Teachers’ experiences of supporting the mental health needs of refugee students in resource-poor settings: a qualitative study in Iran

ABSTRACT

Background: Exposure to traumatic events is common amongst children from refugee backgrounds. Given the restricted access of refugee children to formal specialist resources and disrupted parental support mechanisms in low- and middle-income countries (LMICs), teachers are increasingly expected to be the primary responders to the complex psychosocial needs of trauma-exposed refugee children. However, despite LMICs hosting over two-thirds of the world’s refugee children, our current knowledge of how teachers respond to these needs is predominantly drawn from studies conducted in well-resourced, high-income countries, which fails to capture the unique experiences of teachers in inadequately resourced schools in LMICs.

Objective: We aimed to explore qualitatively the experiences of school teachers in responding to the mental health and psychosocial needs of trauma-exposed refugee students in resource-poor settings. Method: Semi-structured qualitative interviews were conducted with 30 teachers from eleven schools in socio-economically deprived communities in Iran. Data were analysed using thematic analysis.

Results: Teachers expressed that establishing close relationships with refugee students works as a ‘strategy’ to identify the trauma-related mental health needs of this population. Almost all teachers strongly emphasised that achieving positive outcomes from their support efforts requires a collaborative home-school partnership, with refugee caregivers playing a fundamental role in this process. It was also described by teachers that a welcoming school climate facilitated refugee students’ sense of belonging and maximised their ability to offer support. Whereas schools were recognised as the most accessible place for disadvantaged refugee children to receive timely psychosocial support, teachers noted context-specific barriers, such as financial stress, that negatively influenced their capacity to continuously support refugee-background students.

Conclusion: Our findings highlight the need to expand the evidence base to capture the unique experiences of LMIC refugees and those supporting them, and to develop contextually-culturally relevant training programmes to help teachers better respond to the unique needs of refugee students.

HIGHLIGHTS

• This study provides insight into the unique experiences of teachers supporting the mental health needs of refugee children in poorly-resourced schools in a low-and-middle-income country.

• Teachers repeatedly emphasised the importance of regular engagement with refugee caregivers to address the complex psychosocial needs of refugee children within the school environment.

• Recognition from non-refugee peers played a crucial role in fostering a sense of belonging for refugee children, which in turn encouraged them to seek support from teachers.

1. Introduction

The majority of forcibly displaced families originate from and reside in low- and middle-income countries (LMICs), and their numbers have risen dramatically in recent years (UNHCR, 2023a). Roughly 82.1 million, 75% of the total forcibly displaced populations, have been resettled in LMICs. Iran is the world’s largest host country for refugees, with approximately 3.8 million mostly Afghan and Iraqi nationals (UNHCR, 2023b). Refugee-inclusive policies, including granting access to healthcare services and public education facilities, have raised the number of forcibly displaced families in this country (Hansen, 2019). Notably, since the imposition of severe restrictions on educating female students in Afghanistan, Iran has become a major destination for school-aged refugees and asylum seekers seeking access to high-quality schooling (Arooje & Burridge, 2021).

Refugee students entering a new school environment in host countries typically experience acculturation difficulties such as insufficient host country language proficiency (Seker & Sirkeci, 2015), trouble adapting to a new schooling system and inconsistencies with their prior educational backgrounds (Boyson & Short, 2012), and inadequate knowledge about the host country’s cultural norms and values (Borsch et al., 2019). Importantly, refugee children have typically been exposed to multiple traumatic events and adversities prior to and during their transitional period, resulting in elevated rates of serious mental health problems (Scharpf et al., 2021). Correspondingly, there is substantial evidence to indicate higher prevalence rates of post-traumatic stress disorder (PTSD), depression, and anxiety disorders in refugee children and their caregivers compared to non-war-affected populations (Back Nielsen et al., 2019; Blackmore et al., 2020; Bronstein & Montgomery, 2011; Fazel et al., 2005; Kandemir et al., 2018; Reed et al., 2012; Scherer et al., 2020).

Despite high levels of exposure to traumatic events and high prevalence of mental health problems, many refugee children and adolescents face restricted access to mental health services in post-migration contexts (Colucci et al., 2014; DesMeules et al., 2004). However, most refugee minors attend schools after resettlement (UNHCR, 2019). Therefore, the school environment plays a vital role in meeting the mental health and psychosocial needs of refugee students in the host country, and is considered a main access point to addressing students’ post-migration emotional distress (Fazel & O’Higgins, 2020). Robust evidence from HIC contexts indicates that refugee children and their parents often prefer to seek help from community members and school personnel rather than from mental health professionals (Chiumento et al., 2011; Fazel et al., 2016). Therefore, given the sizeable proportion of school-aged refugees in LMICs and the lack of access to mental health professionals in deprived contexts (Hughes, 2014), locating teacher-led psychosocial support in schools can increase accessibility and help reduce the stigma associated with psychosocial distress refugee children face, particularly during resettlement and adaptation to a new environment (Fazel et al., 2016; McDiarmid et al., 2021).

To date, evidence examining teacher capacity to support refugee students with their mental health-related needs has focused on high-income countries (HICs). Qualitative research with primary school teachers in Australia showed that refugee students disclosed past traumas to their teachers, and that trauma-induced behavioural changes were observable in the classroom (Barrett & Berger, 2021). Similarly, adults who arrived in Denmark or England as refugee minors described being reluctant to share negative experiences with their parents, but finding their teachers a valuable resource to discuss difficulties during the initial months post-arrival (O'Toole Thommessen & Todd, 2018). Such support from teachers is potentially important for recovery and preventing mental health problems. In a sample of 214 male refugee students in Italy, high levels of psychosocial support from teachers were found to be a strong protective factor against depressive symptoms (Cristini et al., 2011). Conversely, teachers’ discriminatory attitudes have been linked with worse mental health outcomes amongst forced migrant students (Fazel et al., 2012; Luthar et al., 2015; Montgomery & Foldspang, 2008). Despite this growing evidence of the potential importance of teachers, there is limited evidence of whether and how teachers are able to identify and support the trauma-related mental health needs of refugee students within the low-resource settings in which most refugee children are resettled.

The wider experiences that refugee children have within schools are also critical to their adjustment. For example, data from a large sample of refugee and asylum seeker minors in Western contexts found that the experience of belonging to the school and inclusive school climate was associated with improved mental health outcomes (Fazel et al., 2012). In contrast, it is well-documented that negative school environments can be considered as a risk factor for refugee students. Many refugee students experience peer discrimination and bullying, which has been linked with reduced feelings of happiness (Correa-Velez et al., 2010; Guo et al., 2019; Hek, 2005), lower self-esteem (Oxman-Martinez & Choi, 2014), and physical and psychosomatic problems (Samara et al., 2020). Crucially, supportive interactions between teachers and students can help to enhance social integration and peer connections amongst refugee children (Thijs & Verkuyten, 2008).

