Beyond Resiliency: An Exploration of East African Refugees Psychological Well-Being

Background and Purpose: Refugees experience a myriad of traumatic experiences in each stage of their journey which consequently impacts their psychological well-being. In recent years, there has been an increase in studies on refugees' mental health and resilience. However, there is a dearth of research on the trauma and psychological well-being of Ethiopian and Eritrean refugees. Thus, this exploratory qualitative study explores the life histories of Eritrean and Ethiopian refugees, focusing on their pre-migration, in-transit, and resettlement experiences and their influence on their psychological well-being after resettlement in North Carolina. Two research questions guide the study: 1) What are the conditions experienced by Ethiopian and Eritrean refugees pre-migration, in transit, and upon resettlement? 2) How do these different stages of forced migration affect the psychological well-being of the refugees?

Methods: This study used non-probability purposive and snowball sampling techniques with multiple entry points into the community for participant recruitment such as resettlement agencies and local churches. Semi-structured in-depth interviews with open-ended questions were used to interview 11 East African refugees (6 Ethiopian and 5 Eritrean refugees) and 6 service providers who work directly with Ethiopia and Eritrea refugee populations. The research was conducted using three languages: Amharic, Tigrinya, and English. We conducted semi-structured interviews over the phone or the internet via video chat using Zoom technology. The interviews lasted between 60 and 90 minutes. We analyzed the data using the thematic analysis approach.

Findings: Pre-migration was replete with traumatic experiences for both Ethiopian and Eritrean participants. Participants from Eritrean escaped from their country mainly in fear of the indefinite military service which is characterized by inhuman treatment and widespread human rights violations. Ethiopian refugee participants fled from their country due to civil war, and ethnic tension. Participants spent an average of 7.2 years in refugee camps, ranging from 2 to 15 years. Their experiences in refugee camps were horrific marked by a lack of access to services, abuse, uncertainties of resettlement, boredom, and a high rate of suicide. Upon resettlement in the US, participants continued to face psychological, social, economic, and gender-based challenges. Participants reported experiencing loneliness and depression, cultural shock, language barriers, harsh working conditions, and economic uncertainty in resettlement. Furthermore, during resettlement, lack of access to resources, insecure and unsafe neighborhoods, domestic violence, and alcoholism and substance abuse as coping mechanisms were reported by participants.

Conclusions: Based on the findings of this study, Ethiopian and Eritrean refugees encounter trauma at all stages of their forced migration, but their access to services is limited. Participants were often labeled as resilient and not in urgent need of mental health care. However, refugees’ exposure to traumatic events in each stage of migration increases their risk of mental health challenges outside of their resilience. Based on an Understanding of refugees’ journeys (pre-migration, transit, and post-resettlement), there is a significant unmet need for culturally appropriate mental health care intervention for refugees.