By the top of 2023, More than 100 million people worldwide were displaced. Their homes resulting from war, violence, fear of persecution and human rights violations.
Most are hosts. Low and middle income countrieswhere many individuals live in overcrowded camps or urban settlements, With limited access to food, employment and essential services. Many endure. Traumatic experiences Not only before their migration but additionally during and after it. They face armed conflict, marginalization and poverty at every stage of their journey.
These experiences can add up. Chances of developing a mental health disorderwho can. Persists for years after relocation.. This makes it harder for refugees. earn a living And integrate into society.
As World Health Organization (WHO) Director General Tedros Adhanom Ghebreyesus said 2019 Global Refugee Forum:
It is a hidden epidemic and a silent killer. The news shows us the devastation of war. They show us refugees on the move, refugees in cities and refugees in large camps. But they don't show us inside people's minds, the way it affects their lives … wounds heal. Houses are rebuilt. The news cycle continues. But psychological wounds often go unnoticed and untreated for years.
Despite this recognition, there are gaps in what is understood in regards to the mental health of refugees.
Most studies deal with host refugees. High income countriesthough 75% refugees Live in low and middle income countries.
We have one A multi-country survey 16,000 refugees and host community members in cities and camps in Kenya, Uganda and Ethiopia. At the time of our research (between 2016 and 2018), these three countries hosted about 40% Of the refugees in Africa – about 1.8 million people. The survey included Congolese and Somali refugees from many of the sites, in addition to South Sudanese refugees in camps in Kenya.
Our study found that refugees in East Africa experienced higher rates of depression (31%) and functional impairment (62%) than the host population (10% and 25%, respectively).
The prevalence was even higher amongst those exposed to prolonged periods of violence and displacement. They also faced more economic hardships, resembling high unemployment, low wages and poor food.
Our findings highlight the profound impact of mental health on refugees' ability to rebuild their lives. This highlights the urgent need for targeted screening and evidence-based treatment to forestall the vicious cycle of mental illness, economic hardship and poor social integration.
which we studied.
Our study had three primary objectives.
First, we desired to see how common depression is in several refugee groups and the way this compares to local host communities. We measured depressive symptoms using a Questionnaire which might predict moderate to severe depression. We too Measured How well people were capable of perform on a regular basis activities, resembling getting around, completing tasks and participating in community life – abilities which might be often affected by depression.
Second, we wanted to grasp how past experiences of violence – before refugees fled their home countries – affected their mental health. Used it Event data which tracked violent incidents in refugees' home districts through the three years before they fled and a subjective, self-reported measure of violence experiences. This allowed us to review the connection between violence and depressive symptoms.
And third, we explored the hidden toll depression has on various life domains, including employment, health, and overall well-being.
High levels of depression
The study found that 31% of refugees suffered from depression, in comparison with 10% of individuals in nearby host communities.
A staggering 62% of refugees reported difficulties working, in comparison with 25% of host community members. For example, many refugees reported moderate to severe difficulties walking (35%), doing household chores (31%), concentrating (22%), or participating in community activities. In joining (24%).
Women, older refugees, and those that had been in exile for long periods of time suffered particularly poor mental health.
More than half of the refugees surveyed experienced or witnessed violence either of their home countries or while fleeing. Refugees who experienced violence were roughly 17 percentage points more more likely to experience depression, and 18 percentage points more more likely to report functional impairment.
We also found a “feedback” relationship between violence and depression. This implies that the more violence refugees were exposed to, the more serious their mental health worsened over time.
The impact of violence and depression extends far beyond mental health. Along with high levels of depression, refugees and victims of violence also faced significant economic challenges. They were more more likely to be unemployed, receive low wages, have poor diets, and report low life satisfaction.
This shows that depression directly affects individuals by limiting their ability to operate. It also not directly hinders their possibilities of rebuilding a stable, fulfilling life.
Mental health interventions
Our findings highlight that refugees – particularly victims of violence and prolonged exile – are disproportionately affected by depression. It is difficult for them to realize economic stability and integrate into their host communities.
We also found that mental health problems worsen the longer refugees remain in exile, emphasizing the necessity for early screening for mental illness.
Based on our findings, we hypothesize that effective treatment of depression could potentially create a virtuous cycle, improving each the mental health of migrants and other broader economic outcomes. This makes a robust case for investing within the mental health of refugees in low- and middle-income countries.