Poster A holistic health approach to integration in Sweden

  • Dr. Önver Cetrez, Uppsala University
  • Prof. Dr. Valerie DeMarinis, Uppsala University
  • Mudar Shakra, Uppsala University


Among newcomers in Sweden, the health condition is noticeably connected with their experiences of journey, borders, legal status, employment possibilities, housing, and the future as a whole. In health services, though newcomers express easy access, they also express lack of compassion by caregivers or not being taken seriously. Considering providing strongest meaning-giving factors for newcomers, religion, family, children, and work are identified.


The general health condition of newcomers depends notably, in an accumulating process, on experience in the country of origin, transit experience, and experience in the host country. Experiences through the journey related to borders and reception have had a tremendous effect on current psychosocial health.

Interview themes emerging are structured along the Adaptation and Development After Torture and Persecution Model (ADAPT) (Silove, 2013), consisting of five core life systems.

Main Results

Safety & security: chronic and recurrent threats, fear of physical harm, forms of physical, psychological, and/or sexual abuse; experiences of disorganised, uncoordinated and/or uncaring societal systems or programmes that do not feel safe or trustworthy.

Interpersonal bonds & networks: experiences of negative social and spatial isolation; loss of social networks; experiences of avoidance from majority community; alienation.

Justice: experiences of discrimination and injustice; perception of a double standard of living for different populations.

Identities & roles: threats to family values and structures; disruption of interpersonal roles; experienced distress and discomfort with loss of employment status and/or loss of communication ability.

Existential meaning: experiences of societal disapproval of meaning-giving beliefs and practices; loss of physical safe spaces; loss of a sense of hope; experiences of a desperate need to change religious beliefs in order to improve chances for gaining permanent resident status.

Uncertainty of legal status results in despair, fear and hopelessness, individually and for the whole family. Those in deportation stage are affected most strongly:

I cry very quietly so no one will hear me.
I don’t want my children or my husband to know that I am crying. I have a lot of pain. Some of my neighbours have told me that after four rejections the police will come and deport you back...
I am very scared now...

Afghan woman

Methods and Material

Interviews were conducted with 61 newcomers (equally divided by gender, three quarters of middle age, more than half married and a third single, two-thirds with higher education, and of Syrian, Afghan, and Iraqi origin) and various stakeholders during 2018-2019, in a spread of geographical location - centre and periphery.

Lessons Learned
  • Pre-migration and migration factors and experiences are naturally important references for understanding the mental health of newcomers.
  • The interviews provide evidence for the need of intersectoral strategies in planning for successful integration and positive health of newcomers into an existing host culture and context.
  • Assess the function of different life systems, as the host society’s programme planning for integration is essential for successful integration at different levels.

  • Cetrez, Ö., DeMarinis, V., Pettersson, J., & Shakra, M. (2020). “Integration: Policies, Practices, and Experiences, Sweden Country Report” in Working Papers Global Migration: Consequences and Responses. http://doi.org/10.5281/zenodo.3951714
  • Silove, D. (2013). The ADAPT model: a conceptual framework for mental health and psychosocial programming in post conflict settings, Intervention. Volume 11:3, pp.237-248.

Önver Cetrez
Uppsala University

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