In sum, evidence mainly from research in HICs suggests that teachers are well-placed to support refugee children with their mental health-related needs, and that support from teachers is a factor for improving the mental health of refugee students. However, much less is known about teacher support for refugee students in deprived, poor-resource settings in LMICs, despite the fact that LMICs provide homes to the majority of the world’s refugees. In LMIC contexts, children may face additional challenges in accessing emotional support from their primary caregivers, as caregivers themselves are facing severe economic hardship and major resettlement challenges, and harsh parenting strategies that hinder positive and supportive parent–child interactions may be more widespread (El-Khani et al., 2018; Sim et al., 2018). Consequently, children’s broader social networks, including teachers and school staff, may become particularly important sources of support (Didkowsky et al., 2024). At the same time, LMIC teachers typically receive less training in supporting vulnerable students, have more limited resources, and have larger numbers of refugee students than their counterparts in HICs, which might make it more challenging for them to provide timely psychosocial support in these areas (Karkouti et al., 2021).

Given the unique challenges, the predominantly HIC-based evidence necessarily provides limited insight into the experiences of teachers in providing support to refugee children in LMIC communities. To address this knowledge gap, we conducted a qualitative investigation of the experiences of Iranian teachers in providing day-to-day support to primary and secondary school-aged refugee students. Iran is home to large numbers of refugee children, predominantly from Afghanistan and Iraq. Most refugee families are resettled in areas of Iran with profound deprivation, limited healthcare infrastructure (Hosseini Divkolaye & Burkle, 2017), and high adversity (Abdollahi et al., 2015), which together can create a higher risk for developing mental and physical disorders (Roozbeh et al., 2018). Despite these challenges, the majority of refugee children in Iran have access to free public education and attend integrated, single-gender classrooms alongside their Iranian peers, regardless of legal status, although the recent influx of Afghan refugee families has led authorities to designate a small number of educational centres in refugee-populated areas exclusively for displaced students. Notably, refugee families have typically been exposed to a wide range of traumatic events before, during, and following their resettlement (Alemi et al., 2023; Mohammadsadeghi et al., 2022), with the highest weighted prevalence of PTSD being reported for Afghan minors resettled in Iraq when compared to their Iraqi and Syrian counterparts (Solberg et al., 2020). Narratives of newly arrived Afghan refugee families describe extensive losses, ‘near-death’ experiences, and exposure to physical violence during their journey to Iran, mirroring these quantitative (Mohammadsadeghi et al., 2022).

Despite the substantial and growing number of refugee children in Iran, there is limited understanding of how Iranian teachers manage trauma-related issues and address the diverse socioemotional needs of these students. Our qualitative study aimed to address this gap by exploring two questions: (1) How do Iranian teachers experience and perceive their role, needs, and available training resources in supporting the mental health of trauma-exposed refugee students? and (2) What are the key barriers to and facilitators of providing psychosocial support for refugee students in the school environment?

2. Methods

2.1. Design

We used one-to-one semi-structured interviews with teachers working at refugee schools to explore qualitatively their understanding and experiences of supporting the mental health of trauma-exposed refugee students in Iran.

2.2. Recruitment and participants

Thirty primary and secondary school teachers were recruited through advertising via local schools and educational centres in different provinces of Iran. The target schools (n = 11) were located in deprived and disadvantaged areas across Iran, including rural, peri-urban, and urban settings. These schools were identified as having at least 30% of students being newly arrived refugees. Recruitment took place between April and September 2023. Participants were eligible for the study if they were aged 18 years or older; and had been employed for at least 1 year as a teacher at refugee or asylum seeker educational centres, or at a school with a significant refugee/asylum seeker intake, working at least 50% of their time in that context.

To facilitate recruitment of teachers we collaborated closely with the Association for Protection of Refugee Women & Children (HAMI NGO), a leading NGO supporting refugee families in Iran, which has an established network of schools in various refugee-hosting communities. Participants were recruited through purposive sampling by distributing study flyers and advertisements at eligible schools and educational centres. Snowball sampling (Goodman, 1961) was additionally employed to expand the participant pool by recruiting other teachers who were referred by participants. Interested potential participants were contacted via email or telephone and provided with a study information sheet. Of the 56 eligible teachers initially approached by the researcher (MR), 26 declined due to being too busy, unable to schedule online or face-to-face, being reluctant to share their attitudes with the researcher, or failing to attend a scheduled interview. Data saturation was evaluated by concurrently listening to and coding interview data, in line with Hennink and Kaiser’s (2022) guideline. Thematic saturation, the point at which no new insights or issues are identified or deemed applicable by the authors to the dataset (see Braun & Clarke, 2021), was achieved by the 26th interview. To verify the stability of our thematic framework, we conducted and analysed four additional interviews, all of which were consistent with the existing themes. Therefore, no additional participants were approached after recruiting 30 teachers.

2.3. Measures

2.3.1. Qualitative interview schedule

A semi-structured interview topic guide was developed based on the research questions and literature regarding the role of teachers in providing school-based psychosocial support to refugee students. Feedback from HAMI staff was sought to ensure context-specific relevance and to flag any unclear or culturally insensitive topics. Our initial questions were designed to explore: (i) teachers’ experiences and needs relating to supporting the mental health of trauma-exposed refugee students; (ii) training resources available to teachers to help them support refugee students; (iii) teacher perceptions of the mental health needs of refugee students in the school environment; and (iv) perceived barriers to and facilitators of the provision of support for refugee students. As teachers in LMIC regions may face unique context-specific challenges, we piloted the interview schedule with two teachers and a school manager (Majid et al., 2017). This led to a number of questions being paraphrased and some probes being refined, with minor revisions in phrasing being made to increase clarity. The question set was also slightly reduced to allow for more in-depth responses from participants (see Appendix S1 for a summary of the final interview guide).

The initial version of the interview guide was developed in English prior to being translated to Farsi by the lead author (MR), who is bilingual. Subsequently, the Farsi version of the interview guide was back-translated into English by two bilingual translators in Iran. No significant discrepancies or inaccuracies in translation were identified.

2.3.2. Demographic information

Teachers completed a demographic questionnaire, providing details about their age, gender, education and employment status, level of income, length of time teaching refugee students, typical class size, geographic location of the school, the type of school (primary/secondary, refugee-focused), and refugee student characteristics (gender, countries of origin).

2.4. Procedure

Following recruitment, one-to-one interviews were arranged with teachers. All interviews were conducted in Farsi by an Iranian male doctoral researcher (author MR) with training in qualitative methods. Interviews were face-to-face with teachers in their school (n = 6) or online (n = 24), according to teacher preferences. Interviews lasted 54 minutes on average (range: 39.8–91.2 min) and were audio-recorded and subsequently transcribed verbatim.

2.5. Coding and data analysis

An inductive thematic analysis was conducted using a phenomenological lens, guided by the methodological steps and recommendations for improving both the conduct and reporting of thematic analysis set out by Braun and Clarke (2006, 2023). This approach was selected due to the exploratory nature of the study, aiming to capture and convey teachers’ first-hand experiences of supporting refugee students in schools.

