Mental health as a non-communicable disease among refugees, asylum seekers, and beneficiaries of subsidiary protection: A scoping review.

BACKGROUND

The number of forcibly displaced people has reached unprecedented levels, exposing refugees, asylum seekers, and beneficiaries of subsidiary protection to cumulative adversities that severely affect health. Non-communicable diseases - particularly mental health conditions - represent a growing yet inadequately addressed component of this burden, with mental health remaining poorly integrated into non-communicable disease care frameworks. Within the NCD framework, mental disorders are increasingly recognized as chronic, disabling conditions with profound social and economic consequences.

OBJECTIVE

This scoping review mapped and synthesized evidence on mental health outcomes and associated risk factors among forcibly displaced adults in host countries. It also examined how mental health has been conceptualized and integrated within the broader non-communicable disease framework.

METHODS

We conducted a scoping review in accordance with established methodological frameworks and reported it in accordance with the PRISMA-Scoping Review guidelines. Six databases were searched for studies published between 2000 and 2020. Eligible studies included observational, qualitative, mixed-methods, and review articles addressing mental health outcomes or associated risk factors among forcibly displaced adults in host countries. Data was extracted using a standardized tool and synthesized narratively.

RESULTS

Of 4,341 records identified, 231 met the inclusion criteria, and 82 reported mental health outcomes. Depression, anxiety, and post-traumatic stress disorder were most common, with prevalence consistently higher than in host populations. Pre-migration trauma - such as war exposure and torture - and post-migration stressors, including unemployment, discrimination, social isolation, language barriers, and legal insecurity, significantly worsened mental health. Women and older adults were particularly vulnerable. Barriers to access, cultural incongruence, and limited-service availability were recurring challenges. However, substantial heterogeneity in study design, sampling strategies, and assessment instruments limited direct comparability across contexts.

CONCLUSIONS

Mental health disorders among forcibly displaced populations constitute a critical yet often overlooked aspect of the global non-communicable diseases burden. Addressing them requires integrated, culturally competent, trauma-informed care and supportive social and legal measures to improve equity and inclusion. Policy responses must therefore extend beyond clinical care to address structural determinants, including legal status, employment, housing, and social integration.