Financial Vulnerability and Mental Distress Among Refugees In the United States

Background and Purpose:

Refugees are immigrants who experience forced displacement because of government persecution or violence due to one's nationality, religion, race, political opinion, or membership in a particular social group. Refugee arrivals in the United States (US) significantly decreased in 2025 to 38,102 refugees, compared to 100,034 refugees in 2024. US refugee resettlement programs have helped meet the basic human needs of refugees with housing assistance, employment training, and limited cash assistance. Research has indicated that refugees experience high rates of mental health issues, including psychological trauma, as well as economic vulnerabilities such as low wages and poverty. This study examines this area by exploring the following research question: To what extent is financial distress associated with mental distress amongst refugees in the US?

Methods:

This cross-sectional study includes n=330 adult refugees who resettled in the Northeast US between 2021 and 2024. Data was collected from an administrative dataset that was shared by a non-profit organization. The dependent variable was mental distress, which was measured with the Refugee Health Screener-15 (RHS-15). The RHS-15 is an instrument that measures mental distress using a five-item Likert-style scale (0=not at all; 4=extremely). The independent variable, financial distress, was measured as a two-category variable that assesses if a refugee is experiencing financial challenges (e.g. unemployment, low wages, etc.) (1=yes; 0=no) based on data collected from clinical case notes. Additional covariates included age (years), sex (male/female), region of origin (Africa, Latin America, Middle East), and employment status (employed/unemployed). Data analysis included univariate statistics, independent samples t-tests, and ordinary least squares regression models.

Results:

The mean age of participants was 35.99 (SD=12.67). Most participants identified as male (54.85%) followed by female (44.15%). Most participants migrated from the Middle East (50.30%), followed by Africa (25.76%), Latin America (21.82%), and Asia (2.74%). Approximately one third of the sample reported experiencing financial distress (31%), and 42.42% of the sample was employed. More than one quarter of the sample (27%) reported experiencing mental distress. Results show that refugees who experience financial distress report significantly higher mental distress (M=10.39; SD=9.13), compared to refugees who don’t experience financial stress (M=91.7; SD=9.63) (p<.05). Results from a multiple regression analysis found that experiencing financial distress (b=0.35, CI=0.002-0.70, p<.05) and females, compared to males (b=.58, CI=0.25-0.91, p<.01), are both associated with greater mental distress, controlling for age and employment status.

Conclusions and Implications:

Results show that financial distress is associated with experiencing greater mental distress. Furthermore, results from multivariate analysis reveal that both financial distress and age are associated with greater mental distress, controlling for age and employment status. Given the importance of economic stability for refugees navigating resettlement, the results indicate that financial distress, including unemployment and low wages, can complicate integration in resettlement settings by exacerbating mental health symptoms. These results can inform social work practices that provide targeted clinical supports for refugees who report experiencing financial distress and female refugees. Future research should include qualitative studies that explore how refugees describe the challenges of financial distress during resettlement.