Migration, Adaptation, and Mental Health: The Experience of Southeast Asian Refugees in the United States

Policy-oriented research has tended to focus on objective dimensions of the refugee adaptation process (such as economic “self-sufficiency”, employment, and welfare dependency rates) than on subjective factors that are not only more difficult to measure but more often than not are seen as epiphenomenal (such as migration motives, acculturative attitudes, and mental health). Yet refugee “mental health” is no mere epiphenomenon: it both shapes and is shaped by those objective realities and as such, needs to be taken seriously into account by refugee policy. This paper seeks to contribute to our understanding of subjective aspects of the Southeast Asian refugee experience and of their import for refugee policy. Specifically, the paper reports on findings from a longitudinal survey (IHARP) of a representative sample of Vietnamese, Cambodian, and Laotian men and women in the San Diego metropolitan area, site of one of the largest Indochinese refugee concentrations in the United States. A general model of migration, adaptation, and mental health is proposed and tested with the survey data. A typology of motives is developed empirically from a diverse set of open-ended responses, distinguishing between “targets,” “rebels,” “victims,” and seekers.” Rates of psychological well-being and distress were measured at two points in time. The paper examines the varying effects of a wide range of pre-arrival and post-arrival factors on their adaptive responses over time. The refugees’ changing levels of psychological distress and of satisfaction with various areas of their lives in the United States – which serve, respectively, as affective and cognitive indicators of their “mental health” – are analyzed as principal outcome variables in this study. Adult mental health outcomes, in turn, are shown to be independent variables in their own right, affecting other aspects of the refugee adaptation process – from their economic self-sufficiency, to pregnancy outcomes of refugee mothers, and even the educational attainment of their children several years later – and thus medical, educational and economic policy goals