*2.2. Study Design and Recruitment of Participants*

The study employed a qualitative inquiry and respectively conducted 23 face to face interviews and one focus group discussion with eight youths aged 18–25 years who lived in South Australia. Participants had arrived in South Australia between 2000 and 2012. Participants were purposively selected to ensure we had representation from different age groups, year of arrival, and countries of origin from Central, Eastern, and Western Africa. Although the majority of the participants had a refugee background, participants who did not have a refugee background were also included recognizing that the youth population is susceptible to a mental health issue in their new country [6]. Because we have included both migrant and refugee youths, we will from here on use African migrant youths to denote both participants with or without a refugee background and we acknowledge the overrepresentation of those with a refugee background among the study participants.

We recruited participants through an African community youth worker who invited potential youths who spoke conversational English to enroll and participate in the study. This method of recruitment was a strength for the project in that, it did draw from the perspective of the community strength, using the youth worker's position, and not rely upon other service providers to link researchers to participants. The researchers explained the aim and scope of the research to the community youth worker who then invited other youths to participate. Individuals then referred the researchers on to friends who were eligible to be invited to participate face-to-face. All participants were informed about the study and accepted to participate voluntarily.

Data collection included 23 one-on-one interviews and one focus group discussion with eight participants. All interviews and focus group discussion were conducted in English and held at a place where young people felt comfortable.

The interview and focus group guides (Table 1) explored issues on premigration experiences, challenges and difficulties faced in Australia, why some young people may use AOD or take their own life, how they come to use drugs or alcohol, the impacts of AOD use, how they would describe the AOD use among their friends, issues concerning AOD and mental health, social networks and support, family relationships, seeking support from mental health and AOD services, and community support. The interview and focus group discussion guides were informed by research literature and questions were designed to ensure flexibility to expand on points of interest and to explore issues that were important for the topic [23]. Participants were encouraged to actively engage in expressing their views and were made to feel safe talking about stigmatized issues.

**Table 1.** Focus group discussion and interview guides.


#### *2.3. Ethical Considerations*

The Flinders University Social and Behavioral Ethics Committee (SBREC) approved the study protocols. The permission to collect information from members of the community was also obtained from ACCSA. Each study participant received an information sheet outlining details of the research and its purpose before commencing interviewing or focus group discussions. Participants were assured that their identity would be kept confidential and all names would be replaced with pseudonyms. Although they all lived across the suburbs of Adelaide, some, but not all focus group participants knew each other.

Researchers reminded participants that information disclosed in the focus group discussion needed to remain confidential. All participants provided written consent and received information on their rights to terminate their participation at any time during the focus group discussion or the interview. Each participant received a list of professional counselling agencies and offered a free, private, and anonymous follow-up counselling session with costs covered by ACCSA. Each participant was reimbursed \$30 for their time and other expenses incurred to participate in the study.

#### *2.4. Data Analysis*

The focus group discussions and interviews were audio-recorded and transcribed verbatim. Both authors are experienced qualitative researchers, were part of the investigating team, and analyzed the transcripts to ensure credibility, rigor, transparency, and validity of the analytic process [24].

To provide coherence and structure [25], we used the framework approach described by Ritchie and Spencer [26]. The framework identified five steps of data analysis involving familiarization with the data, coding and identifying themes, indexing, charting, mapping, and interpreting the data. In line with this framework, the researchers identified passages of text according to the context, coded them to several relevant categories and assigned the related codes into themes. The analysis was dualistic including inductive, with categories emerging purely from the data and deductive, with categories derived from prior knowledge and the thematic approach enhanced the rigor, transparency, and validity of the analytic process [24,25]. Table 2 provides a snapshot of data analysis for the current paper.

The research team members are experienced in working with young people from African backgrounds and were also members of the African community in South Australia. This background was vital across the continuum of the project and eased the data collection, analysis, and interpretations. Additionally, being members of the African community facilitated trust and rapports between the participants and researchers, although it could have played out exactly in the opposite way.

**Table 2.** Examples of thematic analysis and interpretation of study data.


#### **3. Findings**

#### *3.1. Characteristics of the Study Participants*

The average age of the interview (Table 3) and focus group (Table 4) participants was 22 years old. The interview participants involved 8 females and 15 males from five different countries, including the Democratic Republic of Congo (DRC), South Sudan, Liberia, Ethiopia, and Burundi. The focus group members consisted of six females and one male originally from South Sudan, Ethiopia, Ghana, Liberia, Burundi, and Somalia. Tables 3 and 4 provide the characteristics of the study participants.

There were three themes describing the perspectives of African migrant youths in South Australia reported, including (i) Pre-migration contexts and losses, (ii) Post-migration contexts and realities, and (iii) Contextualizing AOD use and mental health. These themes are described in detail below.

**Table 3.** Characteristics of face-to-face interview participants.



**Table 3.** *Cont.*

**Table 4.** Characteristics of focus group youth participants.


### *3.2. Pre-Migration Contexts and Losses*

The narratives from the participants revealed that most African youths arrived in Australia as refugees and stressors related to separations from or witnessing deaths of family and relatives while fleeing from home countries had significant life impacts. The pre-migration deaths of parents meant that many youths came to Australia with relatives or sole parents. Some youths described their relationships with their guardians as strained as the below quote demonstrates:

*I don't have parents. My mum passed away. And most of these young people here they don't have like family and some of them might have a mum, but they don't have a dad. And they might struggle with the family, but most of them don't talk about it.* (Participant 21)

Also, some youths fled their countries of origin and lived for many years in refugee camps in the countries of asylum. Some had to move from one country of asylum to another in challenging circumstances as the following quote encapsulates.

*All my parents and the other families stayed in South Sudan. So, we first went to Uganda, we stayed there for a couple of months, in the northern part of Uganda. At the time, it wasn't safe; there was no difference between Northern Uganda and South Sudan because of the war in South Sudan and the Lord Resistance Army operating in Northern Uganda. We stayed there for a couple of months, but every night was a nightmare. We moved from Northern Uganda, and we went to Kenya, and we arrived in Kenya in 1995. So, we stayed in the refugee camp from 1995 until 2003 when we finally came to Australia.* (Participant 14)

Similarly, respondents described the experiences of separations from families and uncertainties related to not knowing whether their parents were alive or dead, factors that had a lasting emotional impact and effects on their growth and resettlement in a new country.

*Before I came to Australia, I didn't know that I had a family. When I came to Australia, people started calling me up and saying, 'we are your parents', and I just said, 'oh my God'. I didn't know my family because during the war you don't live with your parents.* (Participant 20)

Furthermore, as a result of frequent movements from one country of asylum to another, and before arriving in Australia, African migrant youths reported to have lost important opportunities, including educational disruption. Some youths noted that these disruptions were a hindrance to continuing their education in Australia and were forced to grow up early to meet social obligations including looking after younger relatives and marrying at a young age. These experiences are illustrated in the following assertion:

*Because of the war, I was in a camp. I started my education there from year three to year 12. When I came to Australia, I went to the factory, I work. I decided to marry, so I went back home and proposed my wife to come to Australia. My wife came with three boys, one is my nephew, and two are cousins. So, from there, I decided not to go back to school because it has been a long time plus I have personal issues.* (Participant 22)
