2. MENTAL HEALTH AND FAMILY COMPOSITION AFTER MIGRATION TO SWEDEN
Elisabeth Mangrio
Senior Lecturer
Care Science, Malmö University
Malmö Institute for Studies of Migration, Diversity and Welfare, Malmö University

3. Background
Refugees` mental health frequently presents a challenge to clinicians and policy makers
Some studies report a gradual improvement in symptoms over a period of a decade, other studies not
Refugees are at higher risk of a variety of psychiatric disorders related to exposure to war, violence, torture and the uncertainty of their refugee status in the host country

4. Background
Temporary changes in granting permanent residence permits based on family reunion
Willingness of states to authorize reunification of migrant families is supported by international human rights laws
Family is a natural and fundamental group in society
If families are split, they are deprived of this fundamental right

5. Aim
Mental health of refugees can be affected by whether or not a family is reunited in the new country after flight
Mental health is of crucial importance to participation in the integration programme of the host country
It is therefore critically important to determine how different post-migration family structures are associated with the mental health of recently arrived adult refugees in Sweden

6. Method
1,700 questionnaires were distributed to refugees speaking Arabic or Dari
Participating in the mandatory public integration support programme in the Scania region of Sweden
Response rate of approximately 39.5 per cent
Self-administered questionnaire that included questions about health, sleep, level of education, well-being, accommodation type, social relations, work and access to health care

7. Method The study included 681 recently arrived refugees
461 were males, 204 were females and 16 did not specify their gender
301 respondents had a high educational level, 141 had a medium educational level and 146 had a low educational level

8. Method Definition of complete and incomplete family
The family composition was defined as complete if both spouses were presently in Sweden with all their children (if any).
And incomplete family was defined as:
(a) married or partner in another country and without all children in Sweden,
(b) unmarried/widowed/divorced with all children in Sweden
(c) unmarried/widowed/divorced without all children in Sweden or
(d) unmarried/widowed/divorced and no children.

9. MILSA-support platform for migration and health
Research regarding health for newly arrived refugees
Activities related to regional and national efforts regarding health and inclusion
Many parties involved: Universities, Public employment service, municipalities in Scania, the county administrative boards, etc

10. Results
Adjustments were made for accommodation type, age, educational level, type of immigration, BMI, smoking, economic stress
Increased OR of mental illness for a complete versus an incomplete family structure (being married or having a partner in another country and without all children in Sweden) (OR % CI ) in men
The odds of mental illness for females with an incomplete family structure (being married or having a partner in another country and without all children in Sweden) decreased (OR % CI )

11. Results
Independent of gender, there were increased odds for incomplete families (being married or having a partner in another country and without all children in Sweden), with OR 1.85 (95% CI )

12. Conclusions
To compound an already difficult living situation for refugees after flight, the present study suggests that separation from family increases risks to the mental health of refugees
There is an urgent need for host countries to address the fact that family reunification is an effective mechanism for helping migrants to adapt in the new society

13. Conclusions
The educational level of recently arrived refugees is lower today than 15 years ago, contributing to increased challenges in introducing refugees to the labour market
Mental health is an important factor for integration and entry into the labour market in Sweden, making it important for politicians to recognize family reunification as an important influence on the refugees` ability to integrate themselves into the host country