A Systematic Review of Factors Affecting Mental Health and Well-Being of Asylum Seekers and Refugees in Germany

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.

Post-Migration Stressors and Health-Related Quality of Life in Refugees from Syria Resettled in Sweden

“…However, refugees have been shown to continue having lower employment rates than other immigrants and natives, even ten years after migration [ 33 ]. Moreover, adequacy of income and employment have been shown to be significant predictors of general mental health for resettled refugees [ 34 , 35 ] and to moderate the adverse mental health effects of pre- and peri-migratory stressors experienced by refugees [ 36 ]. Barriers to employment identified by refugees include adverse effects of PTSD, problems with professional recertification and economic barriers to pursuing education [ 37 ].…”

Refugee Mental Health, Global Health Policy, and the Syrian Crisis

“…As previously mentioned, a meta-analysis has confirmed high prevalence rates in studies within Germany of refugees and asylum seekers from many different countries of origin ( 48 ). And a recent review of postmigration contextual factors has identified a range of risk factors, such unresolved asylum status, separation from family, and discrimination ( 212 ).…”

The Impact of Pre- and Postarrival Mechanisms on Self-rated Health and Life Satisfaction Among Refugees in Germany

“…All of these factors make refugees particularly vulnerable in regard to their health situations: previous studies have found that up to 30 percent of adult refugees suffer from health impairments ( Fazel et al, 2005 ; Robjant et al, 2009 ; Bakker et al, 2014 ; Giua, 2017 ). It is, therefore, not surprising that some scholars have termed the situation of refugees in Germany as a mental health crisis ( Schauer, 2016 ; Hajak et al, 2021 ).…”

“…The handful of studies examining the health status of recent refugees in Germany ( Dietrich et al, 2019 ; Walther et al, 2020 ; Jaschke and Kosyakova, 2021 ; Löbel and Jacobsen, 2021 ) have focused primarily on access to healthcare services and the role of family ties abroad, as well as the role of pre- and postarrival stress for psychological and physical health and psychological distress ( see meta-analysis by Hajak et al, 2021 ). These studies, however, mainly focused on the level differences while neglecting the role of the postarrival experiences for the development of health outcomes over the duration of the stay.…”