I am in my first year of completing a PhD looking into the impact of post-migration life difficulties on mental health and somatic symptoms. I would like to take this opportunity to present my current work which focuses on the mental health and somatic symptoms of asylum seekers and refugees in the context of post-migration life difficulties. In addition to presenting my research work as it is developing, I would also like to briefly talk about my personal background and how this has influenced my personal and academic development.
My research focuses on the mental health and somatic symptoms of asylum seekers and refugees in the context of traumatic experiences related to migration and post-migration life difficulties (PMLDs). PLMDs is an umbrella term, which encapsulates a number of issues and includes the impact of unfair treatment at border zones, poor conditions in detention centres, poor access to healthcare, homelessness, destitution, language difficulties, discrimination and racism. These potentially highly distressing experiences are documented to have a deleterious effect on individuals’ mental health (Silove, Austin, & Steel, 2007).
The focus on these specific issues derives from the understanding that, in addition to pre migration and migration related life difficulties, asylum seekers and refugees suffer from a host of additional stressors, defined within the research literature as PMLDs.
This doctoral research will include three main studies: a systematic review and critical interpretative synthesis; a quantitative research study by means of routinely collected data; and a qualitative study using participatory methods. Furthermore, we are trying to develop research collaborations with third sector organisations working in support of the mental health of asylum seekers and refugees.
Due to the scarce availability of quantitative data in this area of research, we may not be able to conduct a quantitative study. If this is confirmed, we may opt to extend our qualitative work using participatory research methods. At this stage in the research development, we think that the people taking part in the qualitative phase will comprise of asylum seekers and refugees based in the city of Glasgow.
The primary objective of the systematic review is to investigate the relationship between pre-migration traumatic events and post-migration life difficulties on the mental health and somatic symptoms of asylum seekers and refugees. Having developed a search strategy, and applied it to five databases, we are now in the process of completing Level 1 screening (title screening) on DistillerSR. This will be followed by Level 2 (abstract screening). Once this two-levels procedure is completed, the papers included will undergo full text screening. This process is being carried out by two independent reviewers to ensure transparency. The research papers selected for inclusion in our systematic review will also be analysed using critical interpretative synthesis (CIS) (Dixon-Wood et al., 2006). As expressed in Dixon-Woods et al. (2006), using CIS to synthesise a diverse body of evidence enables researchers to generate a theoretical understanding of the issue at hand, through the integration of quantitative and qualitative studies into a coherent narrative. Based on our scoping work, we believe that the available literature is suited for interpretative synthesis
Structural vulnerability is the theoretical lens through which we will approach the research. Structural violence, from which the concept of structural vulnerability derives, can be defined as the violence of injustice and inequality ‘embedded in ubiquitous social structures [and] normalised by stable institutions and regular experience’ (Winter & Leighton, 2001 p.99). These include cultural, political and economic structures such as patriarchy, slavery, apartheid, colonialism, neoliberalism, poverty, discrimination and migrant/refugee status. ‘Structures’ such as these can be considered violent because they result in otherwise avoidable deaths and illness. Furthermore, they make individuals vulnerable by marginalising people and communities, limiting their capabilities, curbing their dignity, and reproducing inequalities.
My experiences as an Italian living in various countries, as well as volunteering in Calais’ refugee camp, an orphanage in Kenya and youth football coaching with South Sudanese refugees in Australia enabled me to develop a deeper understanding of cultural, ethnic, religious and gender differences among people. These experiences have played a direct role in shaping my academic path, which includes a B.A. (Hons) in Psychology and an M.Sc. in Global Mental Health.
In April 2018, I began to embark on a portfolio Ph.D. within the department of General Practice and Primary Care at the University of Glasgow, under the supervision of Professor Kate O’Donnell, Dr Sara Macdonald and Dr Barbara Nicholl – to whom I am forever indebted.
I strongly believe in the importance of conducting research in the field of migrant mental health and specifically asylum seekers, refugees, undocumented and stateless people. These are some of the most vulnerable and under-served groups in society and their treatment often highlights how social inequalities and health inequalities are inter-connected. Therefore, in order to improve the latter, we must address the former. Alongside my research, I am currently training as a CBT therapist with the intention to integrate research and clinical practice.
- Dixon-Woods, M., Cavers, D., Agarwal, S., Annandale, E., Arthur, A., Harvey, J., . . . Sutton, A. J. (2006). Conducting a critical interpretive synthesis of the literature on access to healthcare by vulnerable groups. BMC Medical Research Methodology, 6(1), 35. doi:10.1186/1471-2288-6-35
- Silove, D., Austin, P., & Steel, Z. (2007). No refuge from terror: the impact of detention on the mental health of trauma-affected refugees seeking asylum in Australia. Transcultural psychiatry, 44(3), 359-393.
- Winter, D. D., & Leighton, D. C. (2001). Peace, conflict, and violence: Peace psychology in the 21st century. New York: Prentice-Hall.