Introduction
In recent years, there has been an unprecedented increase in the number of refugees worldwide, bringing attention to the mental health issues refugees face. People are forced to flee their homes due to war, abuse, and other terrifying circumstances, and refugees may struggle to reach safety. In addition to that, the daily upheaval and lack of social support may cause pessimism and heightened anxiety (Hameed et al., 2018). A refugee's environment influences their mental health. Language barriers, discrimination, acculturation stress, and contradictions between traditional beliefs and host community expectations can exacerbate refugee mental health issues.
This paper aims to provide an improved analysis of refugees' mental health challenges, aiming to enhance the understanding of cultural pressures and influences on their well-being and the implications of these results for providing refugees with quality mental health care. It also analyzes different research paradigms and presents a comprehensive literature review conducted through systematic approaches.
Approach to the Literature Search
To ensure a comprehensive and relevant literature search for this paper, a systemic approach was employed by using academic databases involving PubMed, PsycINFO, and Google Scholar. The findings were honed using phrases like "refugees," "mental health," "trauma," "stress," and "cultural context." The search approach provided peer-reviewed publications published within the previous ten years to guarantee the inclusion of the most current findings. The search was limited to studies conducted in English. The search strategy targeted studies to examine the impact of stress and cultural setting on the mental health of refugees.
The Paradigms
Critical Theory Paradigm:
Abu Suhaiban et al. (2019) research study used a qualitative technique and collected data through questionnaires. They analyzed previous research to provide an in-depth understanding of the topic and explored indicators and combined therapies for survivors of displacement and torture. While unintentional, the research may have adopted a critical theory approach, highlighting the need to address structural problems and power relations. Abu Suhaiban et al. (2019) indicate that refugees and torture victims require comprehensive mental health therapy. The study evaluates integrated care solutions to improve refugee mental health and offer more extensive treatment. The findings promote refugee-focused integrated care approaches in policy and practice.
Beiser and Hou (2017) research study used the General Social Survey of Canada to investigate if certain variables impact the mental health of resilient refugees. By analyzing quantitative data through a scientific approach, the researchers aim to identify patterns and connections between variables that affect the psychological well-being of refugees. While the study focuses on statistical analysis, it may touch upon critical theory ideas if it examines factors such as social support, prejudice, or resource availability. Ultimately, this research aims to identify elements that can improve the mental health of refugees.
Empirical Paradigm:
Kamali et al. (2022) research study employed bivariate and Borden-logistic regression techniques to investigate the connection between social environments and mental health care for children and adolescents in Ontario. Using the empirical paradigm, researchers can explore real-world scenarios and discover new evidence to support their arguments. The study's findings are based on actual observations, which offer an objective understanding of how social environments affect mental healthcare for children and adolescents in Ontario. However, relying solely on empirical data has limitations, as it may not capture the full complexity of individuals' experiences. Qualitative methods can complement the study by providing a deeper understanding of subjective perspectives and contextual factors that may be missing from a purely empirical analysis. The researchers used bivariate and logistic regression techniques to analyze the relationship between social environments and mental healthcare usage. Therefore, the study provides valuable insights into how different social settings and inequalities affect the utilization of mental health services among children and adolescents.
Emerson et al. (2023) explore the mental health of local communities and immigrant and non-immigrant children. This study underlines the importance of considering refugees' social and cultural contexts on mental health. Emerson et al. (2023) combine population-based group research and quantitative methods to examine the social and environmental factors affecting mental health. This research also uses a constructivist technique which emphasizes the importance of considering the subjective experiences and perspectives of the population under study, going beyond purely objective measures of mental health. This allows for a more thorough understanding of the complex interplay between social, cultural, and environmental factors and mental well-being. It provides a platform for refugees and young people to share their voices and experiences, which are considered when formulating mental health policies and interventions. The study aims to address challenges faced by refugees, improve mental health policies, and increase public education on refugee issues.
3. Constructivist Paradigm:
Gadermann et al. (2022) surveyed British Columbia children and teenagers to see how many had mental health issues. The data was gathered from specific British Columbia health promotion initiatives utilizing chart abstraction in a group study of children and teens. To test the empirical hypothesis, the authors conducted a longitudinal cohort study using chart abstraction from health promotion databases to determine the prevalence of mental health issues in children and teens. This article supports the constructivist concept that social and cultural factors must be considered when diagnosing and treating children and teens' mental health. By taking this approach, researchers recognize that language competence, cultural norms, and social inclusion can all play a role in mental health concerns, especially among groups like immigrants, refugees, and non-immigrants. The constructivist paradigm provided a framework and approach to study the prevalence of mental health issues in children and teenagers. The aim is to improve immigrant and non-immigrant children's mental health by assessing an area's surroundings and implementing policies and rules to address mental health issues.