NVivo version 14.2 was used to support the data analysis. First, the researchers immersed themselves in the data by reading and re-reading the interview transcripts. Then they generated a set of preliminary codes, which were systematically organised and refined into candidate themes. Researchers then searched for overarching themes, reviewed their relevance, defined and named each theme, and finally wrote up the analysis (Braun & Clarke, 2006, 2023). Themes underwent iterative refinement to ensure they reflected the ‘essence’ of the data they represented. This process continued until data within each theme demonstrated internal coherence, while themes themselves were clearly distinct from one another (establishing internal and external heterogeneity; Braun & Clarke, 2006). Each emergent theme was rigorously checked to ensure strong evidence within individual transcripts and across the entire dataset. Throughout this process, the researchers did not impose a predetermined framework but remained open to the meanings emerging from the data (transcripts) and sought to understand how teachers made sense of their experiences in responding to the psychosocial needs of refugee students in the school environment.

The primary researcher (MR) led the coding and theming process. Throughout the research process, the primary researcher (MR) used a hand-written reflexive journal to document his personal fieldwork observations in refugee schools and to reflect on how his prior experiences, values, and assumptions might influence the analysis. This served as a tool to avoid making premature interpretations of the data (Mason, 2017). In addition, memos were recorded to capture ongoing reflections and to consider the relationships between developing themes, consistent with an inductive analytical approach.

All interviews were analysed in their original language (Farsi). Evidence consistently supports the use of the original language in qualitative data analysis, as it promotes trustworthiness and maintains cultural and linguistic understanding in the interviews (Dolan et al., 2023). This approach ensures that nuances, expressions, and contextual meanings are preserved, leading to more detailed interpretations and richer insights from the transcripts.

2.6. Positionality statement

Throughout the study, the research team engaged with regular reflexive discussions to critically examine how their prior experiences, standpoints, and positionalities, especially during joint coding checking meetings between MR and FB, influenced the interpretation of the results. The research team utilised their awareness of components of the ecological model of psychological trauma (Harvey, 1996) and socio-ecological model of psychosocial support (Wachter et al., 2022) to guide the investigation of how teachers support refugee students in resource-poor educational settings. The research stemmed from the premise that refugee children in LMIC resettlement contexts could be more dependent on informal sources of support – specifically the school system – due to the inaccessibility of ground-level mental health services.

The research team included one male and one female researcher originally from Iran as well as non-Iranian colleagues. Potential biases were mitigated by seeking broader supervisory input from HAMI staff experienced in teaching refugee students, ensuring a balanced and inclusive approach to recruitment and data analysis. Furthermore, close collaboration with HAMI as a local NGO and the team’s cultural diversity expanded our understanding of the context, practices, and norms when reporting the study findings. Further details about the researchers’ backgrounds are provided in Appendix S2.

2.7. Coding integrity and trustworthiness

To ensure integrity and coding trustworthiness, a second bilingual researcher from Iran (FB) independently coded eight randomly selected transcripts (28% of the dataset). The lead researcher (MR) and FB then examined and compared all codes and emerging themes for coherence and agreement. Any discrepancies between researchers (MR and FB) were discussed and addressed through a re-examination of the data set (Guest et al., 2012). Any code or sub-theme identified in one coder’s analysis but not in the other’s was discussed and then retained or removed based on its relevance. In the final stage, any major inconsistencies were further discussed and themes refined once again, improving the wording of four codes and two sub-themes, and two new codes were included in the analysis. This inter-coder review checking produced a high level of congruence in the codes and themes generated by both coders (Silverman, 2013). In addition, the entire research team engaged in ongoing discussions to scrutinise the interpretations, identify potential biases, and refine the thematic structure (Morrow, 2005), further establishing the credibility of the findings. Regular feedback was sought from co-authors on the interpretations of the raw data and final themes. Finally, following reviewer feedback on the first version of the manuscript, themes were re-reviewed and additional quotes were identified and provided as evidence. More information on our adherence to quality criteria can be found in the supplementary file (see Table S3), which depicts this study to the COREQ checklist for reporting qualitative research.

2.8. Ethical considerations and safeguarding

This study received ethics approval from the Psychology Research Ethics Committee at the University of Bath (Ref: 23-022). All participants provided informed consent prior to their participation. For online interviews, participants received the information sheet and informed consent form in advance via email or social media platforms. Verbal consent was again obtained immediately prior to the interviews and was recorded as part of the interview process. All potentially identifiable or location-specific information was removed from transcripts prior to analysis. This study intentionally collaborated with a local NGO to facilitate recruiting participants and ensure that both online and in-person participants could have access to post-trial psychological services if needed following their participation.

3. Results

3.1. Demographic characteristics

The final sample comprised 30 Iranian teachers (n = 17 female, n = 13 male) from single-gender schools with a mean age of 30.9 years (range: 23–44 years, SD = 6.02). On average, teachers had 4.83 years of experience teaching refugee students (range: 2–13 years, SD = 2.98). The schools in which they taught were located in urban (40%), rural (36.7%), and semi-urban (23.3%) areas. Two-thirds of teachers (66.7%) reported living below the poverty threshold. All participating teachers in this study were from mixed refugee schools (see Table 1). Full demographic characteristics of the sample are presented in Table 2 in the Supplementary file.

Table 1.

Demographic information of participants (n = 30).

Characteristic	Statistic
Nationality, n (%)
Iranian	30 (100)
Age in years, M (SD)	30.9 (6.0)
Proportion female, n (%)	17 (56.7)
Educational level, n (%)
Bachelor’s degree	22 (73.3)
Master’s degree or above	8 (26.7)
Proportion below poverty threshold*, n (%)	20 (66.7)
Years experience teaching refugees, M (SD)	4.83 (2.09)
Same sex schools, n (%)
Boys only	21 (70)
Girls only	9 (30)
School level n (%)
Primary	19 (63.3)
Secondary	11 (36.7)
School setting n (%)
Rural	11 (36.7)
Semi-urban	7 (23.3)
Urban	12 (40)
Number of students per classroom, M (SD)	33.2 (7.82)
Primary origin of refugee students in the classroom n (%)
Afghanistan	30 (100)
Pakistan	6 (20)
Iraq	2 (6.7)

Note. * The minimum living wage in Iran is generally established at a national level. For instance, as of January 2024, the Ministry of Labor set the minimum living wage for workers at 111,077,870 Iranian Rials (IRR) per month, which was approximately 205 USD as of 17th January 2024.

3.2. Thematic analysis findings

We generated four overarching themes and twelve sub-themes from the data, summarised in Table 2 and described in detail in Supplementary Table 1, with additional supporting quotations.

Table 2.

Themes and subthemes following thematic analysis.

