Abstract
The study identifies acculturative challenges and opportunities experienced by Arab-speaking MENA refugees in the United States. The research team conducted 24 semi-structured interviews with refugee parents (11 fathers and 13 mothers) in Arabic. The findings reveal two main categories: (a) acculturative challenges and (b) opportunities and hopes for a better future in the United States. Refugees described several acculturative challenges, including the language barrier, unrealized mental health issues, intimate partner violence (IPV), and the added struggle of COVID-19. Refugees faced several challenges, but their stressors were mitigated by their hope for a better future for their children. Findings suggest practitioners must introduce early interventions targeted at family conflict resolution in Arabic. Future research should explore culturally acceptable mental health interventions and gender-specific resources for IPV.
The number of immigrants and refugees from the Middle East and North Africa (MENA) region in the United States has risen dramatically since the 1980s, with a 36% increase between 2010 and 2016 due to conflicts in Syria and Yemen (Cumoletti & Batalova, 2018). Among MENA immigrants arriving in the United States in recent years, two-thirds were from the Middle East and one-third were from North Africa, accounting for nearly 3% of the country’s immigrant population as of 2018 (Cumoletti & Batalova, 2018). There are an estimated 3.5 million MENA individuals in the United States (Albqoor et al., 2020), and the immigrants and refugees from this region represent a group that is growing but less studied as compared with other immigrant populations (Awad et al., 2019). This study focuses on MENA refugees who may face higher levels of challenges because of their exposure to pre-migration war trauma. Article I of The 1951 Refugee Convention defines a refugee as “someone unwilling or unable to return to their country of origin owing to a well-founded fear of being persecuted for reasons of race, religion, nationality, [or] membership of a particular social group, or political opinion.” (United Nations High Commissioner for Refugees [UNHCR], 2023, p.14).
Throughout the migration process, from pre-migration to resettlement, refugees face a continuum of challenges. Refugees may be exposed to traumatic pre-migration experiences in their birth country, such as religious persecution, war, and political conflict (Mawani, 2014; Shannon et al., 2016). During migration, many refugees spend time in refugee camps and experience economic stress due to prohibitions on working for lengthy periods, both of which can lead to significant mental health impairment including depression, anxiety, and posttraumatic stress disorder (PTSD; Brabant & Raynault, 2012; Ehntholt & Yule, 2006). Post-migration stressors include cultural bereavement and uprootedness, resettlement pressures, racism and discrimination, social exclusion and isolation, the need to process loss, maintaining relationships with family members in the home country, and difficulties finding and keeping housing and employment (Castro et al., 2017; Eisenbruch, 1990; Falicov, 2013; Frounfelker et al., 2020; Fruja Amthor & Roxas, 2016; Kim, 2016; Kira & Wrobel, 2016; Porter & Haslam, 2005; Sorrell et al., 2019; Stewart, 2014). Adult refugees may experience a loss of social standing and socioeconomic status and often struggle to maintain gainful employment as the degrees they earned in their home countries, even advanced degrees, may not be recognized in the United States (Capps et al., 2015). The COVID-19 pandemic, which disproportionately impacted immigrants (Hayward et al., 2021) and refugees who were experiencing pre- and post-migration stressors, presented a new set of challenges for MENA refugees and magnified existing ones (Brickhill-Atkinson & Hauck, 2021).
Previous studies of MENA immigrants have focused on intimate partner violence (IPV) (Barkho et al., 2010; Kulwicki & Miller, 1999), service utilization by victims of IPV (Abu-Ras, 2007; Kulwicki et al., 2010), stigma associated with and attitudes toward mental health (Ahmed et al., 2011), barriers to acculturation (Al Wekhian, 2015), and suicidal ideation (Stark et al., 2022). Such studies have found that forced migrants have an elevated risk of mental health disorders such as PTSD and major depressive disorders (Siriwardhana et al., 2014; Steel et al., 2011). Importantly, mental health stigma, a lack of knowledge about mental health care, and cultural practices can inhibit refugees from seeking mental health services, resulting in diagnostic underreporting (Shannon et al., 2016).
Furthermore, prior studies of MENA refugees have found that ethnic identity (Ahmed et al., 2011; Childress et al., 2024), religious support (Ahmed et al., 2011), positive school experiences (Bennouna et al., 2019; Trentacosta et al., 2016), and supportive parental experience (Trentacosta et al., 2016) are protective factors, while acculturative stress (Ahmed et al., 2011), strict gender roles, patriarchal cultures (Kulwicki et al., 2010), and child maltreatment (Haboush & Alyan, 2013) are risk factors for mental illness. To develop a more nuanced understanding of the experiences of the growing number of MENA refugees who have recently resettled in the United States, the current study explores these refugees’ experiences of migration, trauma, and resilience as they face a wide range of acculturative challenges in their daily lives. To the best of our knowledge, this is the first study to explore the full range of challenges and opportunities faced by Arab-speaking MENA refugees in the United States, including the struggles generated by COVID-19.
