Data_Sheet_1_Mental Health and Integration: A Qualitative Study on the Struggles of Recently Arrived Refugees in Germany.PDF

Introduction: Forcibly displaced people are at particular risk of mental health problems and also face specific integration challenges upon resettlement. Existing literature suggests that there may be a bidirectional relationship between mental health and integration. The present study seeks to understand the relationship between integration processes and mental health problems or significant negative emotional experiences among adult refugees in Germany.
Method: Applying a qualitative approach, we conducted 54 semi-structured interviews with refugees and asylum seekers who arrived in Germany between 2013 and 2018 currently residing in Berlin, Leipzig, or the Duisburg area in North Rhine-Westphalia. Data was collected between December 2018 and September 2019. We analyzed transcripts inductively using thematic analysis.
Results: Five themes covering the various links between integration and mental health problems or significant negative emotional experiences were identified. First, we found that the mental health consequences of past adverse experiences, as well as ongoing worries about those left behind in the homeland, can seriously impede refugees' ability to pursue activities key to integration. Second, the process of applying for and securing asylum can result in uncertainty and fear, which, in turn, burden the individual and may impact motivation for integration. Third, many of our participants described mental health ramifications related to feeling stuck and thwarted in the pursuit of building a life, especially in securing employment. Fourth, some participants described feeling so overwhelmed by fundamental tasks throughout the integration process, namely, language learning and bureaucratic processes, that these take a psychological toll. Fifth, we identified several forms of social disconnection between refugees and members of the host community due to xenophobia, social and cultural differences, physical and emotional isolation in refugee camps, as well as with co-nationals and fellow refugees. Negative emotions, mistrust, and socio-cultural differences that emerge throughout the integration processes seem to erode social cohesion among refugee communities, potentially further threatening mental health.
Conclusion: Mental health problems and integration processes appear to be closely related across different areas of integration. Innovative solutions to challenges identified by members of the refugee community in Germany stand to benefit mental health and integration outcomes simultaneously.

引言：被迫流离失所者（forcibly displaced people）罹患精神健康问题的风险尤为突出，且在重新定居过程中还会面临独特的融入挑战。现有研究表明，精神健康与社会融入之间可能存在双向关联。本研究旨在探究德国成年难民的融入进程与精神健康问题或显著负面情绪体验之间的关联。

研究方法：本研究采用质性研究范式，对2013年至2018年间抵达德国、目前居住在柏林、莱比锡或北莱茵-威斯特伐利亚州杜伊斯堡地区的难民与寻求庇护者（asylum seeker）开展了54次半结构化访谈（semi-structured interview）。数据采集时间为2018年12月至2019年9月。研究采用归纳式主题分析法（thematic analysis）对访谈转录文本进行分析。

研究结果：本研究共识别出5个涵盖融入与精神健康问题或显著负面情绪体验间各类关联的主题。其一，过往创伤经历所带来的精神健康后遗症，以及对仍留在原居地亲友的持续牵挂，会严重阻碍难民开展融入所需的核心活动。其二，申请并获得庇护身份的过程会引发不确定性与恐惧情绪，进而加重个体负担，可能削弱其融入社会的动力。其三，多数受访对象提及，在谋求新生活（尤其是稳定就业）的过程中屡屡受挫、陷入停滞，由此产生了一系列精神健康方面的负面影响。其四，部分受访者表示，融入进程中的基础任务（如语言学习与行政流程办理）令其不堪重负，进而造成了心理损耗。其五，研究发现，由于仇外心理（xenophobia）、社会文化差异、难民营中的身体与情感孤立，以及与本国同胞及其他难民之间的隔阂，难民与本地社区成员间存在多种形式的社会脱节。融入进程中滋生的负面情绪、不信任感与社会文化差异，似乎会削弱难民群体内部的社会凝聚力（social cohesion），进而可能进一步威胁其精神健康。

研究结论：精神健康问题与融入进程在融入的各个维度均呈现出紧密关联。针对德国难民群体所识别出的挑战提出创新性解决方案，有望同时改善精神健康状况与社会融入效果。