Coping mechanisms associated with depression among refugees at Palorinya refugee settlement: A cross-sectional study.

Jasper  Adoto; Maurice Yukei Osire

doi:10.51168/sjhrafrica.v7i3.2506

Authors

Jasper Adoto Clarke International University
Maurice Osire Tukei Clarke International University

DOI:

https://doi.org/10.51168/sjhrafrica.v7i3.2506

Keywords:

Depression, Coping mechanisms, Refugees, Mental health, Palorinya Refugee Settlement, Uganda

Abstract

Background

Depression is a significant public health concern among refugee populations due to trauma, displacement, poor living conditions, and limited access to mental health services. Globally, the prevalence of depression among refugees ranges from 20% to 45%. Refugees employ various coping mechanisms to manage psychological distress, including adaptive strategies and maladaptive strategies. Despite the large refugee population in Palorinya Refugee Settlement in Northern Uganda, limited research exists on coping mechanisms associated with depression in this setting. This study examined coping mechanisms associated with depression among refugees aged 18–50 years in Palorinya settlement.

Methodology

A cross-sectional quantitative study was conducted among 470 refugees selected through stratified random sampling across different zones. Data was collected using a structured interviewer-administered questionnaire incorporating the Patient Health Questionnaire (PHQ-9) to assess depression and the Brief COPE Inventory to measure coping mechanisms. Data were analyzed using SPSS version 26. Descriptive statistics summarized coping mechanisms, while chi-square tests examined associations between coping mechanisms and depression at an α-level of 5%.

Results

Significantly associated coping mechanisms included: self-blame (p < 0.001), humor (p < 0.001), religion (p = 0.006), positive reframing (p = 0.031), substance use (p < 0.001), emotional support (p < 0.001), venting (p < 0.001), active coping (p = 0.005), denial (p < 0.001), and self-distraction (p < 0.001). Individuals experiencing depression were more likely to engage in maladaptive coping mechanisms like self-blame, denial, substance use, and venting; while non-depressed respondents employed adaptive strategies such as active coping, positive reframing, religious coping, and emotional support.

Conclusion

Adaptive coping strategies appear protective against depression, while maladaptive coping mechanisms increase vulnerability to depressive symptoms among refugees.

Recommendations

Strengthening Mental Health and Psychosocial Support (MHPSS) services that promote adaptive coping strategies is recommended.

Author Biographies

Jasper Adoto, Clarke International University

is a humanitarian Volunteer with 6 years of experience in Project Healthcare Management of Populations in Precarious situations, especially with International Humanitarian Organizations responding to emergencies, natural and man-made disasters in challenging environments, including projects with complex security contexts.

At the moment, he holds a Bachelor’s degree in Public Health, a Post Graduate Diploma in Project Management, and is en route to a Master's in Social & Political Science as well as Public Health.

These competencies position him to better manage the challenges of complex humanitarian crises experienced globally.

Maurice Osire Tukei, Clarke International University

is a Clinical Psychologist with a passion for mental health and wellbeing. He has been in practice for the last 10 years and derives a sense of accomplishment from helping mentally distressed people.

Maurice holds a Bachelor's of Community Psychology, a Master of Science in Clinical Psychology, and is currently pursuing a PhD. program with a focus on students’ mental health.

With the above training and practice, Maurice hopes to be able to contribute to Mental Health research to improve awareness and well-being in the community.

References

Al-Shatanawi, T. N., Khader, Y., ALSalamat, H., Al Hadid, L., Jarboua, A., Amarneh, B., Alkouri, O., Alfaqih, M.A., & Alrabadi, N. (2023). Identifying psychosocial problems, needs, and coping mechanisms of adolescent Syrian refugees in Jordan. Frontiers in psychiatry, 14, 1184098. https://doi.org/10.3389/fpsyt.2023.1184098 PMid:37426088 PMCid:PMC10325618

American Psychiatric Association (2013) DIAGNOSTIC AND STATISTICAL MANUAL OF DSM-5 TM. 5th Edition. Arlington, VA: American Psychiatric Association. https://doi.org/10.1176/appi.books.9780890425596

Bwesige, M. & Snider, L. (2021) 'Despair and Suicide-Related Behaviours in Palorinya Refugee Settlement, Moyo, Uganda', Intervention, 19(2), pp. 224-232. Available at: https://doi.org/10.4103/INTV.INTV_12_21.

