Is There a Association Between the Conditions in Accommodations and the Mental Health of Refugees in Germany? - A Cross-Sectional Study

Abstract

Crowded conditions, noise and little privacy and other characteristics of refugee accommodations can have a negative impact on the mental health of the partially traumatized refugees. The study investigates, whether there are correlations between satisfaction with certain accommodation features in individual and shared accommodation and mental health. We used the IAB-BAMF-SOEP survey from Germany 2016 (n=4491 refugees). Linear regression models are calculated to test the association between mental health and the type of accommodation (single accommodation/shared accommodation) and satisfaction with the accommodation (general satisfaction, satisfaction with food quality/noise level/privacy/leisure activities/access to public transport/security, german language courses). We adjust for sociodemographic factors, potentially traumatic experiences prior to arrival in Germany and postmigrant exposures (e. g. asylum status). Within the two accommodation types, there is high heterogeneity with respect to the characteristics examined. Refugees with poor mental health were significantly more likely to live in shared accommodation. When the above covariates were controlled for, the association disappeared. The other eight accommodation characteristics remained significantly associated with poorer mental health. The largest effects on mental health were observed for the satisfaction with safety, privacy, and general satisfaction. Here, the difference between persons who were barely satisfied compared with persons who were very satisfied amounted to 5-6 points on the SF-12 mental sum scale. International results on the relationship between accommodation conditions and mental health of refugees were confirmed for Germany. This results in an increased need for mental health services in subjectively worse housing. Questions about satisfaction (especially safety, privacy, and general satisfaction) are more suitable for identifying critical accommodations than the classification into single or shared accommodations, because shared accommodations were assessed very differently. Screening instruments can help identify problematic shelters. However, reverse causality cannot be conclusively ruled out.