Resilience Theory
This study uses resilience theory to understand the adjustment and coping strategies of MENA refugees. Researchers have defined resilience as the ability to adjust to and rebound from significant adversity, emerging with greater strength and resourcefulness (Theron, 2016; Walsh, 2011). An individual’s capacity to conquer adversity depends not only on their abilities and willingness but also—and possibly even more so—on their social ecology, which can facilitate positive development (Bottrell, 2009; Ungar, 2012). Several ecological systems, such as political processes, funding, family structures, and cultural norms, can promote resilience among people who have endured traumatic experiences (Leadbeater et al., 2005).
Focusing on the acquisition of health resources, Ungar (2011) suggested a more culturally sensitive approach, conceptualizing resilience as encompassing not only an individual’s capacity to navigate challenging circumstances but also the capacity of their family and community to provide assistance and resources in culturally meaningful ways. Scholars have also asserted that interventions should focus on refugees’ resilience and potential rather than viewing them as “passive victims” who may suffer from mental health problems (Watters, 2001, p. 1709). Following this perspective, recent studies of resilience have found better adjustment among refugees who adopted a bicultural orientation by balancing positive aspects of their home culture (e.g., strong family bonds) and positive aspects of U.S. culture (e.g., gender equality; Nguyen & Benet-Martínez, 2013; Qin et al., 2015). In addition, characteristics and experiences such as giving back to people experiencing similar struggles (Alessi, 2016), being positive and hopeful about the future (Baird & Boyle, 2012), and taking advantage of opportunities in the new country (Clarke & Borders, 2014) were associated with increased resilience among refugees. This current study adopts a similar approach, analyzing the resilience exhibited by refugees with a focus on how their social ecology has influenced their efforts to adapt to their new lives.
Method
The data for the present analysis were collected as part of a larger study assessing the psychosocial needs of adolescent refugees resettled from the MENA region (Stark et al., 2020). As part of data collection activities, the research team conducted 24 in-depth semi-structured interviews with refugee caregivers who had recently arrived in the United States. The interview guide was designed to gather information on the lived experiences of caregivers, including acculturation, financial security, COVID-19 challenges, and mental health and family well-being. Before starting each interview, the interviewer obtained the participant’s verbal consent and provided them with information about the study, including its purpose, benefits, and incentives. A US$25 gift card was given to each participant at the end of the interview. Participants were then asked about their demographic characteristics including their age, gender, marital status, time in the United States, employment status, income level, housing, education, and languages spoken. The interviews were conducted in person with the female translator joining online.
Each semi-structured interview lasted between 1 and 2 hr. An English-speaking female interviewer conducted the interviews with the assistance of a bilingual (Arabic and English) female interpreter; all interviewees were fluent Arabic speakers. The interpreter not only translated but also served as a cultural broker, explaining culture-specific responses to the interviewer, and bridging cultural gaps between the interviewer and interviewee. The interviews were recorded, transcribed verbatim in Arabic, and translated into English. The English transcripts were then analyzed using NVivo 12 qualitative computer software.
To ensure the trustworthiness of the findings, the research team employed several strategies, including investigator triangulation (Denzin, 2017), peer debriefing (Oktay, 2014), and presentations of the raw data to explain the findings (Lincoln & Guba, 1985). Using a grounded theory approach (Glaser & Strauss, 1967), a team of three researchers coded the transcripts using an “open coding” technique to identify the main concepts and “axial coding” to reassemble the data fractured during the initial coding procedure. This process extracted the categories and sub-categories emerging from the coded data (Charmaz, 2006). The researchers concluded data saturation was reached when no new categories or information emerged from the interviews and when constant comparisons of the pattern yielded no new properties (Glaser, 2009). This was confirmed through iterative analysis and discussions within the research team (Kitto et al., 2008).