Carver, C. S. (1997). You want to measure coping, but your protocol is too long: Consider the brief cope. International journal of behavioral medicine, 4(1), 92-100.https://doi.org/10.1207/s15327558ijbm0401_6 PMid:16250744 PMCid:PMC8091945

Charlson, F., van Ommeren, M., Flaxman, A., Cornett, J., Whiteford, H., & Saxena, S. (2019). 'New WHO prevalence estimates of mental disorders in conflict settings: a systematic review and meta-analysis', The Lancet, 394(10194), pp. 240-248. Available at: https://doi.org/10.1016/S0140-6736(19)30934-1. PMid:31200992 PMCid: PMC6657025

Chiumento, A., Rutayisire, T., Sarabwe, E., Hasan, M.T., Kasujja, R., Nabirinde, R., Mugarura, J., Kagabo, D.M., Bangirana, P., Jansen, S., Ventevogel, P., Robinson, J., & White, R.G. (2020) 'Exploring the mental health and psychosocial problems of Congolese refugees living in refugee settings in Rwanda and Uganda: a rapid qualitative study', Conflict and Health, 14(1). Available at: https://doi.org/10.1186/s13031-020-00323-8. PMid:33292363 PMCid: PMC7670672

Daniel, W. (1999). Biostatistics: A Foundation for Analysis in the Health Sciences.

Elshafie, R. and Golden, S. (2020). Assessing Mental Health in Bidi Bidi, Uganda: A Representative Survey of South Sudanese Refugees in Zone Five. Available at: www.cvt.org.

Krenke, K, Spitzer, R.L, & Williams, J.B.W. (2001) 'Validity of a Brief Depression Severity Measure', Journal of Gen Intern Medicine, 16(9), pp. 606-613. https://doi.org/10.1046/j.1525-1497.2001.016009606.x PMid:11556941 PMCid:PMC1495268

Riley, A., Varner, A., Ventevogel, P., Hasan, M.M.T., & Welton-Mitchell, C. (2017). 'Daily stressors, trauma exposure, and mental health among stateless Rohingya refugees in Bangladesh', Transcultural Psychiatry, 54(3), pp. 304-331. Available at: https://doi.org/10.1177/1363461517705571. PMid:28540768

Rousseau, C. and Frounfelker, R.L. (2019) 'Mental health needs and services for migrants: An overview for primary care providers', Journal of Travel Medicine. Oxford University Press. Available at: https://doi.org/10.1093/jtm/tay150 PMid:30561687

Schlechter, P., Rodriguez, I.M., Morina, N., Knausenberger, J., Wilkinson, P.O., & Hellmann, J.H. (2021). Psychological distress in refugees: The role of traumatic events, resilience, social support, and support by religious faith. Psychiatry Research. 304. 114121. https://doi.org/10.1016/j.psychres.2021.114121 PMid:34303945

Seruwagi, G., Nakidde, C., Lugada, E., Ssematiko, M., Ddamulira, D.P., Masaba, A., Luswata, B., Ochen, E.A., Okot, B., Muhangi, D., & Lawoko, S. (2022) 'Psychological distress and social support among conflict refugees in urban, semi-rural and rural settlements in Uganda: burden and associations', Conflict and Health, 16(1), pp. 1-12. Available at: https://doi.org/10.1186/s13031-022-00451-3 PMid:35551630 PMCid:PMC9096741

Steel, Z., Marnane, C., Iranpour, C., Chey, T., Jackson, J.W., Patel, V., & Silove, D. (2014a) 'The global prevalence of common mental disorders: a systematic review and meta-analysis 1980-2013', International Journal of Epidemiology, 43(2), pp. 476-493. Available at: https://doi.org/10.1093/IJE/DYU038. PMid:24648481 PMCid: PMC3997379

UNHCR (2021) Global Trends Report 2021 | UNHCR, UNHCR. Available at: https://www.unhcr.org/media/global-trends-report-2021 (Accessed: 26 September 2024).