Living Conditions and the Mental Health and Well-being of Refugees: Evidence from a Large-Scale German Survey

Abstract

Refugees are at an increased risk of mental health problems and low subjective well-being. Living circumstances in the host country are thought to play a vital role in shaping these health outcomes, which, in turn, are prerequisites for successful integration. Using data from a representative survey of 4325 adult refugees who arrived in Germany between 2013 and 2016, we investigated how different living conditions, especially those subject to integration policies, are associated with psychological distress and life satisfaction using linear regression models. Our findings show that an uncertain legal status, separation from family, and living in refugee housing facilities are related to higher levels of distress and decreased life satisfaction. Being employed, contact to members of the host society, and better host country language skills, by contrast, are related to reduced distress and higher levels of life satisfaction. These associations should inform decision making in a highly contested policy area.

A Systematic Review of Factors Affecting Mental Health and Well-Being of Asylum Seekers and Refugees in Germany

“…On the depression subscale of the MHI-18, where higher scores from a total score of 0 to 100 indicate better mental health, females showed a depression mean score of 14.47 (SD = 4.84) (59). In the study by Walther et al (58), participants reported a mean value of 3.14 on the Patient Health Questionnaire for Depression and Anxiety [PHQ-4; (79)], indicating mild psychological distress on average in the past 2 weeks which was higher than the mean score of 1.76 previously determined as the rate for the general German population (80). On the Mental Health Component Summary Scale (MCS), which indicates "a state of mental health well-being" with a total score from 0 to 100, with higher scores indicating better mental health, mean scores of 47.9 and 49.17 were recorded, indicating lower mental health on average, especially among females (M = 46.1), than in the host population (56,57).…”

“…Seventeen different instruments were used in these studies. In six studies, questionnaires were completed by participants (self-report) (50,52,53,55,61,62), while the studies by Comtesse and Rosner (54) and Kaltenbach et al (60) used semi-structured clinical interviews, and five studies conducted computer-assisted face-to-face interviews (51,(56)(57)(58)(59). All instruments used in the studies and their validity are presented in Supplementary Table A3.…”

Out There on Your Own: Absence of the Spouse and Migrants' Integration Outcomes

“…According to the analysis, the source of stress most frequently named by migrants is their inability to reunite with their family. Recently, Walther et al (2019) have confirmed the effects of family separation on stress levels and wellbeing, using a comparatively large sample of refugees in Germany.…”

Thirty Years of Human Rights Study in the Web of Science Database (1990–2020)

“…This is justified by the aspects that affect the wellbeing of refugees or asylum seekers, as they experience a displacement processes, the loss of the feeling of belonging to a geographical space, the distance from their family and cultural environment, and their exposure to situations of violence and xenophobia [ 50 , 51 ]. There are specific risks and exposures which often occur during the migration trajectory [ 52 ] which cause a prevalence of high levels of distress, life dissatisfaction [ 51 ], anxiety, depression, and suicidal ideation [ 53 , 54 ]. It is possible to infer that the subjective aspects of the psychological suffering of refugees are intrinsically related to the feelings of exclusion and the methods of oppression and violence they face.…”