"We are all under the same roof": Coping and meaning-making among older Bhutanese with a refugee life experience. (November 2020)

• Record Type: Journal Article
• Authors: Frounfelker, Rochelle L.; Mishra, Tej; Dhesi, Srishity; Gautam, Bhuwan; Adhikari, Narad; Betancourt, Theresa S.
• Is Part Of: Social science & medicine. Volume 264(2020)
• Publication Date: 2020-11
• Subjects: Older refugees -- Coping -- Meaning making -- Mental health -- Bhutanese -- Resettlement; Social medicine -- Periodicals; Medical anthropology -- Periodicals; Public health -- Periodicals; Psychology -- Periodicals; Medicine -- Periodicals; Medicine -- Periodicals; Médecine sociale -- Périodiques; Anthropologie médicale -- Périodiques; Santé publique -- Périodiques; Psychologie -- Périodiques; Médecine -- Périodiques; Electronic journals; 362.105
• DOI: 10.1016/j.socscimed.2020.113311
• Languages: English
• ISSNs: 0277-9536

Abstract

Abstract: Objective: Refugees have elevated risk of psychological distress and mental health disorders compared to the general population. The majority of research has been conducted with youth and younger adults, and little is known about the mental health of older refugees. We apply the theoretical framework of meaning making to understand how older Bhutanese with a refugee life experience cope with migratory traumas and grief. Method: We conduct semi-structured individual interviews with 41 ethnic-Nepali Bhutanese aged 50 and over with a refugee life experience resettled in the United States and analyze data using thematic content analysis. Results: Forced expulsion from Bhutan was viewed as a violation of core ethnic-Nepali beliefs and sense of purpose related to collective identity. Throughout their 30-year refugee life trajectory, participants utilized coping strategies, including interpersonal support, reappraisal of experiences of trauma and loss, and helping oneself by helping others, that were informed by, and strengthened, this collective identity. These strategies served to both reaffirm worldviews and make new, positive meaning out of a refugee life experience. Individuals who were unable to leverage these strategies struggled to find meaning. Conclusions: We discuss study implications for psychosocial services for older refugees and contribution to theory on meaning making among diverse, vulnerable populations who experience multiple traumas and loss. Highlights: Older Bhutanese with a refugee experience have a strong collectivist identity. Strategies to cope with psychological distress build on this identity. Psychosocial services should help individuals make meaning from life experiences. Interventions should integrate formal and informal systems of care.