The COVID-19 pandemic is a defining global health crisis of our time. While the impact of COVID-19, including its mental health impact, is increasingly being documented, there remain important gaps regarding the specific consequences of the pandemic on particular population groups, including refugees and migrants. This study aims to uncover the impact of the COVID-19 pandemic on the mental health of refugees and migrants worldwide, disentangling the possible role of social and daily stressors, i.e., experiences of discrimination and daily living conditions. Descriptive analysis and structural equation modeling were used to analyze the responses of N = 20,742 refugees and migrants on the self-reporting global ApartTogether survey. Survey findings indicated that the mental health of refugees and migrants during the COVID-19 pandemic was significantly impacted, particularly for certain subgroups, (i.e., insecure housing situation and residence status, older respondents, and females) who reported experiencing higher levels of increased discrimination and increases in daily life stressors. There is a need to recognize the detrimental mental health impact of the COVID-19 pandemic on particular refugee and migrant groups and to develop interventions that target their unique needs.

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BackgroundThe conflict-ridden context of eastern Congo has set the scene for grueling human rights violations, with sexual violence as one of the ‘weapons of war’. Currently, sexual violence continues, with a considerable increase in civilian perpetrators. However, little is known regarding the particular impact of different experiences of sexual violence on adolescents’ mental health. This study therefore investigates the impact of sexual violence on eastern Congolese adolescents’ mental health and its differing associations with daily stressors, stigma, and the labeling of sexual violence (as ‘rape’ or ‘non-consensual sexual experience’).MethodsA cross-sectional, population-based survey design was implemented in 22 secondary schools, randomly selected from a stratified sample, in Bunia, eastern Congo, a region extensively affected by war. A total of 1,305 school-going adolescent girls aged 11 to 23 participated. Self-report measures of mental health symptoms, war-related traumatic events, experiences of sexual violence, daily stressors, and stigmatization were administered. Differences in sociodemographic characteristics, traumatic experiences and daily and social stressors between types of sexual violence (rape, non-consensual sexual violence, no sexual violence) were explored through statistical analysis. ANCOVA analyses investigated associations between those risk factors and adolescents’ mental health.ResultsMore than one third of eastern Congolese adolescent girls reported experiences of sexual violence. Elevated levels of daily stressors, experiences of stigmatization, and stressful war-related events were found amongst girl victims of sexual violence, with the highest levels for girls who labeled the sexual violence as rape. Daily stressors, stigmatization, and war-related events showed a large impact on the girls’ mental health. Last, girls who labeled the sexual violence as non-consensual sexual experiences reported more post-traumatic hyper-arousal and intrusion symptoms compared to those labeling the sexual violence as rape.ConclusionsThese findings point to the important association between how war-affected adolescent girls label sexual violence (rape or non-consensual sexual experiences) and their mental health. This study also documents the large impact of sexual violence on other stressors (daily stressors, stigmatization, and stressful war events) and the impact of these stressors on girl victims’ mental health. It discusses important implications for addressing sexual violence and its consequences in war-affected contexts.

Teachers play a critical role in providing social and emotional support for newly arrived migrant and refugee learners. Such care ordinarily takes place in the classroom, raising questions about the impact of the 2020 COVID-19 school closures on their care work. In this article we analyze qualitative data from phone interviews with eight teachers in Danish preparatory classes, paying particular attention to the challenges they faced staying in contact with, and supporting, migrant and refugee learners during the school closure. The interviews were coded and thematically analysed, revealing significant changes in the teachers' care work. We draw on the concepts of caringscapes and carescapes to unravel how the shifts in space, from physical copresence in the school classroom to distance learning, affected their care work. Despite many efforts, teachers reported difficulties staying in contact with the learners remotely due to their limited access to virtual communication platforms and language barriers. These communication difficulties and the lack of bodily copresence not only made teaching highly challenging, but interrupted their care work, including maintaining daily schedules and facilitating social closeness between learners. Furthermore, the teachers expressed concern about their inability to link and refer the most vulnerable learners to external support services, which were temporarily closed due to the societal lockdown. Our study highlights how COVID-19 induced school closures constrain the care work of teachers of migrant and refugee learners. The concerns and struggles raised in this article not only stress the importance of the physical school space and closeness in facilitating care for newly arrived migrant and refugee learners, but signal the vulnerabilities of this group of children during times of crisis.

While scholarly literature indicates that both refugee and non-refugee migrant young people display increased levels of psychosocial vulnerability, studies comparing the mental health of the two groups remain scarce. This study aims to further the existing evidence by examining refugee and non-refugee migrants' mental health, in relation to their migration history and resettlement conditions. The mental health of 883 refugee and 483 non-refugee migrants (mean age 15.41, range 11-24, 45.9% girls, average length of stay in the host country 3.75 years) in five European countries was studied in their relation to family separation, daily material stress and perceived discrimination in resettlement. All participants reported high levels of post-traumatic stress symptoms. Family separation predicted post-trauma and internalizing behavioral difficulties only in refugees. Daily material stress related to lower levels of overall well-being in all participants, and higher levels of internalizing and externalizing behavioral difficulties in refugees. Perceived discrimination was associated with increased levels of mental health problems for refugees and non-refugee migrants. The relationship between perceived discrimination and post-traumatic stress symptoms in non-refugee migrants, together with the high levels of post-traumatic stress symptoms in this subsample, raises important questions on the nature of trauma exposure in non-refugee migrants, as well as the ways in which experiences of discrimination may interact with other traumatic stressors in predicting mental health.

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Background The COVID-19 pandemic has had a disproportionately hard impact on refugees and other migrants who are often exposed to the virus with limited means to protect themselves. We tested the hypothesis that during the COVID-19 pandemic, refugees and other migrants have suffered a negative impact on mental health and have been unjustly discriminated for spreading the disease in Europe (data collection from April to November 2020). Methods Participants in the ApartTogether Survey (N = 8297, after listwise deletion of missing items final N = 3940) provided data regarding to their difficulties to adhere to preventive recommendations against COVID-19 infection (CARE), self-perceived stigmatization (SS), and psychological distress (PD). Structural Equation Modeling was used to investigate PD as a mediator in the pathway linking CARE to SS, while adjusting for the housing and residence status. To improve confidence in the findings, single hold-out sample cross-validation was performed using a train/test split ratio of 0.8/0.2. Results In the exploratory set (N = 3159) SS was associated with both CARE (B = 0.200, p < 0.001) and PD (B = 0.455, p < 0.001). Moreover, PD was also associated with CARE (B = 0.094, p = 0.001) and mediated the effect of CARE on SS (proportion mediated = 17.7%, p = 0.001). The results were successfully replicated in the confirmation set (N = 781; total effect = 0.417, p < 0.001; proportion mediated = 29.7%, p < 0.001). Follow-up analyses also found evidence for an opposite effect (i.e., from SS to CARE, B = 0.132; p < 0.001), suggesting that there might be a vicious circle between the self-perceived stigmatization and the access to health care and the use of preventive measures against COVID-19 infection. Conclusions Refugees and other migrants who had more difficulties in accessing health care and preventive measures against COVID-19 infection experienced worse mental health and increased discrimination. These negative effects appeared to be stronger for those with more insecure housing and residence status, highlighting from one side the specific risk of insecure housing in the impact of COVID-19 upon mental health and infection protection, and for another side the need to proper housing as a strategy to prevent both COVID-19 and mental distress.