The research team employed theoretical sampling as a strategy to ensure a diverse range of perspectives and experiences among the participants (Oktay, 2014). We purposefully sought out participants who represented a broad spectrum of demographic characteristics, including respondents’ countries of origin, age, gender, religion, working status, number of children, and length of residence in the United States. For example, when recruiting participants for interviews, we made efforts to include individuals from various countries of origin: Sudan, Egypt, Iraq, and Syria. We also aimed to include participants across a wide age range, encompassing both younger and older individuals (30 to 54 years old) to capture the life experiences that may vary with age. Furthermore, we ensured gender diversity among our participants by actively recruiting both men and women (11 fathers and 13 mothers), as we recognized the importance of understanding how gender may influence family dynamics. Religion (3 Christian and 21 Muslim), employment status (3 mothers and 10 fathers employed in full- or part-time occupations), number of children (1 to 6), and length of residence in the United States (1 month to > 5 years) were also taken into consideration during the sampling process. The theoretical sampling approach allowed us to explore the complexity and the range of experiences and perspectives related to the participants’ acculturation. To ensure confidentiality, respondents were assigned pseudonyms, and identifying information was removed.
Results
The analysis of the interview data revealed two main categories: (a) acculturative challenges, and (b) opportunities and hopes for a better future in the United States. Each of these categories includes several sub-subcategories.
Category 1: Acculturative Challenges
Study participants discussed four main challenges they have faced since their arrival: language barriers, the pervasiveness of IPV, a lack of awareness of mental health issues, and pandemic-related anxiety.
Language Barrier
Almost 90% of the refugees shared that their lack of English proficiency served as one of the biggest barriers they faced in the United States. Respondents reported that they could not communicate their needs to others, fill out necessary forms, or approach others for help. Siba is a Syrian refugee and noted that her lack of English language skills, along with her inability to drive, has diminished her job opportunities, making her family vulnerable to financial risks. She shared, “Language and the driving—all my problems will be resolved if I learn how to drive and how to speak English.”
Hamid, who was from Egypt, said that some Americans were rude and dismissive because they could not understand his accent. He explained that at his previous job at the local airport, he was not allowed to speak Arabic because people “thought you were talking about them” and it made them uncomfortable. Ahmed, a Syrian refugee, said that the challenge of not speaking the English language was compounded by his limited understanding of U.S. laws. When discussing the major challenges he faced in the United States, he commented, “There are two difficulties that I face being in America: language and the law. We’re still trying to learn what the law is here, and I’ve learned a few things from my own mistakes.” Husna, who had left her home country of Egypt to escape religious persecution, found that her lack of language proficiency and inability to communicate led her to become susceptible to exploitation, where she put her legal and economic welfare into the hands of others. She shared, “I suffered problems because most of the people I worked with were Americans, and I could not talk very well. So, they gave me lots of work knowing that I would not be able to complain.”
The language barrier severely limited the participants’ opportunities in many areas, especially work, and the refugees indicated that their inability to speak English left them feeling helpless in their new surroundings. The language barrier negatively affected the refugees’ ability to communicate and demand fair treatment at work. Many refugees could not access services available to them and were reliant on apps to fill out forms. The inability to communicate led to acculturative stress and slowed down the adaptation.
Different Cultural Conceptions of Mental Health
Many participants had difficulty responding to interview questions about mental health because they appeared unfamiliar with the concept of mental health. While MENA refugees willingly described the suffering and danger they experienced before coming to the United States, most said they did not have any resulting “psychological disorders,” or they had only minor trauma.
Most participants shared that they were not familiar with the term “mental health” prior to the interview. When the interviewer explained that mental health referred to social and emotional well-being, their responses were diverse in understanding. Hamid explained his understanding of the concept of mental health as follows: Having a good brain, you think right; you can understand people and what their beliefs are. You try to respect their beliefs, even if they don’t believe, so you need to have good mental health to understand what’s going on around you.
Malik, a father of four from Syria who lost his home and factory to bombings, described mental health as “sometimes [a person] is very happy and sometimes something very small can happen and then, he would feel upset. No one can ever control it.” Ali, a refugee from Iraq, commented that the concept of mental health is that “you should always smile, and this is why I am smiling all the time.”
Physical Ailments
Some respondents described their stress in terms of physical ailments such as a lack of sleep or poor appetite but denied these symptoms had anything to do with mental health. Aisha, a single mother of two from Sudan who arrived in the United States after spending time in Egypt, described experiencing a lack of sleep and a poor appetite but did not connect these issues to mental health problems. She stated, “I couldn’t sleep. I only slept for two or three hours. I didn’t have any appetite. They gave me medication, and I’m using it and now am eating better.” Firas, a father of four from Syria who described his arduous journey as a refugee by saying, “the requirements of life are too heavy,” emphasized he did not have any mental health problems. Instead, he attributed his difficulty sleeping to working the night shift at his job. Firas, whose doctor had prescribed a sleep aid, also said that the stress of acculturation, for example learning English, contributed to his sleeplessness. Although many respondents reported suffering physical ailments that are common symptoms of poor mental health, none of them connected these symptoms to mental health issues.
