Gender-Based Violence and Related Mental Health Issues Among Immigrants and Refugees in North America: A Systematic Review of Culturally-Tailored Interventions

Background: The population of immigrants and refugees in the U.S. continues to increase, with more than one million immigrants arriving in the country yearly. More than half of immigrant and refugee women experience some form of gender-based violence (GBV) such as sexual and physical violence, which have significant impacts on their mental health and well-being. A majority are likely to experience mental health illnesses such as depression, anxiety, and posttraumatic disorders. Culturally targeted interventions for survivors are emerging; however, there remains a significant gap in the knowledge about these interventions and how they address immigrant and refugee experiences with GBV and related mental health problems. This study sought to conduct a review of evidence-based interventions that are designed to reduce experience with GBV and related mental health illnesses among immigrants and refugees.

Methods: Peer-reviewed articles were identified using two methods. First, key words were entered into nine electronic databases. Titles, abstracts, and articles were screened for inclusion and exclusion criteria. Second, a hand search of reference lists from key articles was conducted. Studies were included if they addressed both GBV and mental health or trauma among immigrant and refugee populations in the US and Canada. Both qualitative and quantitative studies were included. There was no restriction on the age or gender of the participants.

Results: The systematic review includes 13 peer-reviewed articles. Because one intervention was the topic of multiple articles, there were 10 interventions represented across these 13 studies. The majority of interventions (n=6) focused on survivors of GBV. Three were geared toward domestic violence (DV) perpetrators, and one was directed toward the general population. Survivor-focused interventions had multiple aims, such as improving mental health outcomes and increasing social support, self-efficacy, self-esteem, and knowledge related to DV. Interventions for DV perpetrators were designed for Latino immigrant men and focused on deconstructing cultural conceptualizations and expectations associated with gender. The intervention for the general population addressed knowledge and risk factors related to DV along with local resources for accessing support.

Intervention outcomes demonstrated a plethora of positive results. Some of these outcomes included an increase in positive mental health, resilience, safety behaviors, self-esteem, social support, access to referral services, and knowledge about DV. Immigrants often encounter multiple barriers to help-seeking, so the outcomes related to increased access to referral services and social support was particularly notable. Moreover, by increasing access to services, the intervention further facilitates the target outcome of improving health and well-being. Interventions directed at perpetrators had increased retention rates, suggesting that the participants were more receptive to culturally-tailored interventions.

Conclusion: Risk and experience with GBV has significant mental health effects that are serious and sometimes fatal for victims and their children. Yet, findings from this systematic review reveal only a handful of culturally tailored interventions that address these issues among immigrants and refugees in the US and Canada. These findings helps to define the current gap in both practice and research while illuminating a path forward for addressing GBV and mental health needs of this growing population.