Straiton et al. (2017) research study utilized qualitative interviews and quantitative analysis to investigate the utilization of healthcare services and the number of prescriptions issued. Quantitative data regarding mental health were gathered from primary care clinics and the Norwegian pharmaceutical database, while qualitative data were collected through interviews. The mental health of refugees and non-refugees was examined in this study by analyzing changes in the use of prescription drugs and healthcare services. The constructivist paradigm was employed in qualitative interviews to understand better the unique experiences and perspectives of refugees and non-refugees. Qualitative interviews reveal how individuals live and their thoughts on mental health, whereas quantitative research exposes how healthcare services are utilized and prescriptions are issued. Academic research may communicate refugees' experiences and perspectives (Straiton et al., 2017). Refugees may feel empowered and have greater control over the research if they engage as participants, experts, or companions. Refugees may discuss mental health and activism if their knowledge and experiences are recognized and included in the research.
Hameed et al. (2018) raised awareness of refugee mental health issues. Based on interviews and questionnaires, this article discusses the potential for mental health issues among immigrants. It explores the reasons behind this vulnerability, including cultural, social, and political factors, and uses historical studies, information, and statistics to support its arguments. The article takes a constructivist approach to understanding the experiences of immigrants and their social context, examining how social rejection, abuse, relocation, and a lack of resources and care can contribute to mental health concerns. By highlighting individual experiences and social factors, the article sheds light on the challenges faced by this population.
Conclusion
The reviewed studies identified three research paradigms: critical theory, empirical, and constructivist. Each paradigm offered valuable insights into understanding and addressing the mental health needs of refugees. Studies adopting a critical theory paradigm emphasized addressing structural problems and power relations contributing to refugee mental health issues. These studies highlighted the importance of comprehensive mental health therapy and integrated care approaches to improve the well-being of refugees. Research employing an empirical paradigm focused on analyzing quantitative data to identify patterns and connections between variables that impact the mental health of refugees. These studies aimed to identify factors such as social support, prejudice, and resource availability that can improve the mental health of refugees. The most dominant constructivist paradigm in this paper emphasizes the importance of considering social and cultural factors when diagnosing and treating the mental health of refugees. These studies highlighted the role of language competence, cultural norms, and social inclusion in mental health concerns among immigrants and refugees; the research aimed to raise awareness of these inequalities and empower refugee communities in mental health discussions.
By recognizing and addressing the unique mental health requirements of refugees and by providing accessible and responsive care, it is possible to improve the well-being and adaptability of this vulnerable population. The findings from this paper have important implications for mental health professionals, policymakers, and organizations involved in providing care and support to refugees.
Power Relations
The impact of cultural factors on the mental health of refugees is a significant topic in literature. It highlights how aspects such as socioeconomic status, gender, ethnicity, age, sexual orientation, disease and disability, and the culture of health professionals and institutions are addressed in the literature (Hameed et al., 2018). Social inequalities harm refugees' mental health. The study acknowledges that refugees come from various cultural backgrounds, which may impact how they adjust to moving, stress, and a new life (Kamali et al., 2022). The discourse often portrays refugees who seek mental health support as a vulnerable and marginalized group. They struggle with mental health issues and need assistance. However, their power is limited due to their marginalized status, language barriers, and unfamiliarity with the host country's systems. Cultural differences can also lead to misunderstandings, making it difficult for refugees to have their voices fully heard and understood. Refugees may also face obstacles in expressing their views due to systemic barriers, such as restricted access to communication platforms. Their voices might be suppressed due to inadequate representation and participation in decision-making procedures. These articles demonstrate how cultural differences must be considered when diagnosing and treating migrant mental health issues.
Medical ethos is a cultural aspect worth considering. Healthcare professionals, particularly mental health experts, hold a crucial position in the conversation. They are regarded as the authorities with the necessary knowledge and abilities to diagnose and treat mental health concerns. Their power is derived from their expertise and influence in the industry. Cultural competence helps healthcare workers understand and treat refugees' mental health difficulties (Gopalkrishnan, 2018). Professionals must recognize and rectify personal prejudices. They must also utilize culturally sensitive methods and work with translators or cultural mediators. Most refugee mental health researchers believe cultural awareness is essential to understanding their conditions, difficulties, and potential solutions. A complete and culturally sensitive strategy must address socioeconomic status, gender, race, age, sexual orientation, and illness, according to Abu Suhaiban et al. (2019). The government's power in the discourse can be significant, particularly in terms of policy-making, resource allocation, and the establishment of services for refugees (Bozorgmehr et al., 2023). The government's actions and decisions can directly impact the availability and quality of mental health services for refugees.
Regarding power dynamics, healthcare providers and the government are often in positions of greater authority than patients. Healthcare providers possess the necessary knowledge and expertise to diagnose and treat mental health conditions, while the government holds control over policies and resources. Refugees may have limited power as patients due to their marginalized status and reliance on external support.
