Mental health, chronic pain and migration-related stress in refugees resettled in Norway and Sweden
Sammendrag
The aggregate load of past trauma history and stressors in the post-migration environment renders refugees vulnerable to psychological distress which may undermine quality of life, impede daily functioning and adversely impact integration. In Norway, there is currently a clear lack of systematic and robust evidence on the mental health of newly arrived refugees despite political ambitions to address this limitation. The thesis attempts to fill this void. Specifically, the aim is to contribute with methodologically robust evidence on the burden of mental ill health in different refugee populations in Norway and Sweden, as well as identify important risk and protective factors thereof. Important findings from the studies comprising the thesis include: Resettled refugees have a high burden of mental ill health (i.e. PTSD, depression and anxiety) and chronic pain, and there is a strong link between the two. Personnel working with refugees’ health should be attuned to their co-occurrence as both problems may need to be addressed for either to be effectively mitigated. The cumulative exposure to potentially traumatic experiences before and during flight is a strong risk factor for mental ill health in general, and PTSD in particular. Female gender was found to be an independent risk factor of mental ill health. In addition, gender seemed to modify the association between certain post-migration stressors—social strain in particular, but also financial strain—and subjective well-being, with no association seen in women but a strong negative association in men. Overall, the thesis lends scientific support to the increased focus on mental health in government strategic objectives and policies in Norway. Further longitudinal research is needed to explore long-term trajectories of mental health, what constitute reliable predictors of these trajectories and how mental health impact integration processes in refugees.Artikkelliste
Paper I: Solberg Ø, Nissen A, Vaez M, Cauley P, Eriksson A-K, Saboonchi F. Children at risk: A nation-wide, cross-sectional study examining post-traumatic stress symptoms in refugee minors from Syria, Iraq and Afghanistan resettled in Sweden between 2014 and 2018. Confl Health. 2020;14: 67. DOI: 10.1186/s13031-020-00311-y. The article is included in the thesis. Also available at: https://doi.org/10.1186/s13031-020-00311-y |
Paper II: Nissen A, Cauley P, Saboonchi F, Andersen A, Solberg Ø. Cohort profile: Resettlement in Uprooted Groups Explored (REFUGE)-a longitudinal study of mental health and integration in adult refugees from Syria resettled in Norway between 2015 and 2017. BMJ Open. 2020;10: e036101. DOI: 10.1136/bmjopen-2019-036101. The article is included in the thesis. Also available at: https://doi.org/10.1136/bmjopen-2019-036101 |
Paper III: Nissen A, Cauley P, Saboonchi F, J Andersen A, Solberg Ø. Mental health in adult refugees from Syria resettled in Norway between 2015 and 2017: a nationwide, questionnaire-based, cross-sectional prevalence study. Eur J Psychotraumatol. 2021;12: 1994218. DOI: 10.1080/20008198.2021.1994218. The article is included in the thesis. Also available at: https://doi.org/10.1080/20008198.2021.1994218 |
Paper IV: Nissen A, Hynek KA, Scales D, Hilden PK, Straiton M. Chronic pain, mental health and functional impairment in adult refugees from Syria resettled in Norway: a cross-sectional study. BMC Psychiatry. 2022;22: 1–16. DOI: 10.1186/s12888-022-04200-x. The article is included in the thesis. Also available at: https://doi.org/10.1186/s12888-022-04200-x |
Paper V: Nissen A, Sengoelge M, Solberg Ø. Post-migration Stressors and Subjective Well-Being in Adult Syrian Refugees Resettled in Sweden: A Gender Perspective. Front Public Health. 2021;9: 717353. DOI: 10.3389/fpubh.2021.717353. The article is included in the thesis. Also available at: https://doi.org/10.3389/fpubh.2021.717353 |