Key Facts
As of mid-2024, 122.6 million people worldwide have been forcibly displaced. This includes 68.3 million internally displaced persons, 37.9 million refugees, 8 million asylum seekers, and 5.8 million others requiring international protection.
Low- and middle-income countries host 71% of the world’s refugees and those in need of international protection.
Refugees and migrants facing adversity are more vulnerable than host populations to mental health conditions such as depression, anxiety, post-traumatic stress disorder (PTSD), suicide, and psychosis.
Many refugees and migrants have limited access to mental health services and experience disrupted care continuity.
Despite these challenges, refugees and migrants contribute positively to society. Evidence-based strategies are available to help them reach their full potential.
Overview
Today, a growing number of people live outside the country of their birth. While many migrate voluntarily, others are compelled to flee due to persecution, conflict, violence, or disasters. Some leave to escape inhumane conditions, severe poverty, or to reunite with family.
Refugees and migrants facing adversity often have complex mental health needs arising from experiences in their home country, their migration journey, the policies in the host country, and their living and working conditions. These factors often increase their risk of developing mental health disorders. In host countries, numerous barriers hinder their social integration and restrict access to acceptable and effective mental health care. Addressing these challenges requires targeted, multidisciplinary actions including culturally sensitive and integrated mental health care, social support, legal assistance, and community involvement.
Stress Across the Migration Journey
The migration experience is a key determinant of mental health for refugees and migrants. Each phase of the migration journey presents distinct stressors that may raise the risk of developing mental disorders.
Pre-migration: Individuals often face poverty, lack of access to education or work, armed conflict, violence, natural disasters, and persecution.
During transit and border crossing: Refugees and migrants may experience dangerous conditions, including violence, detention, and lack of access to essential services.
Post-arrival: After reaching the host country, they may face poor living conditions, separation from family and support networks, legal uncertainty, and in some cases, detention in immigration centers.
Integration and resettlement: Refugees and migrants often encounter unemployment, poor housing and work conditions, challenges in cultural and social integration, threats to their religious or gender identity, racism, exclusion, social isolation, and potential deportation.
Risk and Protective Factors
The mental health of refugees and migrants is shaped by a combination of individual, family, community, and structural factors throughout all stages of the migration process. These can be categorized into five key areas:
Community Support: Belonging to a community of shared background and enrolling children in school can improve mental well-being.
Basic Needs and Safety: Insecurity around income, employment, housing, legal status, and food access contributes to poor mental health.
Stigma and Discrimination: Experiencing racism and discrimination can prevent individuals from seeking help, worsening mental health outcomes.
Adversity and Trauma: Exposure to traumatic events such as conflict, abuse, violence, and prolonged detention is linked to depression, PTSD, and other disorders.
Access to Services: Language barriers, lack of awareness, and concerns about confidentiality often impede access to mental health care.
Prevalence of Mental Health Conditions
Many refugees and migrants experience emotional distress, including anxiety, sadness, hopelessness, insomnia, fatigue, irritability, anger, and physical pain. These responses often improve over time, but some individuals develop mental health disorders.
Studies show that conditions such as depression, anxiety, PTSD, and suicide are more common among refugees and migrants than among host populations. In some countries, the incidence of psychosis is also higher among migrants, often linked to accumulated social disadvantages during migration.
Policy Recommendations for Supporting Mental Health
Promote community support and inclusion: Encourage participation in society through community forums and peer-support programs. Avoid family separation, particularly involving children.
Address social determinants: Guarantee equal access to food, housing, legal aid, safety, education, and employment. Collaborate across sectors like law enforcement and social services to integrate mental health support and ensure referrals to appropriate services.
Integrate mental health into general health care: Train general health professionals to recognize and treat mental health issues. Also equip non-health professionals—such as immigration officers, teachers, and social workers—to identify and refer individuals in need. Tailor interventions to accommodate cultural and language differences.
Offer flexible mental health services: Allow individuals to choose where and how they receive care. Clearly communicate service availability through outreach, schools, and religious or community groups.
Protect human rights: Uphold the rights of all refugees and migrants, regardless of legal status. Protect vulnerable groups—including unaccompanied minors, individuals with disabilities, and LGBTIQ+ persons—from violence and discrimination.
Strengthen community capacity: Collaborate with refugee and migrant communities to disseminate mental health information and provide community-based referrals. Improve care continuity by ensuring service providers communicate and maintain portable health records.
WHO’s Role and Response
WHO supports Member States in integrating refugees and migrants into national health systems and ensuring their access to mental health services through its three strategic approaches:
Leadership and Advocacy: The WHO Global Action Plan (2019–2023) promotes refugee and migrant health through international cooperation. The Comprehensive Mental Health Action Plan (2013–2030) focuses on mental health equity and support for vulnerable groups. WHO also plays a leading role in global mental health coordination through the Inter-Agency Standing Committee on Mental Health and Psychosocial Support.
Norms, Standards, and Data: WHO’s Global Evidence Review on Health and Migration (2023) highlights the mental health needs of refugees and migrants, identifies key risks and protective factors, and provides research and policy recommendations. WHO collaborates with partners to produce widely used tools and guidelines to support mental health in emergency settings.
National Support: WHO works with partners such as the International Organization for Migration (IOM) and the UN Refugee Agency (UNHCR) to provide mental health assistance in countries hosting large numbers of refugees and migrants, including Chad, Colombia, Ethiopia, Jordan, Lebanon, Sudan, Turkey, and Uganda.
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