Graduation Year


Document Type




Degree Name

Doctor of Philosophy (Ph.D.)

Degree Granting Department


Major Professor

Heide Castañeda, Ph.D., MPH

Committee Member

Roberta Baer, Ph.D.

Committee Member

Tara Deubel, Ph.D.

Committee Member

Bruce Lubotsky Levin, DrPH, MPH

Committee Member

Dinorah Martinez-Tyson, Ph.D., MPH


control over destiny, critical medical anthropology, Florida, resettlement


This dissertation examines how perspectives of mental health among refugees are situated within the realities of the refugee resettlement system, a population for which information on this issue is quite limited. Through in-depth interviews and participant observation with Congolese refugees and non-Congolese refugee-serving professionals in a major Florida city, this dissertation examines how perceptions of mental health and mental health services among refugees were affected by financial insecurity and disparities in expectations. Local Congolese refugees expected the American Dream; they believed that once they arrived they would find prosperity through hard work. Instead they experienced frustration and distress because the resettlement services provided to them were only enough to insert them into the bottom of American society, and the limitations of the resettlement system posed barriers to them achieving their plan. Limited formal education and limited knowledge of English comprised an additional layer of distress for many local Congolese as it restricted the types of work they could find. Through the scholarly lenses of control over destiny, critical medical anthropology, and critical race theory, I propose the term systemic expectation discord to describe the role of this disparity in expectations and lack of opportunity on refugee distress, as well as on the prioritization of mental health services in their lives. This dissertation has both theoretical and applied implications in its use of theory from anthropology and public health to better understand the lived experience of local refugees. This dissertation also makes practical recommendations on how to provide mental and emotional support to refugees while circumventing the issues that cause them to de-prioritize mental health services as we know them.