Post-migration stressors, correlates, and predictors of post-traumatic stress disorder and common mental disorders in refugees settled in Cape Town, South Africa

Abstract

South Africa hosts the highest number of African refugees, who are susceptible to mental health problems because of their trauma exposure and post-migration stressors. We assessed post-migration stressors, correlates, and predictors of post-traumatic stress disorder, depression and anxiety symptoms among refugees in Cape Town, South Africa. A cross-sectional survey of refugees from war and conflict-torn countries settled in Cape Town was conducted between February and May 2023. Participants ( N = 147) were selected using a respondent-driven sampling technique. The survey instrument consisted of the Post-traumatic Stress Disorder Checklist, Patient Health Questionnaire, Generalised Anxiety Disorder–7, and the Post-Migration Living Difficulties checklist. We found that the prevalence of post-traumatic stress disorder, anxiety, and depression symptoms was 26.5% for post-traumatic stress disorder, 33.3% for anxiety and 33.3% for depression, respectively. Regression analyses identified discrimination, poor access to health services, and poor access to food as significant predictors of common mental disorders among refugees. The document-seeking process, unemployment stress, language difficulties, not getting help with welfare, fears of being sent to their home countries and isolation were also associated with symptoms of mental disorder. The results suggest that common mental health symptoms are highly elevated among refugees and are associated with post-migration stressors that are perpetuated by bureaucratic inefficiencies. Consequently, mental health interventions for refugees should not only address psychological difficulties but also consider the socio-economic and bureaucratic factors as a protective measure against mental health difficulties.