Safe but isolated - an interview study with Iraqi refugees in Sweden about social networks, social support, and mental health.

Background: Problems with social networks and social support are known to be associated with mental ill-health in refugees. Social support after migration promotes resilience.
Aim: To study how Iraqi refugees who arrived in Sweden after the year 2000 perceived their social networks and social support, and to relate the observed network characteristics and changes to the refugees' mental health and well-being.
Method: Semi-structured interviews with 31 refugees, including questions on background and migration experiences, a biographical network map, and three health assessment scales. The findings were analysed with descriptive statistics and content thematic analysis.
Results: The respondents' networks were diminished. Social support was continued to be provided mainly by family members and supplemented by support from authorities. The main themes of the refugee experience of post-migration challenges were weakened social networks, barriers to integration and challenges to cultural and religious belonging. Failed reunion and worrying about relatives was described as particularly painful. Negative contacts with authority persons were often seen as humiliating or discriminating. Acquiring a new cultural belonging was described as challenging. At the same time, changing family and gender roles made it more difficult to preserve and develop the culture of origin. Traumatic experiences and mental health problems were common in this group. Family issues were more often than integration difficulties associated with mental health problems.
Conclusion: In order to strengthen post-migration well-being and adaptation, authorities should support the refugees' social networks. Clinicians need to address post-migration problems and challenges, including the meaning and function of social networks.