Theme	Subtheme
1. Teachers’ experience in recognising and responding to psychosocial needs of refugee students	1.1. Observing behavioural and emotional indicators of trauma-related distress in the classroom
	1.2. Emotional inhibition may hinder refugee students from seeking support
	1.3. Peer recognition as an effective support strategy
	1.4. Building caring relationships with refugee students is essential
2. Instrumental role of refugee caregivers within the school context for sustained support	2.1. Limited engagement between teachers and refugee caregivers
	2.2. Parental mental health literacy and parenting skills are linked to effective teacher support
3. A multicultural school climate can better facilitate support provision	3.1. The critical importance of non-refugee peers and parents
	3.2. Teachers’ discriminatory attitudes undermine refugee student support
	3.3. Fostering an inclusive school climate can promote belonging
4. Barriers to supportive teacher-student interactions	4.1. Financial hardship limits teachers’ capacity and motivation
	4.2. Lack of trauma-informed training
	4.3 Limited access to school-based counselling services

3.2.1. Theme one: teachers’ experience in recognising and responding to psychosocial needs of refugee students

Throughout the interviews, all teachers discussed that their daily interactions with refugee students, who have experienced various traumatic events during and after the migration process, helped them to better understand the psychosocial and educational needs of these students. Such regular interactions allowed teachers to more easily identify signs of emotional distress and provide appropriate psychosocial support within the school environment.

3.2.1.1. Subtheme one: observing behavioural and emotional indicators of trauma-related distress in the classroom

Interviews with teachers revealed their awareness that many refugee children had either experienced personally or witnessed (potentially) traumatic events before fleeing from their home country, during migration, or in the post-resettlement environments. These included witnessing serious violence; the death of family members; harsh parenting and domestic abuse; and sudden separation from their loved ones.

One [refugee] student was explaining to me: ‘When we were trying to cross the border, there were border guards, and the smuggler on the other side who wanted to bring us said, ‘Go back – you have to go through a tunnel.’ When we entered that tunnel, it was full of dead bodies, and my mother covered my eyes so I wouldn’t see, but we still had to walk over the dead bodies through the tunnel.’ … At first, she cried all the time and was constantly terrified by [the other] students’ noises. I mean, a child who at ten or twelve years old saw dozens of corpses with her own eyes and walked over them … many of their problems in class and even outside school can be due to such horrible experiences. (Female teacher, 26 years, primary school)

Drawing on their classroom experience, teachers described that they were able to recognise trauma-related characteristics in their students’ behaviour. They also viewed physical complaints, particularly amongst the newly arrived refugee students, as a common indicator of emotional distress in students.

I had a [refugee] student who said, ‘I was sexually abused at home.’ I noticed in class he seemed depressed – well, not depressed exactly, but there was an anxiety in his behaviour and on his face. Because he had headaches so often, he kept her head on the desk during class. I spoke with him, and after a day or two, he said, ‘They’re [sexually] harassing me.’ When we talked further, he said, ‘They raped me … ’ and things like that. There were a lot of people living in their house. After migration, many live like this [situation] for a long time. (Male teacher, 38 years, primary school)

While a few teachers observed violent or self-destructive behaviours amongst female refugee students, the majority identified bullying, substance abuse, aggressive and disruptive behaviours as being particularly prevalent in older male refugee students.

After the Taliban's war [in Afghanistan], a large group of refugee students came to our school. One time, I watched one of them stabbing another child in the eye with a knife, and when I grabbed it from his hand, he started threatening me. I don’t know if it’s because of the emotional pressure, distress or the hardships they’ve endured in Afghanistan and their journey to Iran, but most of them have very violent behaviour[s]. (Male teacher, 32 years, secondary school)

Teachers explained that trauma-related emotional distress and students’ difficulty in expressing their feelings not only disrupted individual learning and active participation, but also created major challenges for classroom management.

To discuss the mental and psychological issues at that school where I taught[,] I had a refugee student who’d just arrived [and] was doing fairly well academically. Then, a few months later, his grades suddenly got weak. He was upset for a while and became very withdrawn in class, always lost in thought. He didn’t say anything, didn’t follow me, and missed group activities, then he missed school for a few weeks. When I went looking for him and asked around, I realised that his brother had killed someone, and this student had been standing right beside him when he stabbed someone with a knife. (Female teacher, 31 years, primary school)

3.2.1.2. Subtheme two: emotional inhibition may hinder refugee students from seeking support

One repeatedly highlighted observation was that refugee students, compared to their non-refugee classmates, often refrained from expressing their feelings. The majority of teachers understood that this tendency could be linked to the students’ traumatic experiences or family cultural norms that discourage open communication about emotions. Consequently, this reluctance made it challenging for teachers to understand students’ emotional needs and provide appropriate support.

I had a [refugee] student whose father had unfortunately been arrested [following arrival] and whose mother was killed at the border, and there were three children who didn’t have any place or home [to live] … He was very withdrawn. Once I asked his older sister to come [to school], she also didn’t explain much, just like his brother. … (Female teacher, 29 years, primary school)

I felt like she was still really scared … she’d fake saying ‘I’m fine,’ but from what I knew, she totally wasn’t or didn't want to tell me. (Female teacher, 26 years, primary school)

Some early-career teachers reported that working with refugee students who don’t express their emotions led them to use more creative activities – such as animations like the film ‘Inside Out’ or ‘emotion flashcards’ where students match facial expressions with their corresponding name – as traditional ways like ‘merely showing excessive affection by words’ (PID 19) to encourage students to share their feelings was not felt to be effective. Teachers also observed that some refugee students’ unwillingness to speak or engage socially made it difficult to form peer relationships, which further exacerbated their emotional withdrawal in the school environment.

They’re [Iranian students] active and open to connecting with [peers] easily. But refugee students are different; [they] have a harder time connecting. If you don’t have a special plan to engage them, they’re not really inclined to form a close or friendly relationship with you. I think it might be because they feel a bit out of place … some of them have lost their fathers during migration or war. They’ve been through tough times and still face challenges. I feel like there’s this sense of distance in them that makes it hard for them to connect with [peers] and show their emotions. (Female teacher, 27 years, primary school)

3.2.1.3. Subtheme three: peer recognition as an effective support strategy

Teachers cited various reasons why refugee children sought validation from their classmates to form a positive representation of themselves. Incentives such as joining friendship groups, developing self-identity, gaining confidence to express their feelings, becoming more engaged in the learning process, and making more friends were discussed during the interviews. Teachers described a range of methods they used, such as ‘cook your regional food’ in lessons (PID 13), or ‘name two positive thing[s] about your friend’ (PID 2), to help refugee students feel accepted by their native, local classmates. It was mentioned that when refugee students felt valued and included through group activities by their peers, they became less isolated and were more likely to start conversations with teachers about their academic and personal concerns.

Yeah, so I’ve noticed that when all the students help each other out and work together, whether it’s in class or during art or sports, the refugee students actually feel a lot better. When their peers, especially native classmates, help them with schoolwork or group activities, it has a really positive effect on them. They feel like they’re really part of the school, and because of that [feeling], they find it so much easier to connect with me. (Female teacher, 31 years, primary school)

By assigning specific responsibilities to the student (e.g. ‘you [a refugee student] are this month’s Class Representative’ (PID 25)) and encouraging native classmates to provide positive feedback and reinforcement, teachers observed significant improvements in the student’s behaviour and engagement in the classroom, in their self-esteem and willingness to participate in group activities, which subsequently facilitated their communication with teachers. Such strategies had typically been developed informally, in collaboration with fellow teachers, to create a supportive peer network in the classroom.

