This content was kindly written for PTSD UK by volunteer Rhianon Potter, an undergraduate on placement with the Sussex Partnership NHS Foundation Trust PTSD Clinic.

In a time where global conflicts and humanitarian crises force thousands to seek refuge, it is crucial to consider the long-term impact on those escaping catastrophe. The UK government reports that 75,340 people made asylum applications between September 2022 and September 2023 (1). Many of these resilient individuals face enforced returns and detainment, despite the government’s resettlement schemes. Life as a refugee remains incredibly challenging, with approximately 100,000 applicants awaiting a decision as of January 2024 (2). With the distress being far from over when refugees reach their place of resettlement, it is perhaps no surprise that upward of 40% of refugees—and up to 90% of refugee children—experience Post Traumatic Stress Disorder (PTSD).

PTSD is a debilitating condition that affects around 20% of people who experience trauma, and research by University College London indicates a heightened risk of suicide among those with PTSD (3). Symptoms of PTSD include flashbacks, recurring memories, intrusive thoughts/images, avoiding reminders of the trauma, feeling emotionally numb, being easily startled, and feeling unsafe, and these symptoms can take months or even years to appear following the traumatic event. Furthermore, some of these individuals may develop Complex-PTSD (C-PTSD), a subtype characterised by more complex symptoms such as difficulties with interpersonal relationships and self-esteem, typical of individuals exposed to prolonged or chronic trauma. 

Refugee communities are particularly vulnerable to these symptoms due to their exposure to sustained and severe traumatic experiences, such as war, sexual violence, torture, and persecution (4). Upon arriving in a new country, they may face additional stressors—such as housing insecurity, financial struggles, limited job opportunities, and social isolation—which can exacerbate or trigger C-PTSD.

The Struggles Continue After Arrival

Even after reaching a place of asylum, refugees often encounter barriers that make thriving difficult. For instance, unemployment rates among refugees in the UK are 18%, three times higher than among the non-refugee population (5). Limited employment opportunities can lead to ongoing trauma, including homelessness, poverty, and social isolation. These issues are particularly acute amidst the cost-of-living crisis, which disproportionately affects vulnerable communities. Moreover, negative public attitudes toward refugees can lead to discrimination and further isolation, especially when compounded by language barriers and cultural differences.

While social isolation is a common consequence of PTSD, research shows that social support can help buffer its onset (6). Similarly, stable living conditions can foster recovery from trauma without further aggravating PTSD symptoms. Unfortunately, refugees often face significant obstacles in accessing mental health care; immigration status is a major predictor of limited access to healthcare (7), and refugees frequently encounter lengthy waiting times, fear, funding issues, and prejudice when seeking mental health support through the NHS (8).

The Need for Trauma-Informed Approaches

Although refugees often display remarkable resilience, advocating for trauma-informed approaches is vital to promoting their recovery. Trauma-informed approaches recognise the impact and symptoms of trauma and how this affects an individual, particularly important in refugee communities who often are exposed to social isolation, unemployment, and physical health issues following chronic exposure to traumatic events. The NHS Long-Term Plan calls for integrating trauma-informed care across all mental health services, not just those for PTSD and C-PTSD (9). This can be implemented through training and trauma-screening within healthcare systems in order to minimise harm. Evidence-based treatments, such as narrative exposure therapy, have shown particular promise in helping refugees. Moreover, addressing other barriers—like housing and social isolation—through a trauma-informed lens can mitigate the risk of poor mental health, crime, violence, and antisocial behaviour. 

How You Can Help

While the challenges faced by refugees may seem beyond our control, everyone can play a role in alleviating the negative effects of trauma, unemployment, housing difficulties, healthcare access, and social isolation.

Refugees and asylum seekers often struggle with stigma around mental health treatment, further complicated by language and cultural barriers with UK-based therapists. Understanding these challenges and educating ourselves about the refugee experience is an important first step. However, it’s essential to approach refugees’ stories with sensitivity. Asking questions to learn more can unintentionