with insecure visas reported significantly greater PTSD, depression symptoms, and thoughts of 'being better off dead." They were also 2.5 times more likely to report having a suicide plan than refugees with secure visas," A/Prof Nickerson says.
These key findings were statistically significant even when controlling for—i.e. taking into account—refugees' pre-migration exposure to trauma.
More social engagement among refugees with insecure visas
The second key finding of the study was that despite having more severe psychological symptoms on average, refugees with insecure visas were also significantly more socially engaged and connected to the Australian community than those with secure visas.
People on insecure visas were more likely to volunteer in their community, and to be active members of a sports club. Overall, they were a part of and received help from more social groups like sports groups, volunteer and charity groups, and community groups and individuals.
"This suggests that these refugees are forming social connections to help overcome the impact of their premigration experience to make a substantial contribution to the Australian community," says A/Prof Nickerson.
The researchers found several interesting connections between social engagement and mental health: refugees with insecure visas who were part of a lot of social groups had reduced suicidal intent. Those with insecure visas who were part of fewer groups showed greater depression symptoms and had greater suicidal intent than those with secure visas and low group membership.
"This could mean facilitating active engagement in social groups for those with insecure visas is associated with lower psychological distress—highlighting the key role of social engagement in influencing mental health among insecure visa holders," A/Prof Nickerson says.
Policy makers and service providers need to adapt
Around the world, including Australia, governments are developing policies that incorporate temporary forms of protection to address the growing number of people displaced by conflict, and to address irregular forms of migration.
"This study is looking at the long-term wellbeing of refugees and people seeking asylum and provides important new evidence about supporting and providing stronger services for people with insecure visas," says Vicki Mau, Head of Migration Support Programs, Australian Red Cross.
"This evidence indicates to all of us in Australia and around the world—governments, community organizations, support services and policy makers—about how we can keep people safe and recognize and support their contributions to our community, as well as the importance of certainty for those recovering from significant trauma.
"The findings confirm our experience working with refugees and people seeking asylum. People on insecure visas make a substantial social contribution to the Australian community, despite the mental health challenges that many face," Ms Mau says.
SSI General Manager Service Delivery—Settlement, Yamamah Agha, says that for SSI, the study highlights the importance of promoting pathways for social engagement among refugees on temporary or bridging visas.
"Established in 2013, SSI's Community Kitchen fosters social connections and we've seen the benefits of social engagement among refugee communities first hand.
"Underpinned by SSI's vision that everyone should have opportunities for creative and cultural expression, SSI's Arts and Culture program channels the positive roles that arts and culture can play during settlement through community-based initiatives.
"Newcomers deserve to feel at home and connected to their community regardless of their visa status and helping to forge that sense of belonging is essential to their health and wellbeing."
About the study
- The team surveyed 1085 refugees from Arabic, Farsi, Tamil and English-speaking backgrounds who have arrived in Australia since January 2011 and had both secure (e.g. permanent residency or citizenship) and insecure visas (e.g. asylum seeker claims, bridging visa, temporary visa).
- Starting in 2015, participants filled in an online survey in their own language five times over three years, with this study reporting on the data collected at the first of these five times.
- The survey assessed pre- and post-migration experiences, mental health, disability and social engagement.
- Refugees with insecure visas reported significantly greater PTSD, depression symptoms, thoughts of being better off dead and suicidal intent (i.e., having a plan and/or taken steps to take their life in the last two weeks).
- They also experienced significantly more post-migration stressors (e.g. financial, logistical, social, immigration, conflict-related stressors).
- Refugees with insecure visas contributed and volunteered more with charities and social groups. They also received support from significantly more groups in the Australian community than those with secure visas.
- Refugees with insecure membership who had low group membership showed greater depression symptoms and suicidal intent than those with secure visas who had low group membership.
- Refugees with insecure visas had been exposed to significantly more types of traumatic events (e.g. conflict, witnessing murder, torture, lack of food/water) than those with secure visas.