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Depression, violence, and socioeconomic outcomes among refugees in East Africa: evidence from a multi-country representative survey

Abstract:

Background: Existing research on refugee mental health is heavily skewed towards refugees in highincome countries, even though most refugees (83%) are hosted in low- and middle-income countries. This problem is further compounded by the unrepresentativeness of samples, small sample sizes, and low response rates.

Objective: To present representative findings on the prevalence and correlates of depression among different refugee sub-groups in East Africa.

Methods: We conducted a multi-country representative survey of refugee and host populations in urban and camp contexts in Kenya, Uganda, and Ethiopia (n=15,915). We compared the prevalence of depression between refugee and host populations and relied on regression analysis to explore the association between violence, depression, and socioeconomic outcomes.

Findings: We found a high prevalence of elevated depressive symptoms (31%, 95% CI 28% to 35%) and functional impairment (62%, 95% CI 58% to 66%) among the refugee population, which was significantly higher than that found in the host population (10% for depressive symptoms, 95% CI 8% to 13%; and 25% for functional impairment, 95% CI 22% to 28%) (p-values < 0·001). Further, we observed a dose-response relationship between exposure to violence and mental illness. Lastly, high depressive symptoms and functional impairment were associated with worse socioeconomic outcomes.

Conclusion: Our results highlight that refugees in East-Africa – particularly those exposed to violence and extended exile periods – are disproportionately affected by depression, which may also hinder their socioeconomic integration.

Clinical implications: Given the high prevalence of depression among refugees in East Africa, our results underline the need for scalable interventions that can promote refugees’ well-being.

Publication status:
Published
Peer review status:
Peer reviewed

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Publisher copy:
10.1136/bmjment-2023-300773

Authors

More by this author
Institution:
University of Oxford
Division:
MSD
Department:
Psychiatry
Role:
Author
More by this author
Institution:
University of Oxford
Division:
SSD
Department:
International Development
Role:
Author
More by this author
Institution:
University of Oxford
Division:
SSD
Department:
International Development
Role:
Author
ORCID:
0000-0002-3494-2317
More by this author
Institution:
University of Oxford
Division:
SSD
Department:
International Development
Oxford college:
St Antony's College
Role:
Author
ORCID:
0000-0003-3835-9388


Publisher:
BMJ Publishing Group
Journal:
BMJ Mental Health More from this journal
Volume:
26
Issue:
1
Article number:
e300773
Publication date:
2023-08-18
Acceptance date:
2023-07-28
DOI:
EISSN:
2755-9734


Language:
English
Keywords:
Pubs id:
1497523
Local pid:
pubs:1497523
Deposit date:
2023-07-31
ARK identifier:

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