We Need to Talk About the Mental Health of Europe’s Refugees

Existing research shows that refugees are at higher risk of mental health problems —  like depression, anxiety and post-traumatic stress disorder — than other populations. This shouldn’t come as a surprise, though.

A person who has witnessed horrific violence or destruction of his or her community is obviously vulnerable. However, not much research has evaluated whether refugee status makes someone more prone to psychosis, a severe disassociation with reality that can leave the person incredibly vulnerable to self harm and death.

Given that major depression episodes can trigger psychosis, it’s reasonable to guess that refugees might be more prone to this serious mental health condition. But we need the data to back that assumption up and determine how widespread the problem might be.

Now, researchers based at the Karolinska Institute in Sweden and the University College London in the UK have attempted to gain insight into this serious health issue.

In an article published in the “British Medical Journal“ this month, researchers describe how they used anonymous data from a cohort of 1.3 million people born after 1984 — excluding those below age 14.

All individuals were born in Sweden, had Swedish-born parents or were migrants or refugees. The migrant and refugee group included people from the Middle East, north and sub-Saharan Africa, Asia, Russia and eastern Europe.

Researchers then tracked what are known as “nonaffective psychotic disorders” or NAPD diagnosis.

To explain very simply, conditions like bipolar disorder can give rise to psychosis. But these episodes are linked to heightened moods, like extreme depression or euphoria. Nonaffective psychotic disorders are characterized by a lack of those mood components.

After controlling for personal characteristics like age, sex and disposable income, the researchers found that refugees in Sweden were around 66 percent more likely to develop nonaffective psychotic disorders than migrants — people not claiming refugee status — from the same geographic location.

This finding contributes to a body of research that already demonstrated a greater risk of psychosis among migrants. But this is the first study to look at the particular situation of people claiming refugee status.

To put the statistics in a more real-world context, for every 10,000 people tracked in the study, there were about four new diagnoses of psychotic disorders among Swedish-born individuals every year.

However, for migrants and refugees, the figures were eight and 12 out of 10,000, respectively.

“The dramatically increased risk among refugees shows that life events are a significant risk factor for schizophrenia,” lead author Anna-Clara Hollander explained.

The researchers are keen to point out that it isn’t clear precisely what caused this heightened risk. Was it the refugee’s experiences prior to fleeing their home country, the journey they underwent or their life as a refugee that has elevated their risk? Future research will need to investigate these factors.

While refugee health evaluations are standard, unless an individual specifically reports a mental health concern, that aspect of health is rarely given attention.

In other words, there could be thousands of refugees at risk for psychosis who are not being given the care they need.

This study also suggests that detaining refugees in camps for extended periods of time could worsen refugee and migrants’ mental health.

These findings may not prove that current policies exacerbate mental health risks, but they do highlight the importance of considering mental health during policymaking. If we do not, we will face future populations with even greater needs.

This research accompanies a recently proposed policy that would enable EU leaders to send migrants and refugees in Greece back to Turkey.

Refugee advocacy groups have signed an open letter opposing the measure. The organizations warn that the unsustainable policy  perpetuates “the confinement of people and discriminatory practices” that are contrary to European human rights laws. 

Photo credit: Thinkstock.


Jack Y
Jack Y7 months ago


Jack Y
Jack Y7 months ago


Siyus Copetallus
Siyus Copetallus2 years ago

Thank you for sharing.

Ella P.
Ella P2 years ago

I greatly admire and support the organisations who tirelessly work, often for little or not pay, to help give emotional and mental support to the refugees and other people affected by desaster of all kinds, such as the Emergency pedagogic interventions of the Friends of Waldorf Education. My friend is currently on her way home from spending her vacation time in greece, working in refugee camps.

Winn Adams
Winn A2 years ago

The mental health of these people is just as important as their physical health.

Muff-Anne York-Haley

What about the mental health of the people whose countries they're invading?

Nellie K Adaba
Nellie K Adaba2 years ago


Heleen de Boer- van Dijke

You Americans still have a fighting chance, so be very sure where your vote will go before it is to late.

Loretta Pienaar

Money should go to the support and upliftment of all peoples in their own home countries.

Jamie Clemons
Jamie Clemons2 years ago

We can't even get adequate mental health for our citizens.