Violence Exposure and Mental Health Among Resettled Refugees: A Systematic Review

Abstract

Refugee populations are often characterized by their high exposure to violence, which are tied to various challenges upon resettlement. This systematic review synthesizes the empirical literature related to violence exposure for refugees resettled in high-income countries and the impact of that exposure on mental health symptoms. The authors reviewed quantitative studies published from 2000 to 2018 and found 12 studies met criteria for inclusion. Studies were excluded if the study did not include a measured mental health outcome, if violence exposure was not measured and reported on distinctly from nonviolent exposures, if the sample did not include a refugee population, or if the relationship between violence exposure and mental health of refugees was not empirically examined. Overall, studies found that resettled refugee populations were more likely to have higher rates of violence exposure than comparison groups. This violence exposure was significantly related to higher mental health symptoms, including symptoms of depression, anxiety, and, most commonly reported, posttraumatic stress disorder. However, there is substantial heterogeneity in measurement of violence exposure, particularly in the use of author-created scales. The vast majority of included studies examined only exposure to violence prior to resettlement. The review shows significant evidence for the effect of violence prior to resettlement on mental health after resettlement and reveals a need for improved measurement and definitions of violence exposure at different time points for resettled refugee populations. Assessing current exposure to violence is an important step for effective intervention related to mental health dilemmas for refugee populations.

Keywords: PTSD; mental health and violence; violence exposure; war.