Addressing Stress or Mental Health Problems
The respondents described several ways of dealing with stress, in lieu of seeing a therapist or mental health practitioner. Arafa, a refugee from Sudan, explained that Sudanese people tend to brush aside any mental health problems because mental health is not recognized in the country, and mental health problems are stigmatized: Back home people just ignore how they feel. . . if you’re feeling down or if you have serious depression, you don’t say, “Oh, I need help with this.” You just push through it. You try to distract yourself, so you ignore it. You know what people are going to say, this and that. So, it’s stigmatized.
Ghassan, who fled from Syria to Jordan during the war before coming to the United States, dismissed the idea of his wife seeking help from a mental health professional, explaining, “Our doctor told us that he can refer her to a specialist, but we don’t need him. We do have stress in our lives but not to the extent to make us sick.”
Some of the participants expressed doubt that seeing a mental health practitioner would be helpful. Husna, who remarked that even though she is facing numerous stressors, mental health has not “crossed her” and downplayed the usefulness of talking to therapists or outsiders. She explained, “I don’t think talking about it would make a difference because it’s an internal feeling, and it depends on the abilities of the people living with you to help you get out of it.” Tarik, a persecuted Kurd from Syria, implied he did not need mental health counseling despite experiencing recurring nightmares due to the trauma he had experienced: Sometimes I might be asleep and then I wake up in the middle of the night and think that I’m still in the warzone. But then I look around and see that I’m in the US, I am safe, so I get better and go back to sleep. It’s a nightmare, but I’m not scared of it because I’ve been through it, and I am adjusted now so it doesn’t bother me that much anymore.
Intimate Partner Violence
Several of the women participants reported experiencing intimate partner violence (IPV). Aaliyah, a Syrian mother, described the Arab culture of silence surrounding IPV, saying, “There are many women who are subjected to injustice from their husbands, but you wouldn’t know about them because no one talks about it.” She commented that violence against women was an everyday affair: “Assault is like a joke to us. We just tolerate it and move on.” Arafa, a Sudanese immigrant who experienced IPV before divorcing her abusive husband, voiced a similar assessment: Men in our society are raised as if they are kings, and that the whole world is there to serve them. . .. They grow up with the mentality that they’re superior, that they’re better than women. And then, unfortunately, they come to use that power that they have.
Arafa noted that these negative attitudes toward women and wives prevail even after Sudanese immigrants arrive in the United States. She recounted her ex-husband’s opinion of women and their place in society: My ex-husband told me, “Your opinion does not matter, I don’t care what you think. I’m the man of this house. My children are carrying my name.” Unfortunately, this is what men in our society say, and that’s the way they act with their wives.
Arafa was quick to point out that her experience of IPV worsened after her family arrived in the United States, and she believed that the stress of acculturation prompted the escalation in violence. Pointing that acculturative stress was a trigger that unleashed physical violence for the first time, she recounted: Adjusting to the culture, having to deal with a job, providing for the family, all that contributed and made it worse. . ..There was a lot of emotional and verbal abuse, but the physical abuse started here [in the US], and that is because, I guess, he was going through a lot of stress himself.
Some respondents showed empowerment and resilience despite fear of stigma and reported that they had tried to employ the U.S. legal system to fight back against their abusive husbands. A Syrian mother recalled, “Last Sunday I had a fight with him but when he started to attack, I threatened to call the police and complain. I shouted, “Get out of here!” [and] then he left the house and was afraid to come back.” Despite being relatively new to the country, Arafa left her husband, stayed in a women’s shelter with her two children, and filed for divorce. She said she was able to take these steps because she “had the support of the legal system, the resource agencies, and the domestic violence shelters.” She continued, “I felt empowered when I came here [to the US] just knowing that people have rights and that some situations are unacceptable. If I were back home, it would have been much harder to decide to leave.”
In sum, while participants shared that IPV was common among the MENA refugee community, some women reported being empowered and resilient and said they had started to warn their husbands to stop using violence. Women seemed to be increasingly less willing to accept IPV, due to, in part, their access to the U.S. legal system, which they felt was protective against IPV.
The Added Struggle of COVID-19
The interviews were conducted during the COVID-19 pandemic, and many respondents said they had been adversely affected by the lockdown, home-schooling, or job loss. Arafa, a Sudanese refugee, said single parenting coupled with pandemic stress affected her ability to parent. When asked about her experience during the pandemic, she responded, “It stressed me out the most because it was just too much. I was very easily agitated.”