Cultural Issues
The way refugees are portrayed, and their mental health concerns in the academic literature are greatly influenced by cultural differences. By examining these extracts, we can gain insight into how socioeconomic status, gender, ethnicity, age, sexual orientation, illness, and disability, as well as the culture of health professionals and institutions, are presented, treated, and portrayed (Gadermann et al., 2022). The adverse effects of social injustices on refugees’ mental well-being are widely acknowledged. To address their mental health concerns, it is crucial to consider their socioeconomic status, social standing, access to education, and employment opportunities. Furthermore, it is important to acknowledge the diverse cultural backgrounds of refugees, as this greatly influences their ability to manage stress, adapt to new environments, and start afresh (Gadermann et al., 2022).
Another component of society that is examined is gender roles; the study found that men, women, and transgender persons seek mental health care differently (Emerson et al., 2023). Gender norms, expectations, and power relations affect refugees' mental health, highlighting the need for gender-sensitive study and practice. Ethnicity and culture are regularly explored in the academic world. The articles explore how race and culture affect refugees' mental health; it highlights the need to treat refugees respectfully and with care for their varied racial and ethnic origins (Beiser & Hou, 2017). It also examines the impact of prejudice, xenophobia, and discrimination on mental health. One cultural issue that is commonly brought up is population age. The research considers that different groups, such as children, adolescents, adults, and older people, may have different mental health needs and conditions (Straiton et al., 2017).
The articles cover the value of age-appropriate responses and assistance and the difficulties experienced by refugee kids, such as skipping school and being exposed to violence (Emerson et al., 2023). The impacts of physical sickness or disability are also considered when talking about refugees' mental health. Some refugees suffer health issues due to war, violence, or stress. They say refugee therapy must take mental health and disability into account; another component of culture considered is the ethos of medical professions and practices (Gadermann et al., 2022). To better comprehend and address the mental health issues of refugees, the articles explore the significance of cultural competency for healthcare professionals (Ellis et al., 2019). They stress the need for professionals to acknowledge and correct any personal biases.
Additionally, they must use culturally sensitive techniques and, if required, collaborate with translators or cultural mediators. Most research on the mental health of refugees agrees that understanding cultural aspects is crucial to understanding their circumstances, issues, and possible remedies. The research highlights the need to consider the socioeconomic position, gender, ethnicity, age, sexual orientation, and sickness as part of a comprehensive and culturally sensitive approach (Magee et al., 2023).
Overall, the discourse emphasizes the importance of considering cultural variables such as social class, gender, race/ethnicity, age, sexual preference, disease or disability, and the culture of health professions/systems in understanding and addressing the mental health of refugees. It calls for a comprehensive and culturally sensitive approach that considers the diverse cultural backgrounds and experiences of refugees.
Conclusion
After thoroughly reviewing the materials, I have gained a deeper understanding of mental health among refugees. The literature explores the complex dynamics of power and culture, specifically in the discourse between customers, doctors, and governments. Power relations in this context are intricate and multifaceted. Refugees frequently face vulnerabilities arising from limited resources, as physicians and nurses possess more knowledge and decision-making power. This creates a power dynamic that challenges traditional roles. As a result, it was concluded that refugees should be actively involved in decisions that may affect their mental health. This allows them to have a voice in shaping their care.
When addressing refugees’ mental health, understanding cultural factors is important. Things like socioeconomic status, gender, race/ethnicity, age, sexual orientation, illness/disability, and cultural norms in healthcare must be considered. To give quality mental health care, it is important to honour and acknowledge the cultural history of refugees. Every group has its own set of difficulties and distinct national identities., so it is important to develop responses that address these complexities. Although power dynamics and cultural aspects have been previously addressed, continued research is necessary to comprehend the refugee experience fully.
Developing effective mental health policies for refugees requires the involvement of refugees themselves, local leaders, and grassroots organizations. It is crucial to consider the perspectives of immigrants when creating new laws and support systems. Priority should be given to their mental health needs while respecting their cultural backgrounds when formulating policies.
References
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Bozorgmehr, K., Kühne, S., & Biddle, L. (2023). Local political climate and spill-over effects on refugee and migrant health: a conceptual framework and call to advance the evidence. BMJ Global Health, 8(3), e011472. https://doi.org/10.1136/bmjgh-2022-011472
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Hameed, S., Sadiq, A., & Din, A. U. (2018). The Increased Vulnerability of Refugee Population to Mental Health Disorders. Kansas Journal of Medicine, 11(1), 1–12. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5834240/
Kamali, M., Edwards, J., Anderson, L. N., Duku, E., & Georgiades, K. (2022). Social Disparities in Mental Health Service Use Among Children and Youth in Ontario: Evidence From a General, Population-Based Survey. The Canadian Journal of Psychiatry, 070674372211446. https://doi.org/10.1177/07067437221144630
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