Technology-Facilitated Abuse and Mental Well-Being Among Bhutanese Refugee Women: A Community-Engaged Mixed Methods Study

Background and Purpose: Technology-facilitated abuse (TFA) is a form of domestic violence in which intimate partner or former partner uses digital tools to exert control, surveillance, and manipulation. Refugee women may be particularly vulnerable to TFA due to limited digital literacy, constrained social support networks, social isolation, and precarious immigration status. TFA poses a significant threat to the mental well-being of survivors. However, little is known about how these intersecting vulnerabilities shape the mental health outcomes of refugee women experiencing TFA. We explore the patterns and distribution of TFA among Bhutanese refugee women. Specifically, we examine whether social support, digital literacy, and resilience moderate the relationship between TFA exposure and mental well-being in this population.

Methods: Using an explanatory sequential mixed methods research design through a community engaged approach, quantitative data was first collected via community surveys (N=127), followed by qualitative data collected via in-depth interviews (N=10) with female Bhutanese refugees over the age of 18 in a mid-western U.S. state. Data were collected from October 2025- April 2026 in Nepali and English languages. Snowball and nested sampling techniques were used to recruit participants. Quantitative variables included demographic variables, TFA exposure, social support, resilience, digital literacy, and mental health outcomes. Data analysis included a moderation analysis. Qualitative data collection centered around Bhutanese community’s experiences with TFA, barriers to help-seeking, role of social support and resilience, coping mechanisms and mental health impacts. Thematic analysis through three distinct phases (open, axial and selective coding) was used to analyze qualitative data from in-depth interviews.

Findings: Quantitative results identified unwanted messaging, image-based abuse, and partner tracking as the most common forms of TFA. The primary platforms used to perpetrate TFA against Bhutanese women included Facebook, TikTok, phone/text messaging, and Messenger. Moderation analyses showed that resilience significantly moderated the relationship between TFA exposure and mental health (β= -2.06, p< 0.05), with negative effects on mental well-being being stronger at lower levels of resilience. Five major themes emerged from qualitative data: (1) patterns of digital coercive control; (2) barriers to help-seeking: strategic silence, gendered expectations, and structural vulnerabilities; (3) in-network support: both resource and risk; (4) psychological distress and coping for survival; and (5) from vulnerability to digital resilience: a call for action. Integrated mixed methods findings show that mental well-being is compromised due to TFA exposure, but resilience rooted in overall survival experiences and love for children, both protect Bhutanese women and constrain their ability to leave abusive relationships.

Conclusions and Implications: TFA remains an underrecognized form of domestic violence in Bhutanese refugee community. Digital literacy and resilience serve as protective mechanisms for TFA prevention; however, family and community play central yet complex role in help-seeking and violence prevention. Policymakers, service providers, and researchers should prioritize TFA awareness programs, digital safety education, and equitable access to legal, social and mental health resources for women from marginalized communities. Future research should further examine the multifaceted role of social support in TFA prevention and focus on developing culturally responsive, trauma-informed interventions for TFA survivors from refugee communities.