Online schooling and working from home were particularly challenging for many respondents. Aaliyah, a Syrian mother, discussed the challenges of online schooling: “Going to school [in person] is better. They [the children] weren’t committed, they weren’t organized, weren’t disciplined. I couldn’t control all of them.” Zahra, a mother of six from Syria who was parenting her children alone while her husband was in a nursing home with extensive injuries, described online schooling as a “waste of time” for her daughter. She explained, “I don’t know the language. I don’t know how to log her in or to be online with her to attend her school. . . I thought that the whole year was a waste of time because she didn’t learn anything.”
Financial pressures were another main source of worry for interviewees during the pandemic. Ahmed faced a financial crisis when he was laid off, and his wife, who had worked in a kindergarten classroom, was out of work due to shutdowns. He explained, “We had no income for several months. I looked for the unemployment benefit and tried to apply for it. I applied for many jobs.” Ali, who is from Iraq, said officials were constantly asking him if he had found a new job. He recalled, “No person could find a job due to the pandemic. . .. They told me they could not keep paying rent and that I had to find a job.” Ali also commented on the isolation his family experienced during the pandemic. The social isolation was so difficult, that Ali’s wife suggested the family return to Iraq. He explained, My wife was the reason we came here. She was the one who insisted on coming here. But because of the challenges we have been through during the lockdown, she said more than once that she wants to go back. She is a very social person. She used to go out, visit, and talk to people. When we got here, for five months no one talked to her, no one visited her, she visited no one. It was difficult.
Concerns Around the Retention of Ethnic Identity and Norms of Family Life
Several parents expressed worries about being distanced from their cultural roots and their children losing their ethnic identities, cultural heritage, and language skills. Husna, an Egyptian refugee, expressed concern that her daughter might not follow the more conservative culture of Egypt, which entails strict boundaries between girls and boys. She explained, “The society here is open but in Egypt it is more conservative, the concept of friendship between boys and girls. . .. I hope she holds onto the definition of friendship that she knows from Egypt.” Firas, a father of four from Syria, was concerned that his children would not be able to retain their Syrian cultural heritage, Arabic language skills, and religious beliefs. He acknowledged that his children were acculturating very quickly in the United States and had already lost some of their Arabic skills, making it harder for him to communicate with them. Sarah, a mother of two, also hoped her daughters would continue to speak Arabic. Although she wanted her daughters to take full advantage of the opportunities offered in the United States, she was concerned that they might not remember where they came from.
Ahmed, a Syrian refugee who came to the United States through Jordan, described being concerned that his children would follow the common U.S. path of leaving the household when they became adults: It is wrong in my opinion that in America when someone hits the age of 18, they separate themselves from their parents and go and live alone. The idea that they [children] can be wise and independent enough to rely on themselves by the age of 18 is wrong. . .. Parents are supposed to guide their children.
Ghassan also expressed worries about the norms of family life in the United States. He did not approve of the individualistic path typical of the United States. He commented, “We have strong family relationships, but others don’t have it; others call their parents once a year or only at Christmas. . .This is something I don’t like [about the U.S.].” Hamid, an Egyptian Christian who fled religious persecution and sought asylum in the U.S., did not want his children to adopt typical American religious attitudes and behaviors. He explained, Christian life here is not like there [Egypt]. When we worshiped God, it was really hot, like you’re hungry for God, you pray a lot every day. You have a good spirit, you have a good relationship with God, and I want her to keep this tradition.
Worries About Children Keeping the Wrong Company and Using Substances
Zahra, a Syrian mother of six who moved to the United States after spending 5 years in a refugee camp in Jordan, said she was more concerned about her children in the United States than she was in Syria. She revealed: When in Syria, I used to fear for them because of the bombing and the war, but here, I’m more afraid. I always want to know who they are with and where they are going. I am very concerned about someone giving them drugs and them becoming addicted. It’s a big country here; teenagers might lose their way easily, and I fear bad friends. I tell them not to take anything from anyone because I worry about drugs.”
Category 2. Opportunities and Hope for a Future in the United States
Quality of Governance and Freedom
Despite their traumatic experiences and current challenges, the interviewees displayed resilience and hope about their new lives in the United States. Several of the participants focused on freedom from oppression as an important benefit of life in the United States. Malik was a father of four from Syria who endured years of difficulties in Turkey before making it to the United States. Comparing his present life to his struggles in the war-torn home country, he commented, “It is like moving from hell to heaven.” He was very happy that his children had the opportunity to be educated and to live in “a land of liberty and freedom.” Malik proclaimed, “This is our country. This is my country.” Sarah, a Syrian mother of two daughters, said that coming to the United States was a relief. She explained, “When we were in Jordan, we were pressured psychologically, and although we came to an unknown future [in the US], we felt relieved. I feel that here we have a secure future.”