One of my students was always really withdrawn. He wouldn't answer any questions in class. Then, one of my colleagues suggested that I try giving him some small responsibilities, just to help him stand out a bit more in front of his classmates. Some days, I’d have the whole class cheer him on for little tasks. And it really changed things. I noticed he started opening up more … . (Male teacher, 25 years, secondary school)

Another teacher, with over ten years of experience teaching refugee students, reported that increased recognition from peers helped refugee students receive more peer support, both academically and psychosocially, because of the empathy developed through these activities.

At the end of that [academic] year, I saw many situations like that, when Iranian students tried to help their [Afghan] classmates by sharing information about free health check-ups for refugee families or donating books to their [Afghan] friends. (Female teacher, 44 years, secondary school)

3.2.1.4. Subtheme four: building caring relationships with refugee students is essential

Teachers highlighted that the majority of refugee students come from single-parent households, due to parental death or absence due to ongoing conflicts in their homes or other countries. Given these circumstances, teachers described themselves as an important source of emotional support that may be lacking in many students’ homes. As the most accessible, non-familial adult figures in the social network of refugee children, teachers highlighted that supporting refugee students required fostering a sense of emotional safety achieved by building close relationships. Teachers explained that close, supportive relationships acted as a ‘guide’, enabling them to understand and respond to individual student needs and to connect them with school counsellors when professional support was needed. They also stressed that forming secure connections with refugee students, particularly newcomers who had recently experienced multiple adversities, helped these students to share their personal histories and communicate their mental health needs more comfortably.

Each of them has gone through so much hardship to get here. I was like a second mum or a friend to them … A heartfelt connection is kind of an essential prerequisite for encouraging them to speak and share their secrets or sad stories.. Sometimes when they’d tell me what they’d seen, I’d end up in tears. But, honestly, most of them don’t have anyone here besides us [teachers]. (Female teacher, 43 years, secondary school)

While strong teacher-student bonds allowed children to share their trauma-related experiences, teachers clarified that they were not well placed to provide therapy-like support in the classroom. Instead, building trusting relationships could create an opportunity for teachers to offer guidance on broader wellness topics, such as sleep and eating habits, personal hygiene (especially for female students), and stress management – areas in which students may have received very little instruction due to economic hardships and the limited educational backgrounds of their caregivers.

The relationship we build goes beyond being just a teacher to them … we often end up being even gentler with them than their own mothers might be. (Female teacher, 30 years, secondary school)

On the other hand, some teachers described that the parenting-related aspects of their job, requiring deep emotional engagement and listening to trauma-related personal stories, were both demanding and distressing.

When I listened to the horrors she [a refugee child] had been through or realised how much physical or emotional harm they were experiencing at home, I’d get upset … Sometimes I just can’t take it anymore, and I tell [myself], ‘I won’t ask them anything else so I don’t get even sadder.’ Our principal would say, ‘Don’t involve yourself; there are lots of cases like this here.’ And I’d say, ‘That’s true, there are many, but I don’t see or hear the others. This student has no one, and she comes to me and says, ‘You’re like my mother’, so I can’t ignore [her]. (Female teacher, 40 years, primary school)

3.2.2. Theme two: instrumental role of refugee caregivers within the school context for sustained support

Almost all teachers overwhelmingly endorsed that regular contact with refugee caregivers – whether biological parents (e.g. father, mother) or other relatives (e.g. grandparents, older siblings, aunts, uncles) – was fundamental to the effectiveness of teacher-provided support. While schools were recognised as the most accessible place for disadvantaged refugee students to receive educational, financial, and social support immediately following their arrival, teachers perceived that the positive outcomes of this support would be tangible only if they emerged from a collaborative effort involving refugee students, their caregivers, and teachers. Teachers emphasised that without this joint responsibility individual teacher efforts may be insufficient, resulting in students continuing to suffer from emotional distress and social problems outside the school.

What I'm saying is that refugee students come to school to spend about five or six hours of their day. I have no control over their home environment. To really support them, I need to monitor their home situation with the help of the parents. If the whole system could work together, with the school, the family, and the student all aligned as three sides of a triangle, then yes, the school could be a place to either prevent or help improve the psychological and social issues these students face. (Male teacher, 25 years, primary school)

3.2.2.1. Subtheme one: limited engagement between teachers and refugee caregivers

Consistent teacher-parent interaction was identified as key to bridging gaps between home and school when supporting students’ academic and socio-emotional development. Teachers emphasised that caregivers of refugee students were typically the most reliable source of background information about the students’ profiles, cultural and familial contexts and specific needs. However, they noted that refugee caregivers were frequently hard to reach.

We have to call them or there has to be an emergency issue for them to come. I've called and sent letters many times, but they don't follow up. Most refugee parents don't cooperate or come to school at all, especially newly arrived families. (Female teacher, 26 years, primary school)

Drawing on their professional experiences with refugee students’ family structure, teachers described, at length, several possible reasons why establishing mutual relationships with refugee caregivers proved challenging. Fear of being blamed or socially stigmatised, financial hardships, post-migration difficulties, such as dealing with paperwork or family separation, and the responsibilities of caring for multiple children in extended families were seen by most teachers as significant barriers to caregiver engagement. One teacher explained that refugee caregivers often prioritised work and meeting basic survival needs over school involvement, which, in return, placed additional demands on teachers to support their children at school.

I had a student whose father had passed away, and he was living with a stepmother. The whole family was pretty broken up. He was staying with his aunt’s family. One time, I noticed he had been beaten so badly that his ear needed stitches … I asked the school manager to call his family–his aunt and her husband. We called them three or four times, but they really didn’t care … . (Female teacher, 31 years, primary school)

A few teachers mentioned that newly arrived refugee caregivers had experienced significant stressful events and mental health problems, which impaired their ability and confidence to engage with teachers and respond to school-related inquiries.

Another refugee student began crying in class and refused to join others at break time. When I asked his mother to come to school, she told me all the horrific experiences they had endured – and I found that she had recently divorced … She did not have the capacity to support her child or follow up with the school. (Female teacher, 31 years, primary school)

3.2.2.2. Subtheme two: parental mental health literacy and parenting skills are linked to effective teacher support

Most teachers conveyed their belief that the lack of parental understanding regarding children’s emotional and behavioural needs posed significant threats to school progress. They observed that, in many cases, refugee caregivers were unable to identify and provide support for trauma-related mental health symptoms in their children, possibly due to limited mental health literacy and their own experiences of trauma. As a result, refugee children often turned to teachers to share their feelings or personal histories to seek emotional support. Teachers further described how maladaptive parenting strategies employed by some refugee caregivers, such as harsh parenting, not only negated the progress made at school but also exacerbated the children’s overall well-being.

I spent a lot of time working with one of my students, giving him some advice. Once, I invited his father to school to help him more, as the child cried a lot both at home and at school. When his father came, he brought a cable to beat him with and asked, ‘What did he do? I'll punish him right here.’ How can I help this student when his father has no understanding of their child's behaviour at home? (Male teacher, 41 years, primary school)

Teachers also emphasised the importance of aligning school-based support with the cultural values, norms, and practices observed at home to foster students’ mental well-being. While some teachers trusted and valued the educational guidance provided by refugee caregivers to encourage students’ academic achievements, most noted that children became ‘confused’ when they received contradictory advice from their caregivers and teachers regarding their emotional distress or social responsibilities within the school. Indeed, teachers felt frustrated when caregiver advice conflicted with their own recommendations due to perceived underdeveloped parenting skills and the limited educational literacy of refugee families.

