Understanding the effects of being separated from family on refugees in Australia: a qualitative study.

OBJECTIVE: To understand the impact of family separation on refugees living in Australia. METHOD: Thirteen participants with a refugee background and experiencing separation from family participated in a semi-structured qualitative interview. Interviews were coded and a thematic analysis was conducted using NVivo software. RESULTS: Identified themes were organised under four domains. Domain 1 focused on the personal impact of family separation. Themes were the effects on mental health and functioning, driven by incessant worrying about the safety of family and the absence of key attachment figures, the specific effects of having missing family, alterations to self-identity and family dynamics. Domain 2 focused on themes relating to actions taken to find missing family, connect or reunite with separated family. Domain 3 highlighted the coping strategies, support mechanisms and protective factors used by participants. Domain 4 identified core beliefs about the importance of family unity, focusing on security, settlement and a happy future. CONCLUSIONS: Family separation has an enduring effect on the wellbeing of refugees, with key pathways being ongoing fear and insecurity, disrupted social attachments and identity shifts in relation to the future self. IMPLICATIONS FOR PUBLIC HEALTH: Refugees separated from or missing family struggle with ongoing stress and adjustment issues.

Mechanisms underlying the mental health impact of family separation on resettled refugees.

OBJECTIVE: Many refugees experience prolonged separation from family members, which research suggests has adverse effects on mental health and post-displacement outcomes in refugee populations. We examine mental health differences in refugees separated and not separated from their families, and key post-migration factors and cultural mechanisms that may underlie this impact. METHODS: A sample of 1085 refugees resettled in Australia, of which 23.3% were separated from all of their immediate family, took part in an online battery of survey measures indexing pre- and post-migration refugee experiences, mental health symptoms, disability and individualistic/collectivistic self-identity. Family separation was used as a predictor of mental health outcomes in a series of linear regressions, and the separated and non-separated groups were compared in multigroup path analysis models to examine group-specific indirect effects. RESULTS: The separated group reported greater exposure to pre-migration potentially traumatic events and higher levels of post-migration living difficulties compared to the non-separated group. Family separation predicted higher post-traumatic stress and depression symptoms, but not disability, after controlling for potentially traumatic event exposure, age and sex. Path analyses revealed distinct indirect effects for separated and non-separated groups. Principally, higher collectivistic self-identity was associated with elevated post-traumatic stress, depression and disability symptoms via social-related post-migration living difficulties such as isolation and loneliness in the separated group; whereas collectivism was linked with increased depression symptoms via economic-related post-migration living difficulties in the non-separated group. CONCLUSION: These findings indicate that family separation powerfully influences mental health outcomes, but that its effect may be mediated by the type of post-migration stress experienced in the settlement environment and culturally bound differences in how the sense of self is interconnected with family.