ICERAS

A thesis submitted to McGill University in partial fulfillment of the requirements of the degree
of DOCTOR OF PHILOSOPHY

Multiple studies have found that refugees significantly underutilize mental health services. Yet,
little is known about how refugees who live in contexts of protracted displacement cope with and
recover from violence, trauma and chronic stress. The unique experiences of refugees living in
Israel, particularly those fleeing the violence of Eritrea, are even less understood. This thesis
sought to explore Eritrean refugees’ distinctive explanatory models of mental health — their own
ideas or theories of what may have caused their predicament, the consequences of their
psychological distress, and the type of care they believed they needed to recover. In-depth
interviews were conducted with 34 Eritrean refugees aged 26–40 having been identified as
suffering or having suffered from psychological distress. Participants reported experiencing
severe violence and upheaval in Eritrea, during flight, and struggled with daily life in Israel
which was regarded by participants as a demeaning environment marked by confinement,
poverty, injustice, insecurity, isolation, and endless up-rootedness. For participants, liminality
was not simply a juridical status or a spatial/temporal experience, but also an ontological
experience that significantly constrained their opportunities and shaped their sense of self,
identity, and well-being. Reported coping strategies were rooted and shaped by the Eritrean
cultural context, systems of knowledge, values, and cultural perspectives. They included
concealment, silence and forgetting, engaging in religious and spiritual practices, seeking social
support, and, for some, accessing formal health and psycho-social services. My findings
underscore the profound effects of protracted displacement, with participants noting the anxiety,
stress, uncertainty, and inability to build their lives brought forth by their liminal status. Findings
also reveal the ways in which structural considerations in Israel, particularly law and policies,
negatively impact upon the daily lives of Eritrean refugees, contributing to their ongoing distress.
Taken together, these elements may deplete refugees’ coping resources and undermine their
natural processes of recovery and healing. Read full text