The impact of trauma, flight and protracted displacement on the mental health of Eritrean refugees living in Israel: An exploratory study of coping strategies

Abstract

Multiple studies have found that refugees significantly underutilize mental health services. Yet, little is known about how refugees who live in contexts of protracted displacement cope with and recover from violence, trauma and chronic stress. The unique experiences of refugees living in Israel, particularly those fleeing the violence of Eritrea, is even less understood. This study sought to explore strategies of coping used by Eritrean refugee men and women living in Israel. In-depth interviews were conducted with 34 Eritrean refugees aged 26–40 having been identified as suffering or having suffered from psychological distress. Participants reported experiencing severe violence and upheaval in Eritrea, during flight, and struggled with daily life in Israel. Reported coping strategies were rooted and shaped by the Eritrean cultural context, systems of knowledge, values, and cultural perspectives. They included concealment, silence and forgetting, engaging in religious and spiritual practices, seeking social support, and, for some, accessing formal health and psycho-social services. Our findings underscore the profound effects of protracted displacement, with participants noting the anxiety, stress, uncertainty, and inability to build their lives brought forth by their liminal status. Findings also reveal the ways in which structural considerations in Israel, particularly law and policies, negatively impact upon the daily lives of Eritrean refugees, contributing to their ongoing distress. Taken together, these elements may deplete refugees’ coping resources and undermine their natural processes of recovery and healing. Our findings justify the need to re-think traditional models of trauma and recovery, integrate spirituality and cultural healing into interventions, consider how structural realities impact daily experience, and account for refugees' unique perspectives on distress within the care process.

Keywords

• Israel
• Eritrea
• Refugees
• Mental health
• Coping
• Displacement