Trauma Related Psychological Distress, Acculturative Stress, and Psychosocial Treatment Needs in Syrians Refugees Resettled in the UK: A Mixed-Method Study

ABSTRACT
Objective: The focus on psychopathology in general, and posttraumatic stress disorder (PTSD) in particular, has been debated and critiqued recently in the context of refugee trauma. This mixed-methods study broadens the conceptualisation of refugee mental health in resettlement, and explores the relationship between the level of psychological distress (conceptualised as the rate of PTSD, depression and anxiety) and post-resettlement stressors and coping as determinants of refugee mental health.
Method: Fifty war-affected Syrian civilians who arrived in the UK through the Vulnerable Person Resettlement Scheme (VPRS) and asylum route participated in individual interviews. The participants completed self-reported measures of PTSD, depression and anxiety, along with the Demands of Immigration Scale, and shared their post-resettlement experiences through semi-structured interviews. A range of statistical analyses are used to measure the association between psychological distress and post-resettlement stressors. Reflexive thematic analysis is applied to identify themes of post-resettlement experience and coping relevant to the main study questions.
Results: Descriptive statistics using frequencies and percentage computations show that approximately 40% (M=30.96, SD = 16.30) of the participants scored above the cut-off point of 33 on the PTSD Checklist, which indicates a provisional diagnosis of PTSD. Approximately 57% (M=11.43, SD=8.84) of the participants scored 10 or above on PHQ-9 the cut-off point for moderate symptoms of depression. Approximately 40% (M=9.12, SD=4.50) of the participants scored 10 or above on GAD-7, the cut-off point for moderate symptoms of anxiety. A significant correlation is found between post-resettlement stressors and psychological distress. The reflexive thematic analysis reveals five interconnected themes as a model to explain key aspects of refugee mental health in resettlement and confirm the quantitative findings.
Conclusions: Post-resettlement stressors have a significant impact on refugee mental health, reinforce feelings of uprootedness, and lower adaptation prospects. The study findings highlight the need for host countries to create opportunities for agency and autonomy which allow refugees to contribute to and transform local communities. Finally, the study advocates a culturally sensitive approach to improving refugee mental health, enabling them to initiate their own paths to recovery.