Poor family functioning and lower socioeconomic status are significantly associated with worse mental health outcomes among physically healthy Syrian refugee parents resettled in Ontario, Canada post-2015.
Key Findings
Results
Poor family functioning was significantly positively associated with elevated levels of anxiety, stress, and PTSD among Syrian refugee parents.
The General Functioning subscale of the McMaster Family Assessment Device (FAD) was used to evaluate family functioning.
Significant positive associations were found between poor family functioning and anxiety, stress, and PTSD outcomes.
No significant association was found between poor family functioning and depression.
The sample included 398 parents residing in Ontario who reported good to excellent physical health.
Results
Lower socioeconomic status was linked to higher levels of depression, anxiety, and stress among Syrian refugee parents.
Socioeconomic status was identified as a significant factor associated with multiple mental health outcomes.
Unlike family functioning, lower socioeconomic status was associated with depression as well as anxiety and stress.
The study design was cross-sectional, limiting causal inference about the direction of these relationships.
Results
There was a trend toward fathers reporting poorer anxiety outcomes than mothers, though gender differences were not statistically significant after adjustment.
Gender differences in mental health outcomes were not statistically significant after adjustment in multivariate analysis.
A non-significant trend was observed with fathers reporting worse anxiety outcomes compared to mothers.
The study population consisted of Syrian refugee parents resettled in Ontario post-2015.
Methods
The study employed validated screening tools to assess PTSD, stress, anxiety, and depression in a sample of 398 Syrian refugee parents.
The Depression Anxiety Stress Scales (DASS-21) was used to measure stress, anxiety, and depression.
The Primary Care-PTSD (PC-PTSD) scale was used to assess PTSD.
All participants reported good to excellent physical health, isolating mental health outcomes from physical health confounders.
The study was cross-sectional in design and focused on Syrian refugees resettled in Ontario, Canada after 2015.
Background
Refugees are at increased risk of mental health problems including depression, anxiety, and PTSD due to traumatic experiences before, during, and after migration.
The study frames refugee mental health risk as stemming from exposure across multiple migration phases: pre-migration, during migration, and post-resettlement.
Syrian refugees resettled post-2015 represent a population of particular interest given the scale of displacement associated with the Syrian conflict.
The study focused on Ontario, Canada as the resettlement context.
What This Means
This research suggests that among Syrian refugee parents living in Ontario, Canada, how well a family functions together is closely linked to mental health outcomes. Specifically, families that struggle to function well showed higher levels of anxiety, stress, and post-traumatic stress disorder (PTSD) in parents. Interestingly, family functioning was not significantly linked to depression in this group. The study surveyed 398 parents who described their physical health as good to excellent, and used well-established questionnaires to measure mental health and family dynamics.
The research also suggests that financial hardship plays an important role in refugee mental health. Parents with lower socioeconomic status reported higher levels of depression, anxiety, and stress — a broader set of mental health difficulties than those associated with family functioning alone. While there appeared to be a trend where fathers experienced worse anxiety than mothers, this difference was not statistically significant once other factors were accounted for.
These findings matter because they point to two potentially modifiable areas — family support and economic stability — that could be targeted in programs aimed at improving the mental wellbeing of resettled refugees. This research suggests that mental health support for refugees should consider the family as a unit, not just the individual, and that addressing economic barriers to resettlement may have meaningful mental health benefits. Because this was a one-time cross-sectional study, future research following families over time would help clarify whether these associations reflect cause and effect.
Abdallah B, Abdel Rahman A, Zangiabadi S, Tamim H. (2026). Mental health and family functioning among physically healthy Syrian refugees resettled in Ontario, Canada post 2015: A cross-sectional study.. PloS one. https://doi.org/10.1371/journal.pone.0354919