Individuals from refugee backgrounds may experience higher rates of mental and physical health problems compared to the general population, yet the interdependence of these outcomes within couples remains poorly understood. This study aims to understand the relationship between post-traumatic stress disorder (PTSD), socio-economic status and self-rated general health (SRGH) among couples from refugee backgrounds living in Australia. Couples were nested within dyads using multi-level frameworks and mixed-effects logistic regression (n = 436 dyads). In respondents with likely PTSD, 61% of their partners were also likely to have PTSD compared to only 26% of partners in refugees with unlikely PTSD. After controlling for socio-economic factors, respondents with likely PTSD were significantly less likely to rate their health as ‘excellent/very good’ (OR = 0.20), compared to those with unlikely PTSD. Partners with likely PTSD were also less likely to rate their health as ‘excellent/very good’ (OR = 0.54). Individuals who were older, female, born in the Middle East, experienced less community support or more economic stressors were at greater risk of poorer SRGH. PTSD and SRGH had an interdependent effect within couples from refugee backgrounds. Familial and psychosocial contexts must be considered when developing health promotion and policies for refugee communities.

As human displacement rises, the humanitarian funding environment fluxes, and undernutrition continues to affect communities of refugees and internally displaced persons (IDPs); there is a need for evidence to better understand pathways to healthy, self-reliant livelihoods. In non-displaced contexts, livestock-keeping has been shown to increase resilience to malnutrition during crises and improve food security, but much less evidence is available in environments such as displacement camps. This review investigates what empirical evidence exists on the role of livestock ownership in refugee/IDP nutrition. A systematic search of MEDLINE, CAB Abstracts, Web of Science, African Journal Online, Dissertations and Theses Global and grey literature was undertaken according to PRISMA-ScR and JBI guidelines. From 903 records found, 21 studies were included for review, of which 12 reported positive effects of livestock-keeping on nutritional outcomes in the refugee/IDP camp setting, three reported mixed effects and six determined no effect. No study found a solely negative effect. The human nutritional outcomes studied included anaemia, stunting, wasting, dietary diversity and food security proxies. One study explored the general impact of livestock ownership whilst the remainder explored the association between animal source food consumption and nutritional outcomes. The current relative scarcity of data in the refugee/IDP context, along with the lack of standardised study design and outcome measures, limits the ability to undertake formal meta-analysis and give evidence-based recommendations. We call for more research with adherence to existing standardised reporting guidelines such that appropriate analysis can be undertaken in this highly complex system to enhance evidence for these vulnerable communities.

Suicide is a serious global health problem with ~73% deaths by suicide occurring in low- or middle-income countries (LMICs), many of which are among people experiencing humanitarian emergencies. Few guidelines outline specific steps and strategies to tackle suicide risk and manage post-attempt consequences in these settings, leaving program implementers with limited information to translate guidance to practice. This article describes the implementation of the Common Elements Treatment Approach (CETA) suicide safety protocol as part of a randomized controlled trial in northern Thailand for displaced adults from Myanmar with chronic physical health conditions. The CETA safety protocol has been used in many trials and programs to screen for and manage suicide risk, including in a prior CETA effectiveness trial with Myanmar adults. In this article, we describe how this safety protocol was adapted for the study setting, and utilized to effectively screen, assess suicidal thoughts and behaviors, develop and manage action plans for study participants with active suicidal ideation. We present three illustrative case descriptions of individuals with whom we implemented the safety protocol to highlight how suicide risk intersects with physical illness, psychosocial stressors and structural vulnerability. Reflections on feasibility, acceptability and adaptations – such as language translation, culturally grounded referral pathways and training for nonspecialist providers – are shared to inform future implementation. Our findings support the implementation of suicide safety protocols within humanitarian programming and offer practical insights for global health practitioners and policymakers working in similarly complex settings.

