Refugee perspectives on employment and mental health: a phenomenological qualitative exploration

Abstract

Refugees experience multiple challenges and adversities that cause significant psychological distress in the migration and resettlement process. The United States is host to refugees who arrive fleeing war, conflict, and persecution. The Refugee Act of 1980 created ‘The Federal Refugee Resettlement Program’ to provide for the effective resettlement of refugees and to assist them to achieve economic self-sufficiency as quickly as possible after arrival in the United States (Dept. Health & Human Services (HHS), 2020). Refugees are forced to flee and migrate in search of safety and stability. They arrive in the United States with a high adversity burden, often having experienced significant trauma, spending many years in the refugee camps or endlessly waiting to be accepted by the host. As they arrive, they are enrolled in employment programs with the primary goal of securing employment and financial self-sufficiency. In this process, their mental health status stemming from their migration histories is overlooked and left unaddressed. Experiencing traumatic stress adversely impacts their mental health and influences their employment outcomes. Methods: I conducted a phenomenological study with 21 refugees from Afghanistan, Cuba, and Ukraine, resettling in New Jersey. Each participant engaged in an in-depth interview for 60 minutes guided by a semi-structured questionnaire. The study aimed at 1) exploring refugee perspectives on migration, mental health, and employment and 2) exploring employment as a protective factor that facilitates coping as refugees struggle and manage the pre-migration, migration, and post-migration traumas, thereby mitigating the negative impacts of forced migration. All data was collected, transcribed, and uploaded into Nvivo 12. The study utilized the stress and coping theory and the conservation of resources theory to help understand refugee experiences as they made meaning of the role of employment in their lives. The analytical process was complemented by an Interpretative Phenomenological Analysis (IPA), which prioritizes (a) a commitment to an understanding of the participant's point of view and (2) a psychological focus on personal meaning-making in specific contexts. Findings: The study captured refugee voices on forced migration, mental health, and employment. The emergent themes in Aim 1. involved (1) refugees’ traumatic migration experiences, multiple losses, and yet, within these losses, the surfacing awareness of post-migration growth, (2) forced migration caused adverse mental health, isolation, and manifestations of traumatic stress, and finally, (3) within the context of these experiences, refugees make meaning of employment as a means of financial stability, deeply gratifying and a source of identity, self-worth, and growth, while promoting integration. The findings of Aim 2. relate to (1) Multiple post-migration stressors that interfere with employment decision-making making, and achievement of goals, (2) barriers to employment, including limited language proficiency, lack of support with credentialing and work authorizations, adequate employment opportunities, and lack of guidance and mentorship. Finally, in the second part of Aim 2. refugees engaged with employment as a resilience-promoting factor in their lives, helping them cope with the migration stressors. Discussion and Implications: The findings in this study suggest that despite the challenges that refugees experience in securing sustainable employment, employment proves to be a resilience-promoting factor for refugees during this process. The Meaning-making and post-migration growth related to employment, the evolving experiences of dignity, hope, and connection reinforce the importance of employment in the lives of refugees resettling in the U.S. Employment as a critical coping strategy for refugees can be facilitated by investing in helping refugees develop English proficiency, focused employment support including guidance and mentorship, and mental health support as they seek sustainable employment. This dissertation underscores the importance of the close association between mental health and employment within the context of refugee resettlement. This study’s findings significantly inform policy and program development for refugees, and provide a deeper understanding of the refugee experience that can help improve mental health and employment outcomes and ultimately positively affect overall well-being.Ph.D.Includes bibliographical reference