Exploring Mental Health, Resilience and Resettlement Stressors in Women of Refugee Background Resettled in Regional Australia: A Tasmanian Case Study

  • Clare Hawkes

Student thesis: Doctor of Philosophy (PhD) - CDU


Women of Refugee Background (WoRB) are a highly vulnerable population
with complex mental health needs following resettlement. There has been a substantial
increase in WoRB being resettled in rural and regional locations in Australia. Despite
this, no research to date has investigated the mental health, wellbeing, or resettlement
challenges associated with resettlement in rural and regional locations of Australia for
WoRB. The overarching aim of this thesis was to address this gap in research.

Study One involved a systematic review of pre-existing research focusing on the
mental health and wellbeing of individuals of refugee backgrounds resettled in rural and
regional Australia. A systematic literature search located 14 relevant studies, which
were synthesised using thematic analysis techniques. Results identified that individuals
of refugee background resettled in regional locations had higher levels of
psychopathology than the general populations and had substantial difficulty accessing
mental health services. They also had an increased risk of experiencing factors
associated with adverse mental health outcomes, including social isolation,
disconnection from family and communication barriers. In addition to this, specific
gender-based challenges were identified – namely that WoRB were at particular risk of
experiencing higher rates of psychopathology and factors related to poor mental health
outcomes in regional Australia. Despite this, no research to date had explicitly focused
on the mental health and wellbeing of WoRB resettled in regional Australia. This
finding served as a starting off point for the following studies outlined in this thesis.

A qualitative methodological framework was utilised in the remaining studies of
this thesis. 21 semi-structured interviews were conducted on 21 individuals (nine
WoRB, four individuals in volunteer-based roles, and eight service providers [in paid
positions] who support WoRB during resettlement). Interview data was transcribed
verbatim, and transcripts were analysed utilising Clarke and Braun (2006) six-step
framework for conducting thematic analysis, using inductive thematic description at the
semantic level, further underpinned by an essential/realist approach.

Study Two focused on how WoRB conceptualised their mental health and
factors influencing their mental health during resettlement in regional Australia. This
study found that for WoRB, 'mental health' was conceptualised as a pathogenic entity,
with factors associated with regional resettlement exacerbating mental distress in
WoRB. Study Three explored factors that WoRB endorsed as contributing to their
resilience, wellbeing, and coping during resettlement in regional Australia. Findings
from Study Three found that religious practices, community, and having a sense of
wellbeing were paramount to their wellbeing. However, due to significant oversights
from a policy perspective, many WoRB could not access the factors they self-identified
as paramount for their coping and well-being. Finally, Study Four focused on the lived
experience and challenges associated with the resettlement of WoRB to regional
contexts. Challenges were identified on the individual level (language barriers, lack of
access to basic needs), interpersonal level (loss of connection from their culture of
origin), and service level (lack of service provision and accessibility).

Overall, the findings of the studies included in this thesis highlight the factors
that contribute to the mental health and wellbeing in WoRB resettled in regional
Australia. The findings suggest that the current services and supports available to WoRB
resettled in regional locations of Australia are inadequate and under-resourced.
Implications and recommendations include more inclusive policies, which proactively
consider mental health and wellbeing from a cross-cultural perspective and more
consideration surrounding the social determinants of health and greater investment in
regional mental health services.
Date of Award2022
Original languageEnglish
SupervisorDouglas Paton (Supervisor)

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