Social support is a key coping resource; its specific role for refugees from sub-Saharan Africa in high-income settings remains poorly understood. This systematic review synthesises existing evidence on the sources of social support and how these networks aid coping during resettlement. We applied an optimised search strategy to identify studies examining social support among sub-Saharan African refugees across six academic indexing databases. We then undertook a meta-synthesis of the identified studies. This involved the use of meta-thematic analysis of the interpretations and quotes presented in each study, combining thematic analysis through the reviewer’s reflexivity. The PRISMA framework guided the review process to ensure methodological rigour. A total of 22 articles were included in the qualitative meta-synthesis. The synthesis revealed four key sources of social support: 1) family, 2) friends, 3) ethnic and community groups, and 4) cultural and religious supports. These support sources played multiple roles, including enhancing community engagement and reciprocity, providing practical and emotional assistance, offering relief from distress and cultivating cultural continuity and adaptation. However, some individuals distanced themselves from their ethnic community and preferred self-driven coping. Access to social support systems remains a crucial coping resource for many sub-Saharan African refugees in high-income settings, alleviating distress and enhancing resilience. Programs that strengthen informal social support networks through community-driven initiatives can enhance the relevance of social support. Future research should investigate the role of social support across various phases of resettlement in relation to psychosocial well-being.

In 2015, German Chancellor Angela Merkel decided to allow over a million asylum seekers to cross the border into Germany. One key concern was that her decision would signal an open‐door policy to aspiring migrants worldwide – thus further increasing migration to Germany and making the country permanently more attractive to irregular and humanitarian migrants. This ‘pull‐effect’ hypothesis has been a mainstay of policy discussions ever since. With the continued global rise in forced displacement, not appearing welcoming to migrants has become a guiding principle for the asylum policy of many large receiving countries. In this article, we exploit the unique case study that Merkel's 2015 decision provides for answering the fundamental question of whether welcoming migration policies have sustained effects on migration towards destination countries. We analyze an extensive range of data on migration inflows, migration aspirations and online search interest between 2000 and 2020. The results reject the ‘pull effect’ hypothesis while reaffirming states’ capacity to adapt to changing contexts and regulate migration.

Professional asylum seeker-related NGOs (non-governmental organizations) have been visible actors in Turkey, which is one of the most affected countries by forced migration in the world since 2011 when the Syrian civil war erupted. As a result, numerous studies and projects have been undertaken to explore the positions of these NGOs in terms of their effect on integration; yet the difficulties faced by NGO workers in Turkey have remained understudied. This qualitative study aims to close this gap by exploring the challenges that NGO workers face at an individual level. In this regard, data were gathered through semi-structured interviews from 33 staff in asylum seeker-related NGOs which adopt a right-based perspective. According to data, asylum seeker-related NGO workers experience significant problems stemming from both external and internal difficulties.

This article considers how civil society organizations (CSOs) may be understood in relation to the global refugee regime complex. It describes how several leading scholars have conceptualized refugee/internally displaced person (IDP) governance and explores how the neoliberal cognitive frame is impeding the possibility of democratic agency among IDPs/refugees. It argues that CSOs can play essential roles in encouraging democratization of the refugee regime complex by working to reshape their prevailing frame or orientation. Civil society organizations can also work to foster critical reflexivity among the parties that govern refugees and within that population as well. As an example of one such effort, the article employs Fraser’s (Scales of justice: reimagining political space in a globalizing world. Columbia University Press, New York, 2010) democratization framework in a brief case analysis of the Sarvodaya Shramadana Deshodaya initiative in Sri Lanka that has sought to enable IDPs in that nation to embrace critical reflexivity to reimagine themselves as governing agents who can redefine state and international organization-based definitions of refugee protection. Overall, the analysis suggests that civil society organizations can act successfully and intentionally to open democratic spaces in which refugees/IDPs may find possibilities to exercise their innate agential possibility.

Long before the current refugee crisis, third sector organizations (TSOs) have played a pivotal role in dealing with the multifaceted challenge of migration. Researchers have analyzed this role in many ways. What is missing, however, is a comprehensive overview of how the third sector contributes to dealing with migration. To close this gap, we conduct a systematic literature review (SLR) that maps the scholarly debate on TSOs and migration. Our SLR identifies four domains of TSO migration engagement: first, the direct provision of basic services and social welfare; second, migrant-oriented capacity development; third, system-oriented advocacy; and fourth, complementary research activities. We propose a conceptual framework that highlights the contribution of TSOs with regard to individual-oriented and system-oriented services that are necessary for a successful integration of migrants. A key implication of our derived framework is to understand migration as a holistic challenge that requires contributions by different actors on different levels, thus highlighting the need for coordination and communication between the TSOs, the state and other stakeholders.

