Caring for the mental health of Afghan refugee youth through a decolonial paradigm: A qualitative analysis of distress, coping mechanisms, and priorities for treatment

Despite the compounded adversities that displaced youth must navigate throughout their forced migration, they consistently exhibit steadfastness in caring for themselves and their families. Extant scholarship, however, often frames these individuals as needy and inept at informing the models of mental health care they are offered. In this study, we use semistructured interviews to learn from the experiences of Afghan refugee youth (N = 34; M age = 19; range 18-24) who were resettled in the United States after the United States withdrawal from Afghanistan in August of 2021 and explore their insights that can inform decolonial and equitable mental health services. Specifically, we elucidate their most salient sources of psychological distress, current coping mechanisms, and priorities for treatment, with a specific focus on the unique experiences of accompanied versus unaccompanied youth. Unaccompanied youth reported more frequent and intense sources of distress, including pre-resettlement (e.g., exposure to life-threatening sociopolitical conflicts) and post-resettlement challenges (e.g., limited access to basic resources and legal status precarity). Youth used faith-based, relationship-based, and ethnocultural-based mechanisms of coping. While 62% of participants reported doubts about the usefulness of mental health care, most of those who expressed an openness to treatment prioritized clinicians who have personal experience in navigating common challenges among refugees. We situate these findings within decolonial and intersectional theoretical frameworks that capture the nuances of Afghan refugee experiences and offer recommendations for ensuring refugee youth's rights to access equitable mental health services.