The Impact of Forced Displacement on Aging Adult Mental Health: Implications for Developing Interventions

Abstract In the US, there are 7.3 million older adult immigrants (inclusive of refugees), and by 2060 the US’s older adult immigrant population is anticipated to increase to 22 million. Compared to other older adults in the general population, older refugees have a disproportionate burden of challenges related to past pre-resettlement

traumas, language barriers, family stress, social isolation, employment, and access to health care. These challenges and stressors, in turn, are associated with poor mental health. Unfortunately, older refugees receive limited attention from providers, and there is a dearth of evidence-based interventions designed to meet the

needs of this vulnerable population. Our goal is to use a community-based participatory research approach (CBPR) to conduct an exploratory sequential mixed methods longitudinal study of mental health of older adult ethnic-Nepali Bhutanese with a refugee life experience resettled in the US. First, we aim to use qualitative

methods to explore social support as a protective factor for mental health among older Bhutanese and develop a conceptual model that will be evaluated and refined over the course of the study. Second, we will use a 3- year, longitudinal design to quantitatively assess the role of post-resettlement risk and protective factors in the

relationship between pre-resettlement experiences and mental health among 200 Bhutanese aged 50 and older. We will use a longitudinal study design to assess past exposure to war-related traumas/stressors in the country of origin (Bhutan) and refugee camps (Nepal), current bio-psycho-social risk and protective factors, and mental

health outcomes at three-time points. Third, we will qualitatively explore the caregiving experience of Bhutanese older adult caregivers and quantitatively examine the relationship between family caregiver mental health and mental health. A family caregiver of each older adult will be enrolled in the longitudinal study (N=200) and

interviewed at the same three-time points as the primary study participant. We will assess the psychosocial functioning of these caregivers over the duration of the study. Accomplishing these aims will increase our understanding of the impact of forced displacement and immigration on long-term mental health and inform multi-

level interventions to address the psychosocial functioning of aging refugees resettled in the US. This has the potential to reduce health disparities among aging immigrants from racial/ethnic minority groups.