ArticleThe Lancet regional health. Western Pacific2025
The long-term impact of COVID-19 on mental health and the moderation effect of sex and loneliness amongst resettled refugees: findings from BNLA cohort study.
Article in The Lancet regional health. Western Pacific, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Integrated mental health treatment and employment services for refugees with PTSD: randomised controlled trial.BJPsych open · 2026Article
- Mental health disparities by sex: unravelling determinants and changes in the refugee resettlement process over a decade.Epidemiology and psychiatric sciences · 2026Article
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Authors and funding
6 authors.
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Abstract
Background: Vulnerability to mental health problems is well-established in refugees, attributed to the interplay between pre-and post-migration stressors. COVID-19 pandemic was recognized as a universal stressor with potential to further impact refugees' mental health. This longitudinal study sought to investigate the mental health impact of COVID-19 and its moderators in resettled refugees in Australia. Methods: Data from Waves 1 (2013-2014, pre-pandemic), 5 (2017-2018, pre-pandemic) and 6 (2023, post-pandemic) of the Building a New Life in Australia were utilized in this study. High risk of severe mental illness (HR-SMI) and post-traumatic stress disorder (PTSD) were measured by K6 and PTSD-8 scales. Using generalized linear mixed model, we examined the mental health impacts of COVID-19 pandemic and moderation effect of sex and loneliness. The difference in changes in predicted probability of HR-SMI and PTSD across Waves 1 to 5 and Waves 5 to 6 between moderator-based subgroups were calculated. Findings: A total of 2399 resettled refugees participated. The weighted prevalence of HR-SMI (Δ6-5 5.0%) or PTSD (Δ6-5 3.2%) was increased after the pandemic, different from the trend from Waves 1 to 5 (HR-SMI stable trend; PTSD decreased trend). Compared to Wave 5, Wave 6 had a significant effect on HR-SMI (AOR 1.54 [95% CI 1.17-2.04]), especially among females (2.04 [95% CI 1.16-3.56]); causing an additional 8.82% change in predicted probability than males. A significant effect of Wave 6 on PTSD was only found in respondents with loneliness (2.17 [95% CI 1.17-4.05]), causing an additional 14.92% change in predicted probability than those without loneliness. Interpretation: Rates of mental illness increased among resettled refugees in Australia from prepandemic to four years post-COVID-19 and were moderated by loneliness and being female. This highlights the need for ongoing, targeted psycho-social support for specific refugee sub-groups. Funding: Guangdong Basic and Applied Basic Research Foundation (2022B1515020094).
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