Ghassan, a Syrian father of five who chose to come to the United States for the sake of his children, focused on the security offered by respect for people and law. He observed: Thankfully we came to a country that respects people, and as long as you are within the frame of the law, you can work and pay taxes. It’s enough for me to see that my children will have a better future, and to know that my children and grandchildren are growing up in a country that respects human beings.
Najmo, a refugee from Syria, echoed Ghassan’s assessment of the United States’ strong legal system and orderly society when discussing why she was hopeful about her family’s future: “First, respect for other humans. The law is very good and strong here. There is order. There is a future for kids, so life is beautiful.” Tarik, who was persecuted in Syria for being in the Kurdish minority, said that he had never felt discriminated against in the United States. He was not concerned about experiencing discrimination at the hands of fellow Arabs due to the legal protections offered in the United States: If an Arab thinks this way here, according to the law, they cannot do anything about it. Because the law applies to everybody, everyone adheres to the law, nobody can step over the law. I’m proud of such a law.
Support From Fellow Immigrants
Many interviewees described receiving support from fellow immigrants, who had helped them with translations, completing forms, grocery shopping, and obtaining necessary supplies (e.g., furniture). Amal, a refugee from Syria, recalled: When we first came here, my husband started going to the mosque. He met a Syrian guy there, and his father is in a WhatsApp group. The group’s purpose is to help newcomers from Syria; they bring food and anything they need. They helped us. . . it was very helpful to find people who speak the same language you do, you feel that a burden has been lifted.
Amal’s family was also able to obtain financial help from a fellow immigrant. Even though the immigrant was from a different country, the common bond of their faith and the mosque created enough trust between the two. She explained, “My husband borrowed money from our Iraqi neighbor and from other men who prayed with him in the mosque.” The family also received free services from other Arabic-speaking immigrants from the Middle East, which helped them overcome everyday challenges. For example, when Amal experienced dental problems, their Iraqi neighbors stepped in to help: “Our neighbor offered to help me take my tooth out free of charge. He took me to a Palestinian dentist, and when the dentist learned that we were newcomers, he didn’t ask for any money.”
Malik, a father of four who fled Syria when war broke out, received support from his immediate supervisor at work, a fellow Syrian who became Malik’s guide and friend. He expressed gratitude for this new life in the United States and described his supervisor as his strongest support system, commenting, “I ask him for everything I need.”
Quality of Education for Their Children
Many of the interviewees were hopeful for the future because their children were receiving a high-quality education in the United States. Arafa, who came to the United States from Sudan, described her children’s school as being very responsive to any concerns she had, saying, “I really like the school. . .. if I have any questions, the teacher will let me know if there are any concerns, so I appreciate that.” Arafa believed that raising her children in the United States would allow her to teach them to value gender equality and asserted that she “wouldn’t have been able to raise them in Sudan that way.” She continued, explaining that now that her children lived in the United States, “Even if my family and my circle have these [patriarchal] values, the society does not, or most of the society doesn’t.” Sarah, a Syrian refugee and a mother of two girls emphasized similar points, commenting, “I am very happy that they are in a country where they can learn and be educated, and they can have their rights.”
Respondents also highlighted other aspects of the U.S. school system they found valuable. Zahra, a Syrian mother of six, was grateful that the school had a wide range of activities for children. She stated: Something I am also happy about the school system is that they have extracurricular activities. My son likes mechanics and repairing cars, so he has this extra class, and he is very happy about it. In our country we don’t have such things.
Malik, a Syrian father of four, was very pleased that his children were learning English. He recalled, “When I first came here, I was dreaming of the day when my children could speak English. They write for me now. They translate for me. They take me places. They help me a lot.” Tarik, a Kurdish refugee who had immigrated from Syria, pointed to the shortcomings of the education system in his home country, explaining: It was the lack of concern and the lack of care about the student, whether the student shows up or is absent, is present, participates, or does not participate, nobody cares. I have my older son who went all the way up to the 4th grade, supposedly passing up to the 4th grade, but he didn’t even know how to write his name.
By comparison, he found that his children were learning much more in U.S. schools, I envy that they are now well educated, they’re cultured. They come and say, “Hi father, come and we will translate something for you from English,” and I feel like the situation has gotten so much better if you compare this to that. I feel like I am reborn, and I feel like I’m giving my children a better life here.
Discussion
The findings reveal that many MENA immigrants and refugees in the United States are struggling to adjust to their new country, and their struggles are compounded by the COVID-19 pandemic. The study found that language barriers, unrecognized mental health issues, widespread prevalence of IPV, and pandemic-related stresses were significant challenges for MENA refugees. The challenges slowed down the refugees’ acculturation process and added to the post-migration stress. However, several respondents described being very excited that their children were learning English and would live in a country that had opportunities. The paper makes a unique contribution to the literature on MENA immigrants and refugees by showing not only the challenges faced by the refugees amid the pandemic but also their hopes and resilience displayed in the face of intensified struggles.
