Refugees in east Africa suffer from high levels of depression, making it harder to rebuild lives – new study

Refugees in East Africa Suffer from High Levels of Depression, Making it Harder to Rebuild Lives – New Study

A Growing Global Issue

By the end of 2023, more than 100 million people globally had been forced to flee their homes due to war, violence, fear of persecution, and human rights violations.

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The Reality of Refugee Life

The majority of these individuals are hosted in low- and middle-income countries, where they often live in overcrowded camps or urban settlements, with limited access to food, employment, and essential services. Many endure traumatic experiences not only before their displacement but also during and after it. They face armed conflict, marginalization, and poverty at every stage of their journey.

The Mental Health Conundrum

These experiences may increase the likelihood of developing mental health disorders, which can persist years after displacement, making it harder for refugees to earn a living and integrate into society. As World Health Organization (WHO) Director-General Tedros Adhanom Ghebreyesus said at the 2019 Global Refugee Forum:

"It’s a hidden epidemic and a silent killer. News reports show 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 the minds of the people and how it affects their lives… Wounds heal. Homes are rebuilt. News cycles move on. But the psychosocial scars often go unnoticed and untreated for years."

The Reality of Mental Health in Refugee Settings

Despite this recognition, there are gaps in what’s known about the mental health of refugees. Most studies focus on refugees hosted in high-income countries, even though 75% of refugees live in low- and middle-income countries.

A Multi-Country Study

Our team conducted a multi-country survey of 16,000 refugees and host community members in cities and camps across Kenya, Uganda, and Ethiopia. We found that refugees in East Africa experienced higher rates of depression (31%) and functional impairment (62%) compared to the host population (10% and 25%, respectively).

The Impact of Mental Health on Refugees’ Ability to Rebuild Their Lives

Our study highlights the profound impact of mental health on refugees’ ability to rebuild their lives. It highlights the urgent need for targeted screening and evidence-based treatments to prevent a vicious cycle of mental disorders, economic hardship, and poor social integration.

What We Studied

Our study had three main goals:

1. To investigate how common depression was among different refugee groups and how it compared to the local host communities.
2. To understand how past experiences of violence – before refugees fled their home countries – affected their mental health.
3. To explore the hidden toll depression takes across different life domains, including employment, health, and overall well-being.

High Levels of Depression

The study found that 31% of refugees were depressed, compared to 10% of people in nearby host communities. A staggering 62% of refugees reported difficulties in functioning, compared to 25% of host community members.

The Impact of Violence on Mental Health

Refugees who experienced violence were about 17 percentage points more likely to experience depression, and 18 percentage points more likely to report functional impairment. We also found a "dose-response" relationship between violence and depression, meaning the more severe the violence refugees experienced, the worse their mental health became over time.

Mental Health Interventions

Our results highlight that refugees – particularly those exposed to violence and prolonged exile – are disproportionately affected by depression. It’s harder for them to achieve economic stability and integrate into their host communities. We also found that mental health issues get worse the longer refugees remain in exile, underscoring the need for early screening for mental illness.

Conclusion

The study’s findings emphasize the urgent need for mental health interventions in low- and middle-income countries, where the majority of refugees reside. Effective treatment of depression can create a virtuous cycle, improving both refugees’ mental health and other broader economic outcomes. This makes a strong case for investing in refugees’ mental health in these countries.

FAQs

Q: How many people were forced to flee their homes due to war, violence, fear of persecution, and human rights violations by the end of 2023?
A: More than 100 million people globally.

Q: Where are most refugees hosted?
A: The majority are hosted in low- and middle-income countries.

Q: What are the consequences of trauma and displacement on refugees’ mental health?
A: Refugees may experience higher rates of depression and functional impairment, making it harder to rebuild their lives and integrate into their host communities.

Q: What are the long-term effects of depression on refugees’ ability to rebuild their lives?
A: Depression can persist years after displacement, hindering refugees’ ability to earn a living, and increasing their economic hardship.

Q: How can we address the mental health needs of refugees?
A: Targeted screening and evidence-based treatments can help prevent a vicious cycle of mental disorders, economic hardship, and poor social integration.