Many refugees and asylum seekers suffer serious psychological impacts because of their experiences that are often not captured in clinical assessments, a new study has found.

And the functional impairment that this can cause needs to be recognised by countries and agencies resettling refugees and asylum seekers, the researchers say.

The research, carried out by a group of European university academics, looked at people resettled in Austria, Finland, Germany, Italy, Turkey and the United Kingdom who had not had a diagnosis of a psychiatric disorder.

“Refugees and asylum seekers face various pre-, peri- and post-migratory challenges. They are often subjected to persecution for political, ethnic, religious or other reasons in their home countries, some witness death, combat, torture, abuse of relatives, or economic hardship and lack of water, food, and other basic needs,: the study report said.

“On hazardous flight routes refugees and asylum seekers are frequently exposed to physical harm, sexual violence and life-threatening conditions. Even after resettlement in their host countries continuous stressors remain, including uncertainty about legal status, risk of being detained and deported, and difficulties with social integration, social exclusion, discrimination and economic disadvantages.”

The researchers said that while the impact of learning the language was associated with achievement, aspirations and autonomy, barriers to learning, and a sense of shame due to reduced skills were important mitigators of individual well-being.

Also, traumatic life events are associated with common mental disorders such as posttraumatic stress disorder (PTSD), and with reduced functioning, with a more pronounced relationship in women than in men.

The study interviewed a total of 1,101 refugees and asylum seekers, 49 per cent of them female.

They found males reported considerably more often having been held in detention than females, were less likely to be living in a marriage or partnership and had, on average, fewer children and relatives living in the close proximity or the same household.

Men suffered on average more post-migration living difficulties, and reported more lifetime potentially traumatic events, especially those associated with violence and close-to-death experiences.

”Participants in general showed high psychological distress and reduced quality of life. Accordingly, everyday functioning was mild to moderately impaired in the cohort. The most strongly affected domains of functioning were ‘mobility’ and ‘participation’, followed by ‘life activities’ and ‘cognition’,” said the study, published in the journal Frontiers in Psychology.

“This study underlines the need for the consideration of sub-clinical forms of war and trauma-associated disabilities, as patterns of functional impairment are even present in refugees and asylum seekers without a clinical diagnosis of a mental health disorder.

“This finding might be taken into account in the organisation of medical and psychosocial assistance to refugees and asylum seekers.

“We hypothesize that reduced everyday functioning of individuals who had to leave their home country due to war, prosecution, and other hardships could hamper their ability to adapt successfully to new contexts, cope with new tasks and recover from their experiences,” the study said.

Read the full report: Frontiers | Impairments in psychological functioning in refugees and asylum seekers (frontiersin.org)