*3.3. Post-Migration Contexts and Realities*

Upon resettlement in Australia, some participants experienced poverty, poor employment outcomes, unfamiliarity with the new environment, and complex systems and challenges, including language and cultural barriers.

*Coming to Australia was a sudden thing, like 'oh you're coming to this new place'. Like I was young and so didn't know how it was.* (Participant 16)

*I know a few people even now they don't have Centrelink [social security assistance in Australia] money and they don't have an income. They just live with their parents, but the parents are poor too, they don't give them an income. They are looking for work, but they can't get a job, so they have to survive like that.* (Participant 20)

As a result of disadvantages including poverty, low English proficiency and the difficulties associated with growing up as a young person without parents, these youths were desperate and found it difficult to access job opportunities, ending up with poor resettlement and health outcomes.

*Young people in our community, they have no access to jobs—and because they don't have access to jobs, they find something to keep themselves busy. Also, because we come from Africa, some of us don't know English. Some of us, they came here they don't have parents—their parents died—and they come when they are single* . . . *like the cause of all the bad thing is because you don't have a good quality of life, and if you don't have a good quality of life, you think you can do bad things.* (Participant 5)

*They'll be like saying they're looking for work, but they're not going to get a job because of their low level of skill. They can't get a job, and they'll be like 'what can we do?'* (Participant 20)

Participants reported being anxious, bored, depressed, and perceived themselves as having failed to improve their lives in their perceived land of opportunities, which they reported led youths to antisocial and destructive behaviors, including substance use as a coping mechanism. The following statements encapsulate these claims:

*It goes back to the main problems like depression, anxiety, all these kinds of things. When you start to experience those kinds of things, then you tend to put your problems into alcohol to forget the problems.* (Participant 14)

*When they get depressed what I see a lot and is more common, is they tend to drink alcohol a lot. They tend to drink and pretty much do things like maybe smoking weed and all that stuff.* (Participant 21)

#### *3.4. Contextualising AOD Use and Mental Health*

There was a common consensus among the participants that African migrant youths' experiences of loneliness, the loss of informal social networks and family ties in addition to their circumstances in Australia made them vulnerable to social peer pressure, which seemed to facilitate AOD use. One participant observed, "*sometimes peer group. Peer group is one of them, I think. If you fall into the wrong group and the environment*" (Participant 6). Other participants also expressed a similar view.

*When you have friends that take alcohol or other drugs, so you tend to follow so that if you want to fit into that friendship or that company, you have to do what they do.'* (Participant 15)

*I have some of my friends here, they use drugs, they ask me* . . . *they give me—like smoking or drinking.* (Participant 13)

A common agreement among the participant was around the view that there are high expectations on youths in their community, and they are expected to be respectful to maintain their 'reputation'. However, this high expectation sometimes led to a breakdown of personal and social relationships with the broader community, an issue identified by participants as perpetuating AOD use and mental health problems. Additionally, there was a view among the participants that any 'reputational damage' in the community is hard to mend, leading to youths feeling trapped and marginalized from their community.

*If you become frustrated, maybe people don't pay respect to you sometimes. You say there is nothing to fear again because I already lost that reputation'. That's the most important thing in my community, is if you lose that reputation in the community it's very hard to get it back.* (Participant 15)

Similarly, respondents noted that the breakdown of intimate relationships influenced substance use among youths, a view demonstrated by the following statement.

*They come to drug and drinking alcohol because sometimes their relationships break up. They start smoking, and they start drinking, and they start using drugs. And they think doing these things can help them.* (Participant 13)

Complex and conflicting cultural and contextual interplays between the Australian and African communities encouraged the use of AOD among African migrant youths in Australia. Unlike in Africa, the Australian society did not prohibit excessive alcohol use, a freedom which participants revealed African migrant youths preferred but created tensions with parents. The lack of social consequences in Australia and access to government financial safety nets encouraged the use of alcohol, as illustrated here.

*Well because it's a new environment whereby if you have the money you can buy whatever you have and there's the freedom—so the parents are going to advise their kids, but they do not listen to their parents.* (Participant 3)

*There is alcohol in Africa, but there's a way if you're going to drink alcohol—and you know there's no Centrelink—if you're going to drink alcohol you're going to die because you're not going to have any other help.* (Participant 7)

Participants noted the negative impacts of AOD use on physical, psychological, and social health, with risky alcohol consumption both arising from and perpetuating stressors related to acculturation amongst African youths. The following statement demonstrates this sentiment among participants.

*Well, I think alcohol is a health issue because a lot of young people are drinking alcohol. The way I see it, drinking is not the problem, but it's the amount of alcohol they drink at one time is the problem because if you drink too much, then it becomes heavy on you.* (Participant 14)

There was acknowledgement among participants that AOD use leads to antisocial behavior and poor decision making. Participants identified poor decision making typically presenting as violence and inappropriate sexual behaviors, and young youths are being vulnerable to offences committed by older youths within their social group when intoxicated.

*Underage drinking has become a problem because a lot of young boys, a lot of young girls under the age of 18 are drinking heavily. And as a result of that, they end up doing a lot of silly things like sexual offences. So they expose themselves into sex earlier because of alcohol and drugs. Young people, as young as 15 and 16, you know, just because they drink and take drugs too they become vulnerable to older people that hang out with them.* (Participant 14)

Several participants also elaborated on this sentiment with one respondent suggesting that a loss of control with intoxication represented a manifestation of the inability to control turbulent internal emotions. The result of this was violence and arguments with others.

