Abstract
Background: Since the onset of the 2015 European refugee crisis, ~4. 46 million people have sought asylum in the European Union, with Germany logging the largest share of all asylum applications. In addition to the severe adversities before and during flight, the process of settling into a new environment involves stressors that affect psychological well-being and mental health. The aim of this systematic review was to examine contextual factors during post-migration that influence the mental health and well-being of asylum seekers and refugees (ASRs) in Germany.Methods: Following PRISMA guidelines, a systematic review was conducted across multiple databases for English and German studies published between 2015 and 2020 with index keywords.Results: From a total of 303 articles, 156 duplicates were removed and, after title review, another 87 were excluded for not meeting the inclusion criteria. After assessing the abstracts of the remaining 60 articles, 39 were excluded. Full texts of 21 articles were assessed for eligibility and after excluding 8 articles, 13 articles were included in the review. The results demonstrate high rates of psychological distress among ASRs in Germany and the significant influence of contextual factors on their mental health and psychological well-being. The risk factors for poor mental health include an uncertain asylum status, living in shared asylum accommodations, separation from the nuclear family, lack of German language skills, integration issues and discrimination, while employment is a protective factor.Conclusion: Asylum seekers and refugees have high prevalence rates of psychological distress directly influenced by contextual factors in Germany. Based on these findings, policy makers are strongly recommended to apply preventive strategies to reduce mental health problems of ASRs in Germany.
Highlights
In recent years, Europe has been challenged by the largest migration wave since the end of the Second World War [1]
A systematic search of empirical original studies reporting on factors affecting the mental health and well-being of ASRs in Germany was performed for this review
The keywords and search terms might not have identified all relevant available data on the topic, which could represent an evidence selection bias. This is the first systematic review demonstrating the significant influence of contextual factors during post-migration on the mental health and well-being of ASRs in Germany since the beginning of the European refugee crisis
Summary
Europe has been challenged by the largest migration wave since the end of the Second World War [1]. The dramatic increase in the number of people seeking asylum in the European Union (EU) reached its historical climax with the European refugee crisis in 2015 with ∼1.3 million applications, about twice as many as in 2014 [2,3,4]. According to the United Nations High Commissioner for Refugees (UNHCR), asylum seekers are individuals who are seeking international protection, but whose application for refugee status has not yet been determined [6]. 46 million people have sought asylum in the European Union, with Germany logging the largest share of all asylum applications. The aim of this systematic review was to examine contextual factors during post-migration that influence the mental health and well-being of asylum seekers and refugees (ASRs) in Germany
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