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Multisystemic Resilience and Psychosocial Wellbeing among Older Refugees: A Systematic Review with Implications for Mental Health and Psychosocial Support (MHPSS)

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Abstract

Older refugees experience poor mental and emotional health outcomes compared to younger counterparts. Although older adults are instrumental in family/community adjustment in postmigration settings, little is known about how to enhance psychosocial resilience in this population. The aim of this systematic review is to glean deeper insight into the protective factors and processes associated with older refugees’ resilience and positive psychosocial health in postmigration settings. We searched eight electronic health and social science databases. Twenty-three articles met the criteria for inclusion; we analyzed these using a multisystemic resilience lens. Studies spanned 1991 to 2022; importantly, 15 of the 23 articles were published in the past decade, indicating growing attention to the mental and psychosocial health of older refugees. Only six of the included articles focused on older refugees living in low- and middle-income countries, revealing a contrast between where most of the world’s refugees reside and where the majority of mental health and psychosocial support (MHPSS) research is conducted. We found tremendous variation in determinants of psychosocial resilience based on the politico-historical contexts of migration; sociocultural backgrounds of refugees; and distinct postmigration needs, resources, and settings. Broadly, macrosystem determinants of resilience included security, access to basic services, and maintenance of culture and spirituality. Mesosystem factors were related to social support from families, ethnic communities, religious networks, and host country nationals. Finally, microsystem determinants of older refugees’ resilience included language acquisition, cognitive reappraisal, and sense of optimism. Our findings suggest the importance of interdisciplinary, multilevel research designs to highlight how multiple ecosystems interact to promote psychosocial resilience among older refugees. Taken together, this systematic review offers important insight into multilevel protective factors and processes to enhance culturally and contextually meaningful MHPSS for older refugees.

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Acknowledgements

This study was reviewed by members of the Journal of Immigrant and Minority Health editorial board during the 2020 North American Refugee Health Conference. We are grateful for careful input that shaped the direction of the review. We would like to thank Dr. Erica DeFrain, Associate Professor at the University of Nebraska-Lincoln, for her expertise and assistance developing the inclusion criteria for this systematic review.

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The authors received no financial support for the research, authorship, and/or publication of this article.

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Authors and Affiliations

  1. Department of Child, Youth and Family Studies, University of Nebraska-Lincoln, 391 Carolyn Pope Edwards Hall, Lincoln, NE, 68588, USA

    Julie A. Tippens, Sarah Erwin, Kari Eller, R. Marie Dutra Gross & Brittany Bearss

  2. Department of Sociology, University of Nebraska-Lincoln, Lincoln, NE, USA

    Blakelee Kemp

  3. College of Nursing, University of Nebraska Medical Center, Lincoln, NE, USA

    Elizabeth Mollard

  4. Amref International University, Nairobi, Kenya

    Lucy Njiru, Patrick Okwarah & Alice Lakati

  5. Department of Communication Studies, University of Nebraska-Lincoln, Lincoln, NE, USA

    Angela L. Palmer-Wackerly

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  1. Julie A. Tippens
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Contributions

To our knowledge, this is the first systematic exploration of older refugees’ resilience. Additionally, we sought to highlight the importance of multilevel resilience frameworks in mental health research, programming, and policies.

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Correspondence to Julie A. Tippens.

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Tippens, J.A., Erwin, S., Eller, K. et al. Multisystemic Resilience and Psychosocial Wellbeing among Older Refugees: A Systematic Review with Implications for Mental Health and Psychosocial Support (MHPSS). J Immigrant Minority Health 25, 1152–1170 (2023). https://doi.org/10.1007/s10903-023-01516-y

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