Psychosocial wellbeing: An overlooked dimension in the lives of refugees and host communities in Kenya

In October 2024, we had the privilege of presenting our research findings on the economic inclusion, resilience, and wellbeing of refugees and host communities at a research and policy symposium. One of the most inspiring stories we encountered was of Isaro, a refugee in Nairobi, whose journey is a testament to resilience, creativity, and unwavering determination.

Isaro* told us she fled her home country in search of safety and arrived in Kenya’s bustling capital with little more than hope and a desire to build a better future. With just $80 earned from casual jobs, she pursued her passion for fashion—despite the many obstacles ahead.

Building a business as a refugee was no easy feat. She faced countless barriers: Securing proper documentation, navigating harassment from city council officers, and juggling single motherhood with entrepreneurship. Limited resources forced her to innovate. She turned to Nairobi’s flea markets, transforming secondhand bedsheets into stylish dresses, stitching together both fabric and her aspirations.

Hers is just one journey among millions of the displaced individuals striving not only to survive but to contribute meaningfully to their host communities. Yet, while much attention is given to their economic challenges, the psychological toll of forced displacement often remains overlooked.

Insights from the Kenya Longitudinal Socioeconomic Survey of Refugees and Hosts (K-LSRH) underscore the need to address the mental and emotional wellbeing of refugees alongside economic interventions, ensuring refugees have the support they need to integrate and thrive. The socioeconomic survey (June 2022–2023) is Kenya’s first nationally comparable survey of registered refugees and hosts, providing insights into their living conditions, challenges, and into the link between economic and psychosocial outcomes.

Prevalent depression and anxiety-related experiences

In our research we find that symptoms of psychological distress are prevalent among refugee and host communities in Kenya. The survey reveals that 41% of refugees and 29% of hosts had reported experiencing at least mild symptoms of depression or anxiety in the past two weeks.

Urban refugees and those in the refugee settlements of Kakuma and Kalobeyei in Turkana County in northwest Kenya report higher prevalence rates than those in Dadaab in Garissa Country in northeast Kenya and neighboring host communities. Notably, refugees are more likely to report these symptoms than hosts, even when accounting for demographic and household characteristics.

Moderate to severe symptoms of depression and anxiety, which can substantially impact everyday life, are more common among refugees, but still low overall. For example, more than 5% of refugees in Turkana and Nairobi experience moderate to severe symptoms of depression, compared to less than one percent of host community members.

Interestingly, symptoms do not significantly vary by demographic group: Age, gender, and education do not predict depression and anxiety-related symptoms. We noted that refugees from South Sudan, the Democratic Republic of Congo, and Ethiopia reported higher levels of these than Somali refugees. This finding may be influenced by cultural factors, as psychological challenges are particularly stigmatized in some societies, potentially leading to underreporting.

Economic hardship and psychological distress: A correlated reality

The correlation between economic hardship and psychological distress is evident. Better living conditions, such as reduced food insecurity and less crowded homes, are associated with fewer cases of depression and anxiety-related symptoms. This underscores the interplay of economic and psychosocial wellbeing.

Economic interventions, such as cash transfers and livelihoods programs, can positively impact the psychological wellbeing of displaced persons. Research highlights the fact that being employed can have positive impacts on wellness, well beyond the income factor. Likewise, psychological interventions can have large positive spillovers on the labor market.

A path forward: Improving psychosocial wellbeing and expanding livelihoods opportunities

Our research found that a significant proportion of refugees in Kenya exhibit symptoms of common mental health conditions, highlighting the need for comprehensive approaches that address both psychological and economic wellbeing. Programs targeting psychological wellbeing as the presence of wellness—and not merely the absence of disease—are crucial for reducing poverty and enhancing living standards, alongside those promoting improved livelihoods and self-reliance.

These mirror Isaro’s wishes that, besides faster and hassle-free documentation, refugees need access to capital to start (and grow) businesses, along with capacity building. Against all odds, she co-founded an economic empowerment group that trains women in leadership, advocacy, and entrepreneurship.

Understanding the interplay between psychological challenges and strengths can guide organizations, governments, and stakeholders to use resources effectively to expand their capabilities and reduce vulnerability. Isaro told us that, while there have been improvements in her fortunes over the years, refugee frustrations persist and remain a struggle.

Refugees face a multitude of challenges, including limited economic opportunities, vulnerability to shocks, and persistent poverty, all while navigating complex policy contexts, abrupt life changes, potentially traumatic experiences, and deep uncertainty. These challenges are exacerbated by precarious living conditions, discrimination, and social exclusion, all of which increase mental health risks.

Yet, the psychosocial wellbeing of refugees remains largely overlooked, and access to mental health services is limited. To foster psychological wellbeing, resilience, and self-reliance, strengthening psychosocial support must go hand in hand with expanding livelihood opportunities.

With about 1.5% of the global population forcibly displaced, and a surge in Kenya’s refugee population from 540,068 in December 2021 to 823,932 by December 2024, urgent, coordinated action is needed. By addressing both economic and mental health needs, and by leveraging capabilities, we can create environments where refugees not only survive but rebuild their lives with dignity and hope.

The survey was conducted under the Kenya Analytical Program on Forced Displacement and implemented by the World Bank in partnership with UNHCR and the Center for Effective Global Action, it is supported by the PROSPECTS Partnership, which brings together the World Bank, IFC, ILO, UNHCR, and UNICEF to address the challenges of forced displacement. PROSPECTS is funded by the Kingdom of the Netherlands and, at the World Bank, is administered as part of the Multi Donor Trust Fund for Forced Displacement.

*Name have been changed to protect privacy