Some [of refugee] parents really confuse [their] children. One [refugee] child asked me, ‘Should I always listen to them [refugee parent] just because they're older?’ I told him, ‘You should listen, but only to a certain point.’ He [refugee student] then said, ‘Sometimes, I cry at night because I'm scared. [But] my uncle tells me [you should] stop going to school and start working [to make money]. Should I listen to him?’ I [teacher] didn’t know how to answer this student. This mixed messaging causes problems for us. (Female teacher, 27 years, primary school)

3.2.3. Theme three: a multicultural school climate can better facilitate support provision

Many teachers noted that, beyond their individual role in supporting refugee students, the social interactions in the classroom (e.g. teacher-student or peer relationships), along with broader aspects of the school context (e.g. culturally responsive teaching practices and school policies), collectively influenced whether refugee students felt welcomed and included at school, ultimately shaping their sense of belonging and integration within the school community.

3.2.3.1. Subtheme one: the critical importance of non-refugee peers and parents

Teachers emphasised that the emotional well-being of refugee students was typically more affected by their interactions with native classmates than with their refugee classmates. Teachers described multiple scenarios in which positive peer relationships with native students facilitated newcomer students’ adjustment process and acculturation issues.

Well, good feedback and reactions our [Iranian] students give to the refugee students, honestly, it has a bigger impact than anything I can tell them … they really look forward to being approved by the Iranian students, whether it’s for something they’ve done or even just for their grades. (Female teacher, 40 years, primary school)

In contrast, some secondary school teachers described situations where native students displayed bullying or labelling, as a subset of behavioural discrimination, towards their refugee classmates. Increased violent behaviours, isolation, lowered self-esteem and identity confusion, poor academic performance and irregular school attendance were identified as negative consequences of such discrimination for refugees. Teachers emphasised that high incidences of discriminatory behaviours in the classroom could damage refugees’ emotional well-being and subsequently impede teacher efforts to provide effective support.

With the boys, we always had this issue where refugee children wouldn’t be allowed to join the football games – unless a few of them were really good and skilled enough that the others felt they had to let them in. Before a game, they’d say, ‘We’ll let the “Afghans” play if we need them!’. (Male teacher, 30 years, secondary school)

Teachers identified the significant role that non-refugee parents play in shaping their children's attitudes towards refugee students. Many teachers perceived that exclusionary attitudes amongst native students often originated within the family environment, which underscored the importance of engaging native families in promoting diversity and inclusion in educational settings. Several teachers recounted instances in which they observed parents of native students avoided enrolling their children in schools with a high intake of refugee populations. Such parental behaviours, criticised by most teachers, were seen as a contributing factor to the disengagement of refugee caregivers from the school community (see ‘Limited engagement between teachers and refugee caregivers’).

What’s interesting is that last year, for example, we had a few parents call the school saying they wouldn’t enrol their child if there were any immigrant students. Some parents even told us in group meetings on the first day that they wanted fewer refugee students in their child’s class. (Female teacher, 26 years, primary school)

3.2.3.2. Subtheme two: teachers’ discriminatory attitudes undermine refugee student support

Teachers agreed that classroom climates that were positive, inclusive, and non-discriminatory could enable teachers to better address the psychosocial and educational needs of refugee students, particularly those with complex mental health needs. However, some teachers reported feeling discouraged by other colleagues when they attempted to address the needs of refugee students. They believed that these attitudes held by other colleagues posed significant obstacles to providing long-term support, particularly when collaborative efforts were required.

Among my colleagues, there were comments like, ‘They [refugee students] are taking up space for [native] students’. They would act in a discriminatory way. Many colleagues avoid teaching at schools with refugee students. You can imagine what happens when they [refugee students] hear or notice these [behaviours] in the class. (Male teacher, 28 years, primary school)

Discriminatory behaviours amongst other school staff were seen by most teachers as highly problematic and a key hindrance to their own ability and confidence to advocate for the psychosocial needs of refugee students. However, some teachers acknowledged negative attitudes of their own, and most teachers lacked confidence in responding to or confronting negative attitudes amongst their colleagues.

The first year the administration assigned me to this school, I was really defensive around refugee students. Actually, I wasn’t very positive towards Afghan, Pakistani, and Iraqi communities living in Iran. But over the years, things changed, and now I help these students more than any others, whether it's with their studies or their social and behavioural health. (Male teacher, 41 years, primary school)

3.2.3.3. Subtheme three: fostering an inclusive school climate can promote belonging

Teachers also identified several factors that, while primarily educational, had significant secondary impacts on their support for refugee-background students. In particular, existing curriculum materials and educational resources were described as not age-appropriate or culturally relevant for refugee students. It was additionally highlighted that some school policies could make refugee students feel excluded, compromising their sense of belonging.

Sometimes, some school circulars say that refugee students are not allowed to participate in regional or national competitions. So, what am I supposed to do with a child who has worked hard all year to participate in competitions? These children really feel like outsiders at school when comparing themselves with their [native] peers. (Female teacher, 31 years, primary school)

Despite these challenges, which were difficult for teachers to control, some teachers shared their experience in using group sports clubs or interactive games to mitigate the adverse impacts of feeling excluded in the school environment. Activities that served to educate all students on the importance of inclusivity and diversity were found to be effective in compensating for structural gaps in the school system, fostering a more welcoming classroom atmosphere.

When [native] students don’t want to be in groups with Afghan students, I try to switch their groups and create activities focused on exploring each other’s food, customs, languages, and more, to help them understand our diversity … or sometimes I set up art or food exhibitions to introduce Iranian students to the culture and traditions of their refugee classmates. (Female teacher, 23 years, primary school)

3.2.4. Theme four: barriers to supportive teacher-student interactions

While some teachers reported adequate competence and skills to support students from refugee backgrounds, there was a strong consensus that addressing the unique needs of these students in socio-economically disadvantaged areas was highly challenging.

3.2.4.1. Subtheme one: financial hardship limits teachers’ capacity and motivation

Teachers highlighted that the emotional and educational support required by refugee students was highly intensive and emotionally exhausting. However, they believed their salaries did not reflect the level of effort and responsibility their work involved, which gradually reduced their motivation.

I mentioned earlier, my salary was 15,000,000 Rials [equivalent to $29 USD]. Even that hasn't been fully paid; they still owe me about four months’ salary from six months ago. Teachers lose their motivation to work under these financial difficulties. (Female teacher, 29 years, primary school)

Teachers pointed out that follow-up tasks, such as tracking students’ academic progress or assisting them in accessing social support services, often required additional time and effort outside their contractual duties. Without receiving a reasonable level of monetary compensation, it was emphasised that extending support to refugee students and their families beyond regular working hours became too much to handle, even when urgently needed. For many, financial issues were the most significant obstacle to supporting the refugee student population.

