Protective and Risk Factors Contributing to Mental Health and Well-Being Among Youth from Refugee Backgrounds

Background: According to the United Nations High Commissioner for Refugees (UNHCR), as of midd-2022, there are approximately32.5 million refugees globally, 41% of those are children and adolescents. Refugees often experienced many pre- and post-migration stressors, which may increase their risk off poor mental health and well-being. As young refugees make up a significant proportion of refugees globally, it is imperative to provide mental health support for these young refugees. Literature on refugees' mental health often focuses on psychopathology add their traumatic experiences. Although there is emergent research highlighting the importance of emphasizing protective factors, such as strengths, individual agency, and family and school connectedness, less is known about these processes on refugee from a Burmese background. Thus, this study focuses on two constructs of mental health-positive well-being and psychological distress-and examines the influence of both protective and risk factors associated with the mental health of Burmese youth from a refugee background resettled in the United States (U.S).

Methods: This cross-sectional study surveyed 133 Burmese youth from a refugee background who resettled in the U.S. Participants completed the Stirling Children's Well-Being Scale (SCWBS) and the depression subscale off the Hopkins Symptoms Checklist (HSCL-D), which assessed mental health status. Protective factors of family congruence was measured with the Intergenerational Congruence in Immigrant Families-child Scale, school connectedness with the Psychological Sense off School Membership, and resilience with the resiliency subscale of the Acculturation and Resiliency Scale for Adolescents. Risk factors include acculturative stress and perceived discrimination, and were assessed with the Daily Hassles Microsystem Scale and Measure of Perceived Discrimination Scale. Descriptive statistics examined the distribution of demographic characteristics and the study variables. Further, hierarchical linear regression analysis examines the association between protective and risk factors and mental health, controlling for demographic characteristics.

Results: Participants ranged in age from 10-17 years (Mean age=13.88, SD=1.99), the majority of whom were girls (55.6%), and 44.4% were boys. The mean total score on SCWBS was 37.58 (SD=9.29), and the mean score on HSCL-D was 26.71 (SD=10.16). The results of hierarchical linear regression analysis indicated that higher levels of school connectedness (B=.35, p<.001), resilience (B=.28, p<.001), and family congruence (B=.15, p<.05) were significantly associated with higher levels of positive mental well-being, explaining 54.4% of the total variance in SCWBS. Further, higher levels of resiliency (B= -.21, p<.05) were significantly associated with lower psychological distress. Conversely, higher levels of perceived discrimination (B=.18, p<.05) and acculturative stress (B=.19, p<.05) were significantly associated with higher levels of psychological distress and explained 28.5% of the variance in psychological distress.

Implications: Most youths in this study reported higher positive mental well-being. School connectedness, resiliency, and family congruence, enhanced their mental well-being. on the other hand, acculturative stress and perceived discrimination were associated with poorer mental health status. These findings indicate the need to understand protective and risk factors for mental health status among Burmese youth from refugee backgrounds. Furthermore, implications for refugee-related strategies in schools, social services, and mental health services are discussed.