Refugees, asylum seekers especially vulnerable to COVID-19 stressors
Various COVID-19 stressors negatively impacted health anxiety among refugees and asylum seekers in Australia, according to findings published in the European Journal of Psychotraumatology.
“We ran our study because we were interested in finding out how refugee communities in Australia were being affected by COVID-19,” Belinda J. Liddell, PhD, professor at UNSW Science’s School of Psychology, told Healio Psychiatry. “Over 650 refugees and asylum-seekers responded to our survey in June 2020, which asked about COVID-19 experiences and worries. We wanted to know how strongly these experiences were related with psychological health.”
Liddell and colleagues surveyed 656 adult refugees and asylum seekers (50% men; average age, 42.85 years; 78.4% Arabic-speaking; 58.7% Iraqi; 16.9% Syrian) living in Australia to determine their mental health (posttraumatic stress disorder (PTSD), depression, health anxiety and disability) and COVID-19 experiences. All data were collected in June 2020, and by June 30, 2020, there were 7,834 COVID-19 cases in Australia.
Using multiple surveys, researchers evaluated demographic measures, COVID-19 events and stressors measures and mental health outcomes. Participants were asked to describe the extent to which different COVID-19 stressors affected them on a 5-point Likert scale (1 = No problem; 2 = A little bit of a problem; 3 = A moderately serious problem; 4 = A serious problem; 5 = A very serious problem). Mental health surveys included the Patient Health Questionnaire, the Posttraumatic Diagnostic Scale and the Bodily Preoccupation Scale of the Illness Attitude scale.
Researchers used four hierarchical linear regression models with three steps to examine the link between specific COVID-19 stressors and four key mental health outcomes.
Surveys revealed the highest stressors related to COVID-19 were worries about being infected (66.5%), of a loved one being infected (72.1%) or infecting others (47.7%). These stressors were linked to increases in PTSD and health anxiety symptoms among participants. Similarly, social-related difficulties due to COVID-19 led to predicted depression and disability symptoms. However, researchers did not find a significant link between trusting information from authorities and COVID-19 stressors.
Study limitations included limited diversity and data due to the low rates of COVID-19 infection in Australia at the time of data collection.
“The findings suggest that the stress, threat and uncertainty of COVID-19, as well as the public health measures that act to curb the spread of virus including lockdown, social distancing, increased government control and mask wearing, may be reminiscent of past traumatic experiences for refugees,” Liddell said. “For example, an increased police or military presence to monitor the compliance of communities to COVID-19 restrictions may remind refugees of living in a warzone or being persecuted. This means that many refugees may be caught between their traumatic pasts and the uncertainty presented by COVID-19, which includes genuine threats to health and lives.”
According to Liddell, these findings have implications for clinical health services.
“Health and mental health practitioners need to be aware of these often more hidden effects of the pandemic,” Liddell said. “It’s critical that people with a refugee background are able to access mental health services during the pandemic, including during hard lockdowns which include restricted movements.”