Because of the low pay, teachers don’t feel motivated to spend much time on students’ behavioural problems. The low salary and the huge amount of energy needed to work with refugee students are big challenges. Teachers just can’t go beyond their job responsibilities – they’re so caught up with their own family’s financial issues that they can’t focus on the students’ mental health. (Male teacher, 38 years, primary school)

3.2.4.2. Subtheme two: lack of trauma-informed training

Most teachers felt ill-equipped to offer formal support to students, relying on their own informal strategies due to a lack of training in trauma-informed approaches. While some engaged in self-directed learning, such as reading trauma-related materials, short online courses, or seeking advice from fellow teachers, with positive outcomes in fostering trust and encouraging students to share their feelings, the majority recognised that their current mental health literacy was insufficient to address the complex psychosocial needs of this vulnerable population.

I’d talk to them about stuff like what the laws are here and why we need to follow them, that’s about all I could do. Of course, if I knew how to help them with their sadness or horrific events, I could’ve done so much more for them. (Male teacher, 23 years, secondary school)

3.2.4.3. Subtheme three: limited access to school-based counselling services

Teachers highlighted that inadequate access to school-based mental health professionals had significant negative consequences for both teachers and students. Teachers mentioned that primary schools universally lacked dedicated school counsellors; consequently, teachers were often expected to address students’ complex emotional needs, despite a lack of training and confidence in providing therapy-like support. In some teachers, ‘secondary trauma’ was reported as a result of being exposed to such situations. School-based counselling services were therefore considered essential as they provided accessible psychological support for refugee students while also guiding teachers who experienced students’ disclosures of highly traumatic events. Additionally, on-site school versus community-based services were perceived to be advantageous in facilitating engagement, given the financial constraints and cultural barriers experienced by refugees.

When students have serious mental health problems or their parents, we need the help of the school counsellor or psychologist. We're just teachers … sometimes, they [refugee students] need professional help, not just general advice [from us] … (Female teacher, 40 years, primary school)

4. Discussion

Our novel exploration of teachers’ experiences in providing daily psychosocial support to refugee students living in deprived communities in Iran identified four key themes relating to: the professional experiences of teachers in recognising and addressing refugee students’ mental health needs; the fundamental role of refugee caregivers within the school environment; the inclusive context of school that facilitates teacher-led support; and key perceived barriers that impede teachers’ supportive efforts. The interconnections between these themes and their sub-themes are illustrated in Figure 1.

Figure 1.

Interconnected influences on refugee students’ school experiences in low-resource settings.

Note. This figure depicts the interconnected themes and sub-themes identified by teachers in our study that shape refugee students’ experiences at schools in resource-poor settings. Four primary influencer groups were recognised in this study: native parents, refugee caregivers, native peers, and teachers. The outer rings distinguish family interactions (on the left) and school interactions (on the right), as well as additional external factors (e.g. socio-environmental factors in family interactions and barriers/facilitators in school interactions) appear around the perimeter. Smaller arrows represent either reciprocal or one-way interactions, and larger arrows illustrate the broader directional influences amongst the main groups, demonstrating how these relationships may collectively impact refugee children’s psychosocial development in school.

The majority of Iranian teachers in our study identified schools as an optimal setting for refugee-background students to receive psychosocial support post-resettlement in under-resourced communities. Despite the assumption that teachers in these contexts might struggle to confidently address the psychosocial needs of refugee students due to limited training and resources (Schenzle & Schultz, 2024), our findings identified numerous proactive approaches amongst teachers aimed at creating an emotionally safe, supportive environment for refugee students. In fact, a central theme was the importance of caring teacher-student relationships in supporting vulnerable refugee students. Consistent with prior evidence (e.g. Baak et al., 2023; Kia-Keating & Ellis, 2007; Osman et al., 2020), teachers discussed that a strong attachment to their students cultivates a sense of emotional safety, encouraging refugee students to voluntarily disclose painful, trauma-related experiences. Such disclosures may build student confidence in school interactions and promote posttrauma recovery and growth (Yang, 2024). While teachers initially struggled to establish conversations with students, they observed that as trusting relationships developed gradually, refugee students felt more emotionally safe to disclose personal histories and negative feelings. This pattern of communicating emotions supports trauma-informed frameworks, which assert that safe, supportive attachments are essential for self-disclosure (Blaustein & Kinniburgh, 2018). Prior qualitative studies with school staff similarly indicate that rapport-building preceded any sharing of traumatic experiences (Barrett & Berger, 2021), particularly during the first months post-arrival (O'Toole Thommessen & Todd, 2018).

Most teachers also highlighted that meaningful attachment to refugee students worked as a ‘strategy’ for understanding their mental health concerns, managing trauma-induced emotions, and connecting them with school counsellors, or other services. Although studies in HIC contexts have highlighted challenges in maintaining close teacher-student relationships as facilitators of support (e.g. McDiarmid et al., 2021), our findings suggest that in some contexts, being emotionally attached to refugee children is a ‘prerequisite’ for effective psychosocial support, especially given refugee students’ tendency towards emotional inhibition (Sakulbumrungsil, 2024). This emphasis on building caring relationships with a trusted adult at school aligns with classroom-based practical recommendations for teachers at refugee schools and other recovery models (e.g. Blaustein & Kinniburgh, 2018; De Deckker, 2018) and UNICEF’s STARS model (2016), which, despite variations, include supportive teacher-student relationships as a key component.

All teachers in our study believed that caregivers of refugee-background students can facilitate or hinder positive outcomes of their support in the classroom. Qualitative studies on teachers in HICs have exclusively framed parental engagement within the school system as a means to discuss students’ academic progress (McDiarmid et al., 2021; Nagasa, 2014), rather than broader psychosocial support. Teachers in our study, however, highlighted that many refugee minors are highly dependent on parents to implement teacher advice or to gain access to services, and their caregivers might have poor knowledge of their children’s psychological needs, low mental health literacy, in conjunction with limited financial resources (May et al., 2014). Consequently, even when students sought teacher support, this was sometimes undermined by negative caregiver behaviours or conflicting advice. Notably, traditional cultural norms may discourage help-seeking outside the family unit, and teachers noted limited emotional expression amongst some refugee students that contributed to school isolation. This finding may confirm Pastoor’s (2017) argument that psychosocial needs of refugee minors involve multiple interconnected factors and are unlikely to be addressed by a single group such as teachers. Therefore, future studies should examine the existing barriers to parental engagement in teachers’ support approaches. Importantly, culturally sensitive interventions are needed to normalise mental health issues and reduce stigma around help-seeking behaviours, particularly in communities where stigma may be prevalent in both host and refugee populations.

