An interaction model of environmental and psychological factors influencing refugee mental health

AUTHORS    Shraddha Kashyap, David Keegan, Belinda Liddell, Ted Thomson and Angela Nickerson

LOCATION   International


In this paper, we draw on empirical research and theoretical models of refugee and posttrauma mental health to propose the “Psychological Interaction with Environment (PIE) Matrix Model” of refugee mental health. This model focuses on the mental health of adult refugees and proposes that psychological factors and the external environment interact to influence mental health outcomes and functioning for individuals with refugee backgrounds. Environmental factors include adversity faced before, during, and after the migration journey, including adversity faced in a resettlement or postdisplacement environment. Psychological factors refer to psychological (i.e., cognitive and emotional) mechanisms that individuals may use to cope with adversity. We posit that individuals from refugee backgrounds are likely to show individual differences in psychological processes that may protect against or underpin the development and maintenance of psychopathology following exposure to trauma and displacement. The PIE Matrix Model proposes a framework to guide intervention by identifying key pathways by which psychological and environmental factors impact one another. We suggest that psychological interventions can be targeted according to the kind and level of support different individuals may require, based on individualized and context‐driven assessments of the interaction between environmental and psychological factors at any given point in time. This model draws on existing models of refugee adaptation and highlights the need for longitudinal and experimental research to explain the interaction between these factors and their causal impact on refugee mental health.

How does this research apply to my work?

It is critical to understand which factors positively influence the well‐being of refugees and asylum seekers across diverse contexts to determine the most effective way to allocate the scarce resources that help promote mental health recovery and adaptation.

The model discussed in this paper, has a practical focus and aims to both identify key intervention targets and strategies for services and clinicians working in the field of refugee mental health and provide a tool for tracking client progress in this respect. Further, this model proposes directions for future research inquiry in terms of advancing knowledge regarding the intersection between environmental and psychological factors and understanding how these factors act together to impact refugee mental health.

What should I take away from this research?

The PIE Matrix Model of Refugee Mental Health proposes that environmental stressors and psychological factors intersect in a way that impacts overall psychological well‐being and functioning. Accordingly, both types of factors, which represent the two axes in the model, must be taken into consideration when identifying intervention targets to improve the psychological well‐being of refugees and asylum seekers.

What’s the next step?

Overall, this model highlights the need for longitudinal and experimental research to elucidate the interaction between these factors and clarify their causal impact on refugee mental health.

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