How temporary housing harms mental health of refugees and asylum seekers

Millions of refugees and asylum seekers are forced to leave their homes each year due to conflict, violence, or persecution. Upon arriving in host countries, many are placed in temporary accommodations such as camps or reception centres. While these spaces aim to provide safety, they often fall short in addressing the physical, emotional, and social needs of displaced individuals. Overcrowding, lack of privacy, and impersonal environments can increase feelings of instability and distress, leaving people in cramped spaces for months, or even years.

This issue impacts millions: by the end of 2023, 31.6 million international refugees and 6.9 million asylum seekers - people either granted or seeking international protection - remained displaced. Alarmingly, up to 80% of refugees and asylum seekers have a mental health disorder like anxiety, depression, or post-traumatic stress disorder ⁽²⁾. For simplicity, this blog refers to both groups as “refugees.”

To understand how temporary accommodation impacts refugee mental health, we reviewed 21 studies published since 2016, focusing on interviews with refugees to capture their lived experiences. This review highlights current challenges and offers insights for improving support in host countries.

Key findings

We looked at studies based in neighbouring host countries such as Jordan, Lebanon, Turkey, and Bangladesh, as well as distant host nations like Sweden, Germany, and Greece. The accommodations were separated from the main population, often in rural areas, and included refugee camps and reception and accommodation centres. Our review revealed five common themes, showing how the physical environment impacts refugees' mental health by affecting their ability to connect socially, feel safe, rest, or work.

‘Adjustment difficulties’

Refugees struggled to navigate and get used to their new accommodations. Overcrowded, poorly constructed spaces with inadequate amenities and little privacy exacerbated their feelings of unsettlement and distress. Refugees experienced fear, anxiety, and low moods, due to the trauma of leaving their homes, as well as their current living conditions. For example, a Syrian woman in a Lebanese camp described her deep suffering as follows: “Sometimes I wish I could die to get rid of this life we are living.” ⁽³⁾ Instead of finding safety and respite, refugees spent their time in poorly equipped and run-down environments that do little to alleviate their traumatic experiences of flight.

‘Feeling imprisoned’

As refugees struggled to adjust to their new environments, the physical limitations of their living spaces led to feelings of imprisonment, both physically and mentally. Many refugees described cramped spaces, high walls, and restricted movement. Their housing was often geographically and socially isolating and did not have sufficient space for meaningful activities. These conditions fuelled psychological feelings of suffocation, entrapment, and dehumanisation. Syrian refugees in Lebanese camps shared how they were “in a grave” or “a prison”. ⁽³⁾

‘Lack of meaningful activity’

This deprivation of opportunities in refugee accommodation impacts their mental health, identity, and confidence. Overcrowding and inadequate infrastructure left little room for work, education, volunteering, creative pursuits, or social interactions. Without these outlets, many refugees felt idle and disconnected from the fulfilment their previous jobs or lives had provided. Without opportunities to contribute meaningfully, refugees often internalised a sense of worthlessness and shame. Dependent on aid and unable to provide for their families, many described feelings of self-devaluation, as an Afghani woman in Greece said “I do not want to be a burden. I am disgusted by eating free bread.” ⁽⁴⁾

‘Erosion of trust and safety’

The lack of meaningful activities also contributes to a growing sense of fear and mistrust within overcrowded spaces. Sharing close quarters with strangers and competing over scarce resources heightened feelings of fear and insecurity. The absence of privacy and the frequent conflicts over resources created an environment where refugees hesitated to form connections or rely on others, fearing exploitation. A Syrian man underscored the fundamental role of safety, saying, “If there is no safety and security, there is no life for people.” ⁽⁵⁾ This erosion of trust and stability deepened the isolation many refugees experienced, increasing the psychological burden of displacement.

‘Reclaiming control and humanity’

In contrast, refugees also showed resilience in the face of these challenges. Despite hardships, refugees regained their sense of agency and dignity through acts of resourcefulness. They found fulfilment in teaching children, sharing meals, or helping newcomers. As Burmese refugee in a Bangladeshi camp said, “I share food and receive love and care from my neighbours.” ⁽⁶⁾ These efforts created a semblance of normalcy, connection, and community, demonstrating refugees’ determination to adapt and persevere even under adverse circumstances.

What should policymakers consider?

Refugees often live in conditions that harm their mental health. Better living spaces, opportunities for meaningful activity, and community-building can ease their suffering. Supporting grassroots initiatives – like sharing food or mentoring youth – can also strengthen resilience and inspire hope, helping refugees rebuild a sense of connection and belonging after the trauma of being forcibly displaced from their homes.

Underrepresented groups, such as women, children and older adults, require greater attention, as their unique challenges often remain unaddressed. Moving forward, we should prioritise creating safer, more trauma-sensitive accommodations that consider their specific needs. This must include adequate mental healthcare provision to account for the trauma refugees endured in their home country, their journey, and in adjusting to their new circumstances.

Beyond policy and research, our collective attitudes and beliefs about refugees play a critical role in shaping their reality. On an individual level, we can challenge harmful stereotypes that depict refugees, who are among the world’s most vulnerable populations, as threats. The true challenge lies in the unequal distribution of resources and fearmongering that perpetuates division. By rejecting these narratives and embracing compassion, we can contribute to a world where refugees are seen as people seeking safety, dignity, and the chance to rebuild their lives. As an Afghani woman from one of the studies we reviewed said: “A hope is planted inside the heart of the Afghan people, when we see that people from different countries actually care about us.” ⁽⁷⁾

References

1. UNHCR (2023). Global Trends Report 2023. Available at: UNHCR
2. Song, S. and Teichholtz, S. (2019). Mental health facts on refugees, asylum-seekers, & survivors of forced displacement. American Psychiatric Association, pp.1-3.
3. Syam, H., Venables, E., Sousse, B., Severy, N., Saavedra, L. and Kazour, F. (2019). '"With every passing day I feel like a candle, melting little by little." Experiences of long-term displacement amongst Syrian refugees in Shatila, Lebanon'. Conflict and Health, 13, p.45.
4. Bjertrup, P.J., Bouhenia, M., Mayaud, P., Perrin, C., Ben Farhat, J. and Blanchet, K. (2018). 'A life in waiting: Refugees' mental health and narratives of social suffering after European Union border closures in March 2016'. Social Science & Medicine, 215, pp.53-60.
5. Momani, A.M., Alduraidi, H. and Zaghmouri, A. (2023). '“Safety and security are everything”: a qualitative study on the quality of life of Syrian refugees living in Za’atari camp'. International Journal of Migration, Health and Social Care, 19(3/4), pp.407-416.
6. Alve, Y.A., Islam, A., Hatlestad, B. and Mirza, M.P. (2023). 'Participation in everyday occupations among Rohingya refugees in Bangladeshi refugee camps'. American Journal of Occupational Therapy, 77(3), p.7703205060.
7. Lavdas, M., Guribye, E. and Sandal, G.M. (2023). '"Of course, you get depression in this situation": Explanatory models (EMs) among Afghan refugees in camps in Northern Greece'. BMC Psychiatry, 23, p.277.

More about the study (in preparation)

Title: The impact of temporary and contingency accommodation on the mental health and wellbeing of refugees and asylum seekers: A qualitative systematic review

Authors: Farah Abdulrahman, MSc (UCL) Dr Mary Birken, Clinical Lecturer (UCL) Dr Naomi Glover, Clinical Lecturer (UCL) Dr Miranda Holliday, MSc (UCL) Prof. Cornelius Katona, Professor (UCL)