This study provides quantitative evidence on UK public attitudes towards stateless people, comparing them with attitudes towards refugees and asylum seekers. A cross-sectional UK survey (n = 385) was conducted. Network analysis modelled associations between social policy attitudes and prejudice towards stateless people, refugees, and asylum seekers, alongside other variables, including political orientation and perceived threat. Social policy attitudes were more restrictive towards stateless people than refugees, but less restrictive than towards asylum seekers. Prejudice towards stateless people was not significantly different to that towards refugees or asylum seekers. Prejudice and social policy attitudes were highly interrelated between all three groups, with political orientation and perceived threat the strongest predictors. Findings demonstrate similarities in UK public attitudes towards stateless people, refugees, and asylum seekers. Awareness-raising interventions and interventions addressing political and threat-based narratives may be most effective in reducing discrimination and fostering inclusion of stateless people.

The experience of human trafficking is associated with a high prevalence of mental health problems, particularly post-traumatic stress disorder (PTSD), anxiety, and depression, for which cognitive behavioural therapy (CBT) would be indicated as an evidence-based intervention. However, lack of knowledge about trafficking survivors’ psychosocial needs, and the complexity of their presentation and circumstances can deter clinicians and impact on survivors’ access to evidence-based care. This article aims to offer guidance for clinicians working therapeutically with adult survivors of human trafficking. It draws on existing CBT evidence-based interventions, and highlights survivors’ holistic needs. This article proposes the use of an existing three-phased approach to treatment and draws upon cognitive behavioural principles. The psychological impacts of exploitation, key assessment topics, and safeguarding concerns are discussed. Considerations for psychological formulation and intervention are described, with a focus on trauma reactions, including PTSD. The integration of a survivor’s social and cultural context into treatment is also explored. CBT interventions can be adapted and applied effectively to address the mental health needs of survivors of trafficking alongside other support to meet their holistic needs.

The Syrian government’s violent suppression of pro-democracy protests in March 2011 sparked a civil war that resulted in the deaths of hundreds of thousands of people and the displacement of millions. This study focuses on the emotional achievement of 357 Syrian primary and secondary school students who have moved to Türkiye and are under temporary protection. The researchers used the achievement emotion scale to collect data. They conducted a t-test, analysis of variance, correlation analysis and multiple linear regression to examine the sociodemographic factors affecting students’ achievement emotions. The results revealed that boy students experienced more negative achievement emotions than girl students, and that the longer the students have been in temporary protection, the more their positive achievement emotions have decreased. The ongoing war in Syria has dire consequences for school-age children who have been forced to flee their homes.

Peer Refugee Helpers (PRHs) support peers in humanitarian settings, which may influence their own mental health. This longitudinal study examined anxiety and depression trajectories among Afghan, Iranian and Syrian refugees and asylum seekers in Greece, focusing on how PRH status (paid/unpaid) and sense of coherence influence trajectory membership. The study included 176 adult, PRHs and non-helpers. The following scales were administered three times at ~4-month intervals: Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder (GAD-7), Social Provisions Scale (SPS-24), Sense of Coherence (SOC-13), Perceived Ability to Cope With Trauma (PACT) and Brief Trauma Questionnaire (BTQ). Using latent growth mixture modeling, we identified two depression (high and low) and three anxiety (high, moderate and low) trajectories. The adjusted logistic and multinomial regression models indicated that unpaid PRHs were significantly less likely to follow a low depression trajectory (odds ratio [OR] = 0.55, p = 0.037), while paid PRHs were more likely to follow a low anxiety trajectory (OR = 3.17, p = 0.009). Higher SOC was associated with low depression (OR = 1.03, p = 0.012) and low anxiety trajectories (OR = 1.06, p = 0.002). Our findings suggest PRH mental health may be associated with working conditions, including financial compensation.

This study examined the role of coping resources – self-efficacy (problem-focused) and emotion regulation (emotion-focused) – in supporting mental health and social functioning among refugees in a transit setting in Indonesia. Using a latent profile analysis approach with 1,214 participants, three distinct coping profiles were identified: high coping resources, high emotion-focused coping resource, and low coping resources. Results showed that high coping resources were associated with better mental health and social functioning outcomes. Emotion-focused coping resources were more strongly associated with better mental health, while problem-focused coping resources were closely linked to social functioning. This study highlighted the importance of coping flexibility and offers practical implications for strength-based interventions in transit displacement settings.