The pandemic's stifling days may be long gone but the toll on Australians' mental health still lingers, especially for refugee women.
Some 650 women were surveyed for a study published in a public health journal, including 52 per cent from a refugee background.
Almost 70 per cent of the refugee respondents had a problem or very serious problem with fear or stress prompted by COVID-19 compared to 47 per cent for the non-refugee women.
Researcher Nawal Nadar said traumatic flashbacks that marked the forced migration were never truly gone.
"For a lot of women, the pandemic brought up bad memories and although we don't have lockdowns anymore, it's far from over," she said.
"They've been through a lot - they had to leave their villages, their homes - they've lost everything."
Ms Nadar, who fled civil war in Lebanon before arriving in Australia, works as a maternity liaison officer in western Sydney.
This lived experience helped her connect with the women interviewed.
Led by University of NSW professor Susan Rees, the women were recruited from three public antenatal clinics in refugee-dense areas in Sydney and Melbourne.
About half of the women were Australian-born and the other half were of refugee background from countries including Iraq, Lebanon, Sri Lanka and Sudan.
"When people talk about mental health, they don’t often look at the unique experiences of women who have come to Australia from conflict-affected backgrounds," Dr Rees said.
"Not enough attention is given to supporting people financially, socially and psychologically when they arrive in Australia and settle here."
The psychiatry professor pointed to refugee women of child-bearing age being particularly at risk of experiencing mental distress.
She also said pandemic stressors could be trauma triggers, where a situation induced someone to recall an experience which exacerbated their mental ill health.
"Lockdowns triggered a large concern because some of these people come from regimes where they’ve been controlled and persecuted," Dr Rees said.
"When there was police presence on the streets in western Sydney, that caused a lot of anxiety."
One in three of the Australian-born women in the study published in PLOS Global Public Health reported financial hardship prompted by the pandemic's job losses but that rate was again higher for women from refugee backgrounds.
"For many people who have trauma or are socially or economically disadvantaged, the pandemic is far from over," Dr Rees said.
Lifeline 13 11 14
beyondblue 1300 22 4636
