The Impact of Acculturation, Trauma, and Post-Migration Stressors on the Mental Health of African Immigrants and Refugees in Sweden

Mental health promotion is an important public health issue which warrants increased and immediate attention due to the significant impact that mental health can have on physical health,quality of life, and functioning. Immigrants and refugees often have unique and increased mental health needs secondary to their migration to a new country and the acculturative stressors and living difficulties that often accompany resettlement, as well as prior experiences of trauma. However, little to no prior research has been conducted regarding the mental health of African immigrants and refugees living in Sweden. This thesis describes data from a study which was conducted in Stockholm, Sweden from 2002 to 2005 that investigated African immigrant and refugee health and quality of life. Stratified quota sampling based on the 2001 Swedish census was used to recruit a representative sample of participants by gender and country of origin. Four hundred and twenty participants completed semi-structured interviews that utilized cross culturally validated survey instruments to measure depression, anxiety, post-traumatic stress disorder (PTSD), acculturation, traumatic events, and post-migration living difficulties. Twenty percent of participants met symptom criteria indicative of depression, and 18.5% met criteria indicative of anxiety. Eighty-ninepercent of participants reported experiencing at least one traumatic event prior to immigration,and 47% met DSM-IV symptomology and functional impairment criteria for PTSD. Mental health outcomes were found to be significantly associated with pre-migration trauma, acculturation level and type, and post-migration stressors. Recommendations for future research, mental health service provision, and integration policies are provided