A critical exploration of forces impacting mental health and psychosocial wellbeing of conflict-induced displaced persons in Hong Kong

Abstract

Refugees, asylum seekers, and survivors of torture and cruel, inhuman, degrading treatment or punishment (persons of concern (PoC)) in Hong Kong are extremely resilient people. Many however, are challenged with conflict displacement traumas that often go unaddressed. To compound matters, they have little livelihood options and live in an uncertain state while their protection claims are slowly processed; there is little chance of success. On a daily basis, their bio-psycho-social-spiritual wellbeing intertwines with and is impacted by services and policy within the ecological system in Hong Kong. This doctoral dissertation study uses an ecological systems framework, critical paradigm and social justice perspective to explore how PoC mental health and psychosocial (MHPS) wellbeing are interconnected to systemic and environmental forces. Three phases of narrative inquiry with PoC participants and service providers illuminate PoC lived experiences and provider insight and suggestions at the micro, mezzo and macrosystem of the ecological environment. Inductive and deductive interpretive thematic analysis generates theoretical contributions. The deterioration of mental and overall health were linked to oppressive policy and services such as protection screening retraumatization, inadequate healthcare and inability to work. Traumatic uncertainty negatively affected their lives and was primary linked to their overall deterioration. All systems presented different levels of boundary openness and permeability across ecological interactions. Ultimately, there was systemic empathic failure within the sub-systems of the ecological environment. An array of physical, mental and behavioral health issues have manifested for PoC and often become prolonged due to several systemic barriers. While there is empathic failure in some of the sub-systems, there is also systemic empathic attunement in other areas. Human interaction through empathy could enable more openness in the whole system. Empathic growth pathways to multi-level, trauma-informed services and care are provided and based on the research findings and global MHPSS recommendations. Empathic growth can transform empathic failure into empathic attunement. As the ecological system in Hong Kong enhances its empathy for PoC, positive holistic health and wellbeing for PoC can be realized. While being confronted with extreme levels of gross human rights violations and severe social injustice created by oppressive systems and structures, social work is in a prime position to advocate for change and for the betterment of this resilient yet vulnerable community. Awareness of the ecological connection is essential in work with conflict-induced forced migrants. Also, using an integrated approach can be useful in therapeutic work. Overall strengths based services informed by community, tailored to the context, using advocacy lens can be essential for community empowerment and holistic and trauma-informed health promotion. There is a valuable place for the social work profession to be at the forefront of advocacy, multi-level services, healing and therapy, and research and education within this rapidly evolving practice area.