The relational model of sense of coherence: explaining refugees’ mental health and well-being in Austria

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Purpose This paper aims to construct a model explaining migrant health and well-being from a salutogenic perspective. Accounting for the relational, interactional factors impacting on the health of forced migrants, the “Relational Model of Sense of Coherence” combines elements from Antonovsky’s theory of salutogenesis with elements from Honneth’s theory of recognition. Design/methodology/approach The model has been developed from the empirical findings of a two-year qualitative study with 28 forced migrants in Austria. Besides initial and final surveys on the participants’ perception of health, health literacy and participation, data were gathered in a qualitative, participatory action research setting and analysed by the method of interpretative case reconstruction. The model is applied to the case reconstruction of a female refugee from Iraq explaining the dimensions impacting on her self-perceived status of health and well-being. Findings Next to consistency/comprehensibility and load balance/manageability persons need to experience participation/controllability as well as relatedness/self-confidence, recognition of rights/self-respect and social recognition/self-esteem to develop and/or maintain a strong, relational sense of coherence. All six dimensions contribute to feelings of meaningfulness; all components are necessary for a move towards the healthy end of the health-ease/dis-ease continuum. Originality/value The paper contributes to theory building in the fields of salutogenesis and recognition by developing a model based on an in-depth, participatory qualitative study with a vulnerable target group.