Traumatic experiences suffered by young refugees puts them at increased risk of mental illness, according to a new paper published on 11 May in EClinicalMedicine (1). Even years after, experiences like war, human trafficking, and poverty can lead to a much higher likelihood of developing a psychological disorder.
Furthermore, upon arrival into the country where they are seeking asylum, the living conditions of many refugees can further exacerbate mental stress. For instance, in Germany – the country in which the study took place – asylum seekers are denied access to work and cannot integrate into society while they wait to be granted asylum, which can take months or years in some cases. This “waiting in fear” combined with cramped housing conditions where many refugees are exposed to boredom, violence, and drugs, can lead to psychological and behavioural problems which later manifest as aggressive or criminal behaviour.
To build upon observations derived from previous studies and to further understand the potential impact of trauma on young asylum seekers, the team of researchers at the Max Planck Institute for Experimental Medicine in Germany carried out detailed interviews with 133 refugees with an average age of 22, many of whom had travelled to Germany as an unaccompanied minor.
As part of perhaps the largest and most detailed study of the psychological status young refugees carried so far, they evaluated the history and physical health of each participant and used structured interviews to assess any emerging indications of behavioural problems.
Even aside from the actual migration experience, which itself can be hugely traumatic, many refugees are exposed to a “shocking number of risk factors”, said lead author Dr Martin Begemann, including physical and sexual abuse, consumption of drugs and alcohol, and the added stress of living in cities. Since young brains are still developing, the effect of these risk factors is often more pronounced.
The researchers found that nearly all of the young refugees they interviewed had been affected by challenges that make them more susceptible to mental illness. In addition, around 50 per cent of the participants had suffered traumatic experiences before and during their journey; 25 per cent had endured physical and sexual abuse; and around 40 per cent had scars or wounds from stabbing or shooting injuries, explosions, or burns. Of the four men clearly displaying psychotic symptoms, two had suicidal thoughts.
In general, those who experienced a greater number of risk factors were more likely to show initial indications of psychiatric problems. The type of risk factor seemed less important than how many the person was exposed to. Interestingly, social support — including from family and close friends — appeared to offer little protection against the negative psychological effects.
It will be years before the scientists can determine whether the participants go on to later exhibit psychological problems or even criminal behaviour. And they only expect to be able to follow up with about half of participants due to transfers and deportations. Nonetheless, the current results reveal the need to change refugee policies, said Prof Hannelore Ehrenreich, who led the study.
“Given that each additional risk factor increases the probability of subsequent aggressive behaviour, criminal activity and mental disorders, we have to prevent the accumulation of further stress factors,” Ehrenreich urged. This could be achieved by providing better medical and psychological care, simple work activities, and language courses, even before an asylum decision has been made.
(1) Begemann, M. et al. Accumulated environmental risk in young refugees – A prospective evaluation. EClinicalMedicine (2020). DOI: 10.1016/j.eclinm.2020.100345