An Explanatory Framework for Understanding Mental Health Needs of Afghan Refugees Resettled in the Global North

Afghans are the second-largest refugee population in the world, yet their mental health needs are understudied. This qualitative investigation has two aims: (1) to examine the mental health beliefs of Afghan refugees in one 'Global North' nation who fled following the 2021 Taliban takeover and (2) to provide an example of how explanatory models might be used to support mental health care in diverse populations. Participants (N = 21) were Afghan refugees who resettled in the US after 2021 and cultural experts. We conducted semi-structured interviews to uncover the mental health belief framework of this population by exploring explanatory domains: 'experiences of distress', 'causal attributions for suffering', 'coping strategies' and 'goals for wellbeing'. Also explored were 'attitudes towards host culture treatment'. Thematic analysis revealed several key findings: emotional suffering is ubiquitous and not a target for treatment; distress is caused by specific circumstances and loss, primary coping strategies are avoidance and reliance on family, community, and faith, and primary goals are survival and functioning in valued roles. 'Recommended clinical approaches' for host culture practitioners that bridge provider and client models are discussed, which offer tools to develop rapport, allow for cultural adaptation and increase acceptability of treatments offered.