Continuity of Care, Self-Sufficiency, and Wellness Among Asylees in the U.S.: A Qualitative Case Study

Background & Purpose: According to the United Nations High Commission on Refugees (UNHCR), there are over 100 million forcibly displaced persons due to conflict, war, economic devastation, human rights violations, and climate change (UNHCR, 2022). Asylee- and refugee- receiving countries struggle with policies, services, and integration into the local communities while their legal status often remains unresolved. The United States (U.S.) is among those that accept refugees and asylees through government funded and monitored resettlement programs. Resettlement programs provide services, such as case management and employment placement, for varying periods of time.

Methods: In the U.S., self-sufficiency is generally understood as employment and the ability to pay bills. Using participatory methodology and a constructivist strengths-based approach, researchers worked with a local refugee and asylee resettlement agency located in an urban environment interviewing 21 asylees receiving services. The interview included semi-structured interviews for 60 minutes. The research explored the intersection of asylee integration, the realities of pre- and post-resettlement life in the U.S., and wellness. The study aimed to give voice to the direct experiences of asylees and inform resettlement practitioners and policymakers to identify successful methods for integration. The study explored refugee perspectives on self- sufficiency, integration and wellness beyond federally mandated definitions and ways in which race, religion, gender and other factors may create barriers to a self-sufficiency and wellness.

Results: The themes in the study findings included differences in experiences in the country of origin versus life in the US, gender differences in experiences, concepts of freedom and self-sufficiency, and health and wellbeing. Using open, axial and structural coding the responses were analyzed and placed into contextualized concepts. The primary themes that emerged were based on participant’s experiences, cultural and religious informing, and nuanced understanding of ideas and cultural norms. All participants stated that their experience of self-sufficiency centered on self-determination, short-and-long-term employment, and job security. Education was a consistent theme and included an expressed need for more training as well as access to higher education. Freedom was a recurrent theme that was articulated through individual experiences of gender identity, choice and self-expression (ability to be oneself in safety), and a sense of hope and opportunity. Asylees identified experiences of violence, oppression, lack of opportunity, hope and freedom similar to pre-migration challenges. Additionally, post-migration challenges included detention in the U.S., lack of access to health and wellness, education and employment opportunities, and disconnectedness with the community.

Conclusions: The findings suggest that resettlement policies and programs can benefit from understanding the lived experiences of asylees and their meaning making as they resettle in the U.S. Services should be integrated, and the strengths-based approach incorporated into service delivery. Integrated services reinforce the strengths-based approach facilitating asylee empowerment, self-reliance, and resiliency building. Asylees would benefit from extended case management, long-term housing support, and access to education and training. Furthermore, support in building social networks and social bonds to promote resiliency remains critical in facilitating overall wellbeing. In addition, culturally appropriate psychosocial, psychoeducational, and health and mental health services can benefit asylees.