Julie A. Tippens https://orcid.org/0000-0003-0465-3570
Holly Hatton-Bowers https://orcid.org/0000-0002-4165-791X
Ryan Honomichl https://orcid.org/0000-0002-0535-4268
Lorey A. Wheeler https://orcid.org/0000-0001-9975-6702
Kirstie L. Bash https://orcid.org/0000-0002-1425-5632
Michelle C. Howell Smith https://orcid.org/0000-0001-7397-4912
Samuel E. Packard https://orcid.org/0000-0001-8607-792X
Nicolette I. Teufel-Shone https://orcid.org/0000-0002-7548-819X
Date of this Version
Published in American Journal of Orthopsychiatry, 2021
Background: There is limited understanding of the prevalence of psychological distress and associated stressors and supports among displaced adults in low- and middle-income first asylum countries.
Method: This article reports the findings of a cross-sectional study. We recruited 245 Congolese adults (18–80 years) residing in Nairobi, Kenya using snowball sampling. Data were collected using an interviewer-administered questionnaire consisting of sociodemographic characteristics, the Self-Reporting Questionnaire (SRQ-20), and a locally developed stressors and supports survey. We used multivariable logistic regression to examine associations among sociodemographic, stressor, and support variables and the likelihood of experiencing psychological distress.
Results: More than half of the participants (52.8%) reported symptoms indicative of psychological distress. Factors associated with increased psychological distress included perceiving to have a useful role in one’s family or community, AOR = 1.85; 95% CI [1.1.17, 3.11], p = .012, feeling confused or not knowing what to do, AOR = 2.13; 95% CI [1.20, 4.6], p = .014, and feeling afraid to leave home for medical/health care to help with an illness, AOR = 1.57; 95% CI [1.17, 2.15], p < .01. Additionally, ethnic Banyamulenge Congolese adults without legal refugee status had an increased likelihood of experiencing psychological distress, AOR = .07; 95% CI [0, .74], p = .035.
Conclusion: Future research is warranted to understand how to implement targeted mental health and psychosocial support (MHPSS) to improve urban-displaced adults’ sense of safety and belonging. Our findings suggest that legal refugee status is an important structural determinant of mental health, which should be considered in MHPSS practice and policy.