Social determinants, trauma, and mental distress among displaced populations

Johns Hopkins University, Baltimore MD

Investigators

Abstract

The goal of the proposed fellowship is to prepare the applicant, Lauren Yan, for a career in global mental health research to inform programmatic and policy interventions in low-resource communities, with a particular focus on displaced populations. To this end, the applicant proposes to investigate social determinants of mental health, trauma exposure, and mental distress among adult displaced Syrians in Jordan. The applicant will carry out the proposed research while engaging in individualized mentorship, didactic training, and professional development opportunities targeted towards the following training objectives: 1) advancing skills in latent variable modeling methods; 2) developing expertise in complex causal inference methods; 3) gaining experience in new regions and contexts of humanitarian concern; and 4) engaging in professional development opportunities. These objectives will address gaps in Ms. Yan’s training and will help propel her toward a productive independent research career. The proposed research is highly relevant for public mental health. Social determinants of mental health—the living conditions and non-medical factors that impact mental health and illness—are critical for the well-being of over 100 million displaced people worldwide. These populations face exceptional challenges related to their conditions of daily life, which compound the mental health problems associated with high trauma exposure. While social determinants such as employment, healthcare access, education, social relationships, and housing conditions are promising preventive targets for reducing the global burden of mental disorders, existing studies find heterogenous effects with unclear implications for intervention. There is also a paucity of longitudinal evidence from low-resource settings—where most displaced people reside. Consequently, social determinants’ mechanisms of effect are poorly understood in such contexts. Given these gaps in knowledge, research from low-resource displacement settings is needed to inform intervention approaches that more comprehensively support the mental health of displaced populations. To address these gaps, the proposed research will use data from the Syrian Refugee Life Study to: 1) identify the latent factor structure of displaced Syrians’ social determinants of mental health; 2) estimate the main causal effects of social determinants and trauma exposure on mental distress; and 3) evaluate whether social determinants moderate the relationship between trauma exposure and mental distress. The proposed research aligns with Goals 2 and 3 of NIMH’s Strategic Plan by providing contextually relevant evidence and generalizable methodological approaches for understanding mental illness trajectories and enhancing prevention strategies.