*I think that [alcohol] is dangerous. It leads to a lot of disasters because it makes—teenagers especially when they have alcohol they lose control, they don't know how to handle that or control their emotions and stuff like that. They start arguing, they start fighting and stuff like that, so I think it's a big problem for teenagers.* (Participant 8)

Participants recognized alcohol as an accomplice to suicide, although they did not clarify the precise role that alcohol plays in suicide ideation, attempts, or completion. Respondents observed that alcohol consumption precipitates suicide ideation in youths with underlying psychological problems as the following comment demonstrates.

*If their mind is not working, like sometimes if you take alcohol, you know that cause actually somebody to commit suicide.* (Participant 6)

*You know mostly these young kids, they tend to drink and with other people making troubles. They drink, and then they try to kill each other and make themselves suicide because of those factors.* (Participant 5)

#### **4. Discussion**

This study explored the perspectives of African migrant youths in Australia about AOD use and mental health issues. Acculturative stress model provided the framework to understand these issues in migrant youths because of scarce internal and external coping resources available to them when adjusting to life in Australia [27]. Upon numerous challenges that face the youths in the current study, participants were negotiating not only the transition to a new culture but also that of meeting the expectations of their community. It has to be understood that, as a result of losses including of parents, some participants with refugee backgrounds arrived in Australia as unaccompanied minors, had extended stays in refugee camps with unmet basic nutritional, educational, or recreational needs, contributing to a poor start of new life in Australia. A combination of social and peer pressure, vulnerability, and complexities of their social deprivation could influence substance use, ultimately leading to poor social and health outcomes [28].

An important aspect of the acculturative stress model is how stressors experienced because of a lack of internal and external coping resources during acculturation contribute to stresses [27]. While the paper emphasizes the role of acculturative stress, it is important to acknowledge that there are also other factors that could contribute to AOD use and mental health issues among the participants. For example, pre-migration experiences such as traumas of past lives and losses could contribute to mental health issues among youths and the use of AOD as coping mechanisms. The current study shows that participants experienced loss, separation from families and friends, and uncertainties for their future before and after migration. For example, settlement issues such as lack of employment and underemployment could be additional factors that would lead to AOD use. There are views from the data which suggest that such experiences resulted into extreme stresses, which supports previous evidence that young people with refugee backgrounds experience extreme challenges predisposing them to a wide range of poor health and social

outcomes [29]. Participants in this study revealed being trapped in vicious cycles of social disadvantages and socioeconomic situations that affect individuals' health outcomes, particularly mental health [30]. The data from this study show that unemployment was a common issue facing African migrants youths in Australia, which contribute to their impoverishment and marginalization, often in a state of poor physical and mental health, leading to them using AOD as a coping mechanism. These findings support the link between a lack of employment opportunities and poverty as significant determinants of health [31].

Additionally, missed opportunities and the lack of education due to circumstances described elsewhere in this paper meant that African migrant youths felt excluded and at times discriminated against, for example, when accessing social security support. Discrimination is a known stressor and social determinants of health which hampers the socioeconomic opportunities and has implications for AOD use, poor social outcomes, and mental health [32,33]. Moreover, participants in the current study also revealed living in poverty and experiencing other deprivations. These complex experiences, coupled with AOD use and past trauma could shape the way individuals experience mental health issues in this population group [10]. Alternatively, the poor socioeconomic, harsh environment, and other disadvantages and mental health issues experienced by participants in this study because of past trauma could contribute to this population group having a unique experience of AOD use [34,35].

Consistent with other studies that have demonstrated the influence of alcohol on antisocial, disruptive behaviors [36], and poor health among young people [35], the views expressed by participants in this study suggest that AOD use may contribute to many social, emotional, and behavioral problems among African migrant youths. Participants in the current study revealed that the use of alcohol could contribute to risky behaviors and overall vulnerability of youths. Additionally, the participants in this study acknowledged that many migrant youths use alcohol regularly, and this is concerning because the early onset of alcohol use can contribute to alcohol-related behavioral problems later in adolescence or adulthood [37,38]. Earlier research found that people who began drinking before age 15 were four-fold more likely to develop alcohol dependence during their lifetime than were people who started drinking after 21 years old [39].

In Australia, drinking alcohol is a common characteristic of social life among youths and perceived as a pleasant social norm [40]. For African youths in Australia, it is reasonable to argue that drinking is part of assimilation and acculturation processes [41]. Young people adopting to AOD use can be perceived as embracing the norms in their new society [28]. It is also likely that alcohol use among African migrant youths is rising because of conflicting attitudes between African and Australian cultures regarding their use. In Africa, alcohol use by youths is restricted and often carry severe consequences, whereas it is socially accepted in Australia [40]. Previous studies have supported the assimilation and acculturation process as facilitators shaping the behaviors of migrants [28,42].

To this end, it is worth acknowledging that African youths are resilient but also vulnerable because of the social settings and circumstances in which they live. The results in the current study seem to justify the need for broader social determinants of health approach and provide opportunities for service providers to work with youths in this population to improve AOD and mental health services. These youths can be empowered by service providers through targeted initiatives to become ambassadors and agents of change in their communities. The information from this study has influenced youth-specific preventive mental health interventions and programs run by the African Communities Council of South Australia.
