INSIGHT Insight – what do we know about the mental health of refugees? Overview Understanding localized situations With increasing displacement due to conflict and disasters, concerns have grown about the health and well-being of forcibly displaced people. These populations face many health challenges, such as infectious and chronic diseases, malnutrition, access to basic healthcare and interrupted treatment. People struggling with mental health issues are frequently overlooked. The World Health Organization estimates that 970 million people live with mental health issues worldwide (one in eight people).106 Anxiety and depressive disorders are the most prevalent, affecting everybody: young, old, women and men. These disorders are prevalent in all countries, rich and poor. Notably, 82 per cent of people with mental health issues live in low- and middle-income countries.107 Situations of displacement differ in terms of their context, duration and severity, yet they each have a profound and broad impact on mental health. For example, depression is a common concern among forcibly displaced people. In displacement situations, its prevalence varies greatly, as shown by several large-scale studies.110 Newly available data from UNHCR’s Forced Displacement Survey (FDS) and similar studies from several countries is helping to highlight the prevalence of mental health issues among refugees and other forcibly displaced people. While mental health issues can affect anyone, refugees and other forcibly displaced people often endure multiple stressors that affect their mental health and well-being.108 These stressors can occur before, during and after their journey to safety, including during their settlement and integration into new environments. They can include abuse, violence, significant losses, economic hardship and uncertainty for the future. Therefore, the mental health of forcibly displaced people is an important indicator of refugee health and well-being. There are clear interrelated and bidirectional links between mental health and sustainable development.109 Addressing these mental health challenges will contribute to the achievement of the Sustainable Development Goals (SDGs) on Health and Well-being. Progress in other SDGs, such as No Poverty, Zero Hunger, Quality Education and Reduced Inequalities could also have a positive effect on mental health. Insights from UNHCR’s Forced Displacement Survey One of the focus areas of the FDS is to systematically collect nationally representative data about refugees and host communities,111 including their health and well-being.112 To date, surveys have been conducted in South Sudan, Pakistan and Cameroon. In total, more than 12,000 refugees and members of host communities have been surveyed across the three countries, providing a rich and authoritative data source to better understand the mental health challenges affecting refugees and host communities. The surveys show that refugees in all countries have a higher estimated prevalence of depression compared to the host populations (see figure 9).113 In the FDS surveys, the estimated prevalence of depression is 16 per cent among refugees and 12 per cent among host populations. While the specific circumstances vary across different displacement situations, the surveys show that whatever their situation, refugees are at a higher risk of depression than the host communities. These findings align with other studies that have consistently shown similar trends, highlighting the significant mental health challenges faced by refugee populations. 106 See World Mental Health Report, World Health Organization. 107 These countries also host 73 per cent of refugees. 108 See New WHO prevalence estimates of mental disorders in conflict settings: a systematic review and meta-analysis, Charlson et al. 109 See World Mental Health Report, World Health Organization. 110 See Epidemiology of depression among displaced people: A systematic review and meta-analysis, Bedaso and Duko; Prevalence of Mental Distress Among Syrian Refugees With Residence Permission in Germany: A Registry-Based Study, Georgiadou et al; The prevalence of mental illness in refugees and asylum seekers: A systematic review and meta-analysis, Blackmore et al; Depression, violence and socioeconomic outcomes among refugees in East Africa: evidence from a multicountry representative survey, Pozuelo et al; and Prevalence of mental disorders in refugees and asylum seekers: a systematic review and meta-analysis, Patanè et al. 111 In the Forced Displacement Survey, host community is defined as “nationals who live in proximity to refugees/asylum-seekers”. This includes refugees and asylum-seekers within camps and settlements, integrated into households, or living independently. The socio-economic or healthrelated characteristics or access to health services of the host community may differ from refugees and the general population of the host country. 112 See Forced Displacement Survey, UNHCR. 113 In the Forced Displacement Survey, depression was assessed using respondents’ answers to the Patient Health Questionnaire 9. The international standard score of 10 or higher was used as indicative for probable depression. 30 UNHCR > GLOBAL TRENDS 2024