Waiting for family reunification and the risk of mental disorders among refugee fathers: a 24-year longitudinal cohort study from Denmark

AUTHORS    Camilla Hvidtfeldt, Jørgen Holm Petersen and Marie Norredam

LOCATION   Denmark


Family separation is a risk factor for mental health problems, but this is more so for immigrants, refugees and their families. Many families experiencing war and disaster are forced to separate and let one or a few family members travel ahead of the others to seek asylum and, if they are recognized as refugees, apply for family reunification. In Europe, most asylum seekers are men, while most family reunified to refugees are women and children. This indicates that the ‘first arrivals’ are often fathers who begin their life in the receiving country waiting for their families. Fathers face a number of uncertainties: how long their applications for asylum, and then family reunification will take, followed by what will be the outcome of their applications. Therefore, they wait with ‘double uncertainty’. This double uncertainty can increase the risk of mental disorders.

This study included 6,176 refugee fathers who arrived alone and later obtained family reunification. Researchers used data from Statistics Denmark and Danish Immigration Service for the period, January 1986 - December 2019. The study sought to answer the following: Do refugee fathers still waiting for family reunification have a higher risk of mental disorders compared with those who have been reunified with their family? Are longer periods of family separation associated with a higher risk of mental disorders? Is prolonged family separation associated with an increased risk of mental disorders even after family reunification has been obtained?

Findings showed that the fathers’ risk of mental disorders was twice as high when separated from their families compared with those who had already obtained family reunification. Risk of mental disorders increased with longer periods of waiting for family reunification, and this risk was increased even after family reunification was obtained. The results suggested that family separation was mainly associated with an increased risk of post-traumatic stress disorder.

How does this research apply to my work?

Health, settlement and social services providers should factor in the stress of family separation as they deliver care and services for refugee fathers. One recommendation put forward by the authors is establishing networks to support the fathers during the separation period and even after reunification is obtained. In addition, it is important to pay attention to family conflicts and potential limitations in the fathers' ability to support their children. The ideal approach for reconciliation and healing is to include all family members.

What should I take away from this research?

  • Refugees waiting for their families have been shown to feel powerless, distressed, and guilty for being safe while their family remain in potential danger.
  • Findings suggest that family separation may add cumulatively to the stressors and trauma experienced by most refugees, thereby aggravating their mental health problems.
  • Higher age was associated with higher risk of mental health problems. Older fathers may also on average have older children with whom they cannot obtain family reunification, which may further add to their psychological burden.

What’s the next step?

According to the United Nations High Commission on Refugees, in 2019, Canada came out again as the world leader in the resettlement of refugees, ranking first among 26 countries. Previous and emerging conflicts such as those in Afghanistan and Ukraine have contributed to more persons seeking refuge in countries like Canada. Circumstances surrounding forced migration will cause some families to be separated and leave others behind. Family reunification plays a crucial role in resettlement and is pivotal to a family`s economic integration since poor mental health can lead to poor labour market integration, making family poverty more likely.

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