Social Support, Social Networks, and Mental Health of Six Refugee Subgroups in Arizona: Findings from a Pilot Study

Background and Purpose: Mental health care is essential for refugee integration, yet existing frameworks often lack the cultural sensitivity needed to address subgroup-specific needs. Treating refugees as a homogeneous group overlooks how cultural and experiential factors shape mental health and care responses, limiting intervention effectiveness. While social connectedness is known to protect mental health, prior research has often relied on broad social support measures, failing to capture the unique structure and function of refugees’ social networks. This pilot study aimed to fill these gaps by using social network data to explore social support, social network characteristics, and mental health across six refugee groups resettled in Arizona—a key U.S. resettlement site. Research questions included: (a) How do sociodemographic characteristics vary across the six subgroups? (b) How do social support, social networks, and mental health outcomes—specifically psychological distress and suicidal thoughts—differ across groups?

Methods: We collected egocentric network data (July-September 2022) from 150 refugees across six groups—Bhutanese, Burmese, Congolese, Iraqi, Somali, and Syrian—resettled in Arizona. A community-based participatory research approach was employed, with community leaders from each group serving as active research partners. Surveys were self-administered either at ethnic-based community organizations or in participants’ homes, in both English and native languages. Social support was assessed using the 12-item Multidimensional Scale of Perceived Social Support. Social networks were examined through egocentric network analysis, capturing variables such as network structure, location of alters, relationship strength and quality, interaction frequency, relationship type, homophily, and disclosure of suicidal thoughts. Suicidal thoughts were measured using the Wish to be Dead Scale. Chi-square tests and ANOVA compared sociodemographic characteristics across groups. Kruskal-Wallis H tests examined group differences in social support, social networks, and mental health outcomes.

Results: Most participants were male (53.0%), with an average age of 41.4 years; 31.3% had no formal education, and 44.7% were unemployed. Significant differences emerged across refugee subgroups in terms of sociodemographic characteristics, social support, network characteristics, and psychological distress and suicidal thoughts. Particularly, Syrian refugees stood out with the lowest employment and English proficiency rates, shorter U.S. residency, smaller and more dispersed networks, and the highest levels of psychological distress and suicidal thoughts.

Conclusions and Implications: To our knowledge, this is the first study to use egocentric network data to compare social networks and mental health indicators across Arizona’s refugee subgroups. The findings underscore the importance of disaggregating refugee subgroups to better address their diverse mental health needs—recognizing the unique experiences of each population rather than treating refugees as a homogeneous group. Social support, network characteristics, and mental health appear to interact uniquely in each group, suggesting that a one-size-fits-all approach is insufficient. A social determinants of health framework is urgently needed across research, policy, and practice. Mental health professionals and policymakers should consider each group’s distinct social support systems, network composition, psychological distress, and suicidal thoughts to develop culturally responsive interventions that leverage refugee support networks.