Another theme was related to the context of the school and how a multicultural school climate that acknowledges refugee students’ values and capabilities may promote a sense of attachment to the school community. This finding aligns with the evidence indicating that inclusive educational environments positively affect refugee minors’ emotional well-being, academic performance, and willingness to seek support from a trusted teacher (Arora et al., 2024; Chang & Le, 2010; Magan et al., 2024). In the Iranian context, particularly in culturally homogenous communities, the openness to multiculturalism may be limited or even actively discouraged (Badamchi, 2018). The impact of this attitude was observed by teachers in the negative perceptions of native students, their parents, and sometimes other teachers, towards refugee classmates, which were an impediment to teacher attempts to shape a supportive school culture. Teachers in our study believed ‘being multicultural’ should go beyond superficial inclusion (e.g. adapting teaching materials) to address deeper layers of social interactions amongst students, teachers, and caregivers – both refugees and non-refugees. Indeed, a system of care built on empathy by teachers and recognition from native peers, can help empower refugee students, bringing substantial potential benefits. Successful ‘absorption’ of refugee children into Iranian school communities (Komasi, 2023) can ultimately boost their confidence to seek diverse forms of support in the wider community (Fazel, 2015). In line with this, teachers in this study made specific recommendations regarding psychoeducation training programmes to improve refugee caregivers’ engagement and parenting skills, while also educating non-refugee parents to better understand the cultural nuances and vulnerability of refugee families.

While teachers in this study perceived themselves as front-line responders to the trauma-related symptoms of refugee students, they highlighted that low salaries, insufficient trauma-informed training, and inadequate school counselling services further intensified their already demanding role. Much of the existing literature on teacher barriers in supporting refugee children comes from well-resourced schools, where issues such as cultural and linguistic differences (Cowling & Anderson, 2021), unclear professional responsibilities (McDiarmid et al., 2021), inadequate training (Barrett & Berger, 2021), and limited health services (Mock-Muñoz de Luna et al., 2020) have been well-documented. In the context of Iran’s economic instability, teachers experienced significant occupational burdens due to their increasing stress level, compounded by low and delayed salary disbursements, which adversely affected their actual sense of commitment towards students. Many teachers expressed that even basic educational and social support for refugee students required additional hours beyond their standard workload. Indeed, they perceived inadequate financial compensation as a sign of unacknowledged effort by school policymakers, which contributed to feelings of demotivation and reduced their long-term commitment to proactively supporting refugee students. This finding aligns with a recent study by Schenzle and Schultz (2024) in Lebanon, another economically vulnerable country, where teachers reported that economic-related stressors and delayed salaries limited their capacity to support refugee students. Our findings suggest that the challenges faced by teachers may be highly context-specific, influenced by socio-economic factors outside of the classroom/school environment. Therefore, findings from the current study and the wider literature highlight the critical need for more research in order to adapt existing social support frameworks to address the socio-cultural and unique needs of understudied, resource-poor populations (Karkouti et al., 2021; Miller & Berger, 2020).

4.1. Strengths and limitations

Our research provides unique insights into the experiences of teachers working with trauma-exposed refugee students in limited-resource classrooms in an LMIC context. We recruited a robust mixed-gender sample of thirty teachers from primary and secondary schools, ensuring good representation of a hard-to-reach sample. Through close collaboration with a local NGO (HAMI), the interview guide was co-developed to address context-specific considerations, translated and back-translated and piloted to ensure suitability. Flexible interview formats maximised participant engagement. To ensure that cultural dimensions and idiomatic expressions of the original interview language were precisely captured in transcripts (Wong & Poon, 2010), this study employed two bilingual researchers who analysed the data in Farsi, which further strengthened the trustworthiness of our findings. The limitations of this study should also be considered. First, while purposive sampling was used to capture diverse perspectives and experiences of teachers on supporting refugee students, the sample had overrepresentation of teachers working with Afghan refugee students, which may limit the representativeness of the sample and the generalisability of the findings – particularly as no teachers in this study were recruited from refugee-only schools. Second, this study focused solely on teachers’ perspectives on the psychosocial and mental health support needs of refugee students in deprived communities. Future research capturing student experiences, and potentially those of refugee caregivers – whose central role was highlighted in this study – is essential to gain a fuller understanding of school-based support mechanisms for trauma-exposed refugee students.

4.2. Implications

In this study, we found that schools in poor communities, where the majority of Afghan refugee families resettle in Iran, provide psychosocial support to refugee students, with teachers successfully using several strategies to meet students’ needs. This highlights schools as a key potential context in which support for refugee families can be further augmented. Yet, our findings also point out the necessity of a coordinated, multi-level approach to foster refugee students’ mental health in resource-limited educational contexts.

For policymakers and education departments, our findings provide novel insight into teachers’ needs when supporting trauma-exposed refugee students, and highlight areas where further investment is required. For instance, educational authorities could invest in trauma-informed development – providing formal, ongoing training about students’ trauma-related needs; designing peer-support networks for staff; allocating hardship allowances; and assigning school-based counsellors to handle complex cases – to equip teachers to identify and respond to refugee students’ complex mental health needs. Importantly, additional resources should be allocated to scale up existing support programmes outside of schools (e.g. the national programme of NEMAD, see Akbari Zardkhaneh et al., 2023), so that teachers can refer students to formal healthcare professionals in severe cases. Considering the influx of refugee families to Iran and the accessibility of schools for refugee children and adolescents, policy reforms should also enable partnerships with local NGOs to deliver school-based counselling services to refugee students and their families, where specialist mental health services are not accessible or affordable.

Researchers and professionals may also wish to investigate the parental microsystem in future studies, building on our finding that limited caregiver engagement with school staff and low mental health literacy in refugee caregivers can undermine school-based efforts; doing so would strengthen family–school interactions and ultimately facilitate any teacher-delivered mental health interventions and programmes. For interventionists and mental health practitioners aiming to engage paraprofessionals – such as teachers or community volunteers – as stakeholders in school-based mental health interventions in resource-poor settings, our results provide limited but promising evidence that teachers are potentially capable and confident in supporting the mental health of refugee students. However, their responsibilities and job descriptions should be realistically aligned with their non-therapeutic roles to avoid adding to the emotional load and secondary trauma already experienced by teachers when they routinely address refugee students’ needs. Finally, the interconnections between themes and subthemes in our findings highlight the complexity and ongoing challenges in refugee students’ mental health needs, and inform the importance of developing multimodal school-based interventions that operate at all dynamic levels of the ecological framework – including individual, interpersonal, community, and environmental/society levels.

5. Conclusion

To summarise, this study provides new evidence on how schoolteachers in poorly resourced communities respond to the trauma-related mental health needs of refugee students in Iran. Despite significant limitations in resources and training, teachers reported playing a crucial role in providing both basic and, at times, therapy-like psychosocial support to refugee-background students. Our findings show that while teachers recognise their role as primary support providers, a key challenge remains the limited involvement of refugee caregivers in addressing their children's complex psychosocial needs within the school context. As social support systems outside of schools in high-adversity contexts may provide limited support for refugee children’s needs, our study highlights the need for education departments and policymakers to engage teachers as key stakeholders in school-based interventions to support refugee children’s posttrauma adjustment and provide a safe environment for their caregivers to access psychoeducation programmes.

Funding Statement

This work is part of an Economic and Social Research Council (ESRC) SWDTP-funded PhD project [grant number 2689613].

Disclosure statement

No potential conflict of interest was reported by the authors.

Data availability statement

The authors confirm that the data supporting the findings of this study are available within the article and its supplementary materials.

Supplemental Material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/20008066.2025.2551736.