Abstract
Refugees are at an increased risk of mental health problems and low subjective well-being. Living circumstances in the host country are thought to play a vital role in shaping these health outcomes, which, in turn, are prerequisites for successful integration. Using data from a representative survey of 4325 adult refugees who arrived in Germany between 2013 and 2016, we investigated how different living conditions, especially those subject to integration policies, are associated with psychological distress and life satisfaction using linear regression models. Our findings show that an uncertain legal status, separation from family, and living in refugee housing facilities are related to higher levels of distress and decreased life satisfaction. Being employed, contact to members of the host society, and better host country language skills, by contrast, are related to reduced distress and higher levels of life satisfaction. These associations should inform decision making in a highly contested policy area.
Highlights
Research has consistently shown that refugees are at a particular risk of facing mental health problems
Our results support and specify previous claims linking refugees’ mental health and well-being in the first years after arrival to post-migration living conditions, many of which are subject to integration policies
Our study shows that after controlling for key sociodemographics as well as pre- and peri-migration stressors, the legal hurdles refugees face while securing their future life in the host country are related to higher levels of psychological distress
Summary
Research has consistently shown that refugees are at a particular risk of facing mental health problems (reviewed in [1,2,3,4,5]). Despite a substantial between-study heterogeneity in refugees’ mental illness prevalence rates, forced migration has persistently been linked to increased rates of mental illnesses, post-traumatic stress disorder (PTSD), depression, and anxiety disorder [5,6,7]. Even considering that those who embark on flight are likely to exhibit resilience (‘Healthy Immigrant Effect’ [8]), refugees are at risk of facing psychological distress as sequelae. Even when migration leads to economic prosperity, it may remain associated with lower levels of well-being [14, 15]
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