Resettlement and Mental Health Challenges Among Rwandan Refugees in the U.S: A Descriptive Phenomenological Study

Background: Survivors of the Rwandan genocide of 1994 were forcibly displaced, with many relocating to the US. It is noteworthy that these survivors continue to experience post-traumatic stress disorder (PTSD), depression, anxiety, and other chronic-related symptoms. There is a paucity of evidence that highlights the experiences linked to genocide, migration, and mental health. However, a sound understanding of these concerns is necessary for researchers to develop targeted interventions. Drawing on the ecological systems theory, the study aimed at understanding the manner in which Rwandan refugees’ mental experiences are influenced by events that occurred during the Rwandan genocide (pre-migration) and resettlement.

Method: The study utilized descriptive phenomenological study to understand the experiences of Rwandan refugees. In this regard, a purposive snowball sampling was used to recruit 13 individuals (10 men and three women, four of whom are genocide survivors) who self-identified as Rwandan refugees. Data were obtained through in-depth interviews before being analyzed using Colaizzi’s (1978) five steps of descriptive phenomenological analysis.

Results: According to findings, Rwandan refugees are confronted with multifaceted experiences that are interactive with ongoing resettlement stressors differing from one individual to another. Drawing from the ecological framework, four themes emerged: Individual level challenges; Community and family life challenges; Main sources of stress and worry challenges; and Mental health challenges and help seeking barriers. Rwandan refugees stated that that host country required adjustment into the new system (i.e. driving, food, weather). For some, migrating from refugee camps to the U.S. was a drastic change, thus causing the majority to feel alienated and disempowered in a large country like U.S., whereas others felt isolated and lonely. Some Rwandan refugees also identified community level factors to include gender reversal roles, changed family structure and increased domestic violence, while others felt isolated and lost touch with the community owing to work constraints. Even though participants reported to have had employment, eight of them expressed financial strains as their major source of stress and worry that causes persistent anxiety. In order to reiterate this fact, four Rwandan genocide survivors in the study pointed out that they continued to suffer from war-related trauma such as avoidance, lack of sleep, trust, anger and flashback memories. Despite the prevalence of the ongoing mental health concerns, the structural and cultural barriers of the majority of participants prevented refugees from seeking services. Rwandan refugees also identified cultural factors such as language, stigma associated with mental health, fear of experiencing stigmatization that hindered them from seeking treatment. Structural barriers included lack of culturally responsible service, which include paucity of train interpretations that can decipher clients’ cultural interpretation and expression of mental health concerns.

Conclusion: These findings build on the body of literature on how untreated traumas may be exacerbated by socio-cultural aspects or migration, thus creating lasting negative effects on survivors as well as refugees. Collectively, the challenges facing Rwandan refugees cannot be resolved by one-size-fits all, but rather underscores the need for development and holistic culturally attuned interventions.