INSIGHT The analysis also revealed that living conditions impact the likelihood of depression among refugees. Refugees living in camps or settlements are slightly less likely to experience depression than those living outside of them,116 while refugees hosted in urban areas are 40 per cent more likely to be depressed compared to those in rural areas. Also, refugees living in households with worse living conditions, including limited access to electricity, water and sanitation facilities or those households that own fewer key assets for livelihood, are twice as likely to report suffering from depression. Figure 11 | Consultations for mental health disorders and related conditions in UNHCR-supported health facilities | 2021 - 2024 117 175K 174K 146K 150K Number of consultations 8% 100K 5% 50K 0K 2.9% 2.3% 2021 1.7% 1.9% 2022 2023 Access to mental health services In 2024, medical staff in UNHCR-supported health facilities provided over 175,000 medical consultations for mental health and related conditions (see figure 11).118 Psychologists, social workers and community volunteers also provided psychological support. Overall, the number of consultations for mental health and psychological support declined by 6 per cent compared to the previous year. The fall was driven by reduced financial support, particularly for community-based psychosocial programmes.119 An assessment of health and well-being challenges affecting Ukrainian refugees in Europe identified several barriers to accessing care.120 It found that 23 per cent of refugees experienced mental health 2% 2024 Percentage of mental health consultations 150K 10% 0% issues, yet less than half of them (46 per cent) sought care. The key barriers reported by refugees were the accessibility of services in terms of language, concerns about the affordability of care, the limited availability of services, long waiting times and the stigma associated with using these services. These challenges are likely to increase as the impact of declining levels of humanitarian and development aid is felt. Worryingly, refugees’ access to essential mental health services is likely to be disproportionately impacted, especially in lowincome countries. The uncertainty surrounding refugees’ futures and pathways for durable solutions only deepens the challenges they face in accessing care. Refugees are concerned about the efficiency and fairness of the asylum process, their legal status and opportunities 116 See Settlement Typologies in Emergencies. The proportion in camps or settlements includes formal settlements, informal settlements, collective centres and transit centres. 117 The statistics represent consultations by healthcare personnel in UNHCR-supported health facilities, but not psychological support provided in other settings. See Annual Public Health Global Review – 2024, UNHCR. 118 See Strengthening Mental Health and Psychosocial Support in UNHCR. Annual Report 2024, UNHCR. 119 Ibid. 120 See Navigating Health and Well-being Challenges for Refugees from Ukraine, UNHCR. 32 UNHCR > GLOBAL TRENDS 2024