Reciprocal relationships between employment status and psychological symptoms: findings from the Building a New Life in Australia study

Background Finding work is an important priority for many refugees in the initial years following settlement in a host country. Difficulties in finding work could conceivably both contribute to and be a consequence of symptoms of posttraumatic stress disorder (PTSD) and psychological distress commonly reported by refugees. Purpose We sought to determine the direction of these relationships and the possibility of a reciprocal association between employment status on one hand, and symptoms of PTSD and psychological distress on the other, in a large refugee sample. Methods A secondary analysis of three face-to-face interview assessments conducted across 5 years with 894 adult refugee participants (M = 39.9 years, SD = 12.8) from the Building a New Life in Australia study was conducted. Symptoms of psychological distress, posttraumatic stress, and employment status were assessed on each occasion. Preliminary analysis identified the cross-sectional relationships between psychological distress, PTSD symptoms, and employment status, while cross-lagged models were used to identify the longitudinal relationships between these respective symptoms. Results Symptoms of psychological distress and not being in paid work were significantly correlated with each other at each time point (ranging 0.09-0.25) and they reciprocally influenced each other over time. Likewise, PTSD symptoms and not being in paid work were correlated with each other after 3 years and 5 years (r = 0.21 and 0.23 respectively), and a reciprocal relationship between these was found over time. Conclusion The current findings indicate that interventions which target either mental health or work opportunities could have multiple downstream benefits for refugees.