Post-Migration Living Difficulties As a Significant Risk Factor of Psychological Distress in Burmese Refugees

Background Purpose: Post-migration living difficulties (PMLD) have been shown to have negative impact on the mental health and integration of refugees and immigrants. This study investigated the role of PMLD and psychological distress among 205 resettled Burmese refugees in the United States.

Methods: Data was collected by means of self-administered questionnaire. The frequency and severity of post migration living difficulties was assessed with PMLD, and psychological distress with the Kessler-10 scale. Demographic information such as age, gender, relationship status, residency status, employment status, and length of residence were also collected. Logistic regression analysis was conducted to assess the effect of the number of PMLD on psychological distress. All respondents provided written consent.

Results: Respondents ranged in age from 18 to 73 years, with a mean age of 35.29 (SD=11.31), of whom 53.2% were female, 71.7% were married, and most (64.9%) had one or more children. Of the total sample, 14.6% had primary level education, about half (50.7%) had completed high school, and 16% have a bachelor’s degree or equivalent. About two-thirds (67.2%) were currently employed, reporting a median monthly household income of $2,000. Length of living in the US range from 1 to 24 years (Mean years = 5.84), and all but six respondents are permanent resident and/or American citizen.  

In the whole sample, 35.1% were at higher risk of psychological distress. The most frequently reported PMLDs were “language/communication difficulties” (33.6%), “poor access to emergency medical care” (30.4%). The frequency of reporting at least one serious/very serious PMLD was also higher in participants with high psychological distress. Logistic regression analysis revealed that the number of PMLDs (β = .09, p<.01), and having at least one serious/very serious PMLD (β=-.26, p<.01) significantly increased one’s likelihood of reporting high psychological distress, controlling for age, gender, relationship status (married, nonmarried), education, employment (employed, not employed), and length of residence (years). The log of the odds of high psychological distress is related to the number of PMLD reported, recording an odds ratio of 10.97. The full model was statistically significant, χ² (8, N=205) = 39.57, p<.001, indicating that the model was able to distinguish between respondents who reported low and high psychological distress. The model as a whole explained between 17.6% (Cox & Snell R squared) and 24.2% (Nagelkerke R squared) of the variance in psychological distress, and correctly classified 71.2% of cases.

Conclusions: Experiencing serious/very serious post-migration living difficulties significantly increase the risk of psychological distress in Burmese refugees. Findings have implications for service provision in terms of implementing appropriate interventions to effectively meet the needs of refugees in the US.