Limited awareness of the concept of mental health and the related reluctance to discuss mental health or participate in mental health treatments also had a significant impact on MENA refugees. Although the respondents had escaped war, poverty, and persecution in their home countries, often experiencing harrowing circumstances before arriving in the United States, the majority of the respondents, especially men, denied experiencing mental health problems. Notably, migrant populations are at a heightened risk of mental health problems (Abbott, 2016) with the intensity of disorders depending on the adversities experienced (Kirmayer et al., 2011). In a qualitative study of Syrian refugees in London, almost two-thirds of respondents met the criteria for a diagnosis of PTSD and 54% met the criteria for moderate to severe depression but described numerous obstacles to accessing mental health care (Wood et al., 2022).
Although respondents were not always familiar with the term “mental health,” they described related problems in terms of physical health issues such as poor appetite and sleep disturbances. This is not surprising given that in most Middle Eastern cultures, there is a strong stigma associated with mental health issues (Dalky, 2012; Zolezzi et al., 2018). Indeed, the MENA refugees’ explanations of their physical symptoms and constant worry for their children indicate they were experiencing significant stress. A previous study (Pampati et al., 2018) found significantly higher levels of depression and anxiety among refugees compared to US-born Arab Americans. Thus, there appears to be an unrecognized need among the refugees for mental health counseling. A greater understanding of how MENA refugees conceptualize negative mental health symptoms such as anxiety, depression, or PTSD is necessary to provide culturally salient aid to those with no individualized or cultural conception of mental health.
Intimate partner violence was another major challenge for MENA refugees. Many of the women described IPV as being very common and widely accepted in their home countries, and several had personally experienced IPV after arriving in the United States. Prior research has found that refugee women face higher levels of violence in host countries than in their home countries (Kulwicki et al., 2010) because they often lack a robust support system in their new country (Menjivar & Salcido, 2002). However, the interview data revealed a perceptible shift in gender-based expectations. Some of the women had begun to fight back against the cultural norm of remaining quiet about IPV. A refugee wife from Africa had divorced her abusive husband despite facing stigma among her family and community. Some battered wives had threatened their husbands with police action if they continued to commit physical violence—these women acknowledged that their actions would not have been possible in their home countries, but the U.S. laws had emboldened them. A previous study on Iranian men and women settled in Sweden (Darvishpour, 2002) found cultural shifts coupled with Sweden’s laws and opportunities afforded abused women the prospect of divorce from marriages, leading to higher rates of divorce among resettled Iranian refugee couples.
These attitudes and actions point toward a greater demand for gender equality among MENA refugee women; however, this shift may lead to greater stress in marital relations. In the context of the cultural norms of their home countries, women are to blame for the abuse they face. A qualitative study of Syrian women refugees in Germany (Ahmad et al., 2022) found very high levels of self-blame for IPV, with 9 out of 10 respondents placing the blame for violence on a woman’s “irritating personality” (p. 8). In Arab cultures, a woman brings shame to her family when she challenges her husband’s authority or asks for divorce (Abu-Ras, 2007). Furthermore, abused women may be hesitant to reach out for help because of limited social services and the inability of social workers to respond to refugees’ needs in a culturally appropriate manner. This calls for an urgent need to link MENA refugee women with organizations that offer services to abused women including shelter.
The COVID-19 pandemic seems to have exacerbated refugees’ well-being. Isolation from social contacts, financial stress due to job losses, increased marital conflict due to sharing space for a long duration, and concerns about online schooling amplified refugees’ stress levels. Some considered returning to their home country and many others looked to religion for comfort. During times of destabilization or displacement, faith can provide comfort, meaning, and a sense of security—an earlier study found that Syrian refugees turned to faith as a source of stability and a way to alleviate negative mental health outcomes (Paudyal et al., 2021). Furthermore, in a qualitative study, Hasan et al. (2018) found that participants “actively used their faith as a tool to navigate through the challenges they faced pre and post-resettlement. More than simply a coping mechanism, religion in the lives of these individuals was a central feature of how they identified themselves” (p. 11).
The study found that MENA refugees exhibited resilience via their attempts to adapt to their new adopted country, where local cultural norms were vastly different from those in their home countries. Ungar (2012) asserted that resilience is as much a function of the social ecology as the individual’s willingness to navigate through adversity. The MENA refugees showed individual resilience in the face of a weak social ecology when they fled their home countries and lived in transition countries while waiting for a permanent home country. After arriving in the United States, they experienced a more robust social ecology in terms of legal protections, economic opportunities, and support systems, which enabled them to exhibit greater resilience, remaining optimistic about their future despite the challenges they faced. The resilience displayed by MENA refugees displays the need for an assets-based approach that helps them to thrive through their existing strengths and assets. Previous studies (Awad et al., 2021; Stark et al., 2022) found adolescents born in MENA regions were a vulnerable group that needed culturally responsive interventions to boost existing sources of resilience. The study by Stark and colleagues (2022) found that adolescents with greater hope and school belonging reported higher resilience. Schools should be better equipped to create a welcoming environment among foreign-born students to cultivate resilience among adolescents (Meyer et al., 2023).
Although most respondents had lived in the United States for only a short time, their children were beginning to undergo noticeable changes. Parents reported that their children were losing their Arabic language skills and had few memories of their home countries and heritage. Refugee parents worried about several aspects of this shift among their children, including differences in religious attitudes and practices, beliefs about gender boundaries, living arrangements among young adult children, distance from cultural roots, and a lack of respect for the culture of their home country. The generational dissonance (Portes & Rumbaut, 2001) characterized by children preferring American ways to their parents’ beliefs and behaviors could lead to future conflicts among MENA refugees. Prior research has highlighted other reasons for intergenerational conflicts, including children who were raised in independent and permissive societies not deferring to their immigrant parents (Foner et al., 2007); the “corrupting” influence of mainstream American culture, especially regarding daughters’ clothing choices, dating practices, and arranged marriages (Foner & Dreby, 2011); and power shifting from non-English speaking parents to their English speaking children as parents become increasingly dependent on their children to serve as cultural brokers (Orrellana, 2009; Park, 2005). Further research should be done among the MENA parents and their children to find a healthy compromise that would be acceptable and workable. They should be informed of organizations they can reach for help in case of conflict before the situation escalates to violence. Counselors at schools and education institutes should be trained to deal with such situations in case of complaints from students.
While the MENA refugees faced many challenges, they were happy to be living in the United States because they believed their children would have a better future. Many interviewees were hopeful that their children would receive a good education and have a rewarding career. They were appreciative of the strong laws in the United States and believed they would be safe. In addition, many of the refugees had received support from fellow immigrants and charitable organizations, which had eased the process of acculturation. The results indicate that while most refugees are hopeful for a better future, it would be prudent to introduce interventions that foster awareness of possible conflicts that may arise within refugee families, appropriate responses to these conflicts, and agencies that can provide help.
Implications
Future studies should explore culturally sensitive mental health interventions that would enable MENA refugees to accept counseling and therapy. A previous study found that spiritual struggle partially mediated the relationship between trauma and PTSD symptoms (Wortmann et al., 2011), suggesting that faith-oriented interventions emphasizing postive religous coping may have significant potential to strengthen identity, alleviate trauma, and prevent negative mental health outcomes. Concerning gender, future studies should identify needs specific to women refugees and possible ways to fulfill these needs. Given that most respondents faced language barriers, efforts should be made to provide culturally competent social workers who are well-versed in the refugees’ language and customs. Social workers should also be aware of refugee-specific experiences, such as generational dissonance (Portes & Rumbaut, 2001), and should design culturally sensitive interventions to address these conflicts. Counselors who work with refugees should understand the unique losses, traumas, and harrowing experiences that influence the mental health needs of refugees during their time in their home country, journey to the host country, and post-migration lives so they can effectively support these recently arrived Arab Americans (Carroll et al., 2020).
Conclusion
This study was the first to analyze the challenges and concerns of the Arab-speaking MENA refugee population in the United States during the COVID-19 pandemic. Using qualitative methods, the study found language barriers, lack of mental health awareness, wide prevalence of intimate partner violence, and gender tension to be notable challenges among the refugees. The COVID-19 pandemic slowed down the acculturation process of the refugees while elevating anxiety and stress through fear of infection. Despite numerous challenges, MENA refugees showed resilience to adapt to the new country’s cultural norms aided by a strong social ecology through legal and economic opportunities. Many remained optimistic about their future and that of their children. The children acculturated at a faster rate than the parents, and the women displayed a yearning for more equitable gender relations. There were concerns about conflict in the family due to generational dissonance and gender discrimination; however, the refugees were grateful to live in a safe society with working laws. Future research should focus on providing appropriate interventions to limit possible family conflicts and to explore culturally sensitive mental health interventions so the refugees can progress and thrive in their host country.
Footnotes
Disposition editor: Cristina Mogro-Wilson
Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by Qatar Foundation International (QFI). Research reported in this article was also supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development of the National Institutes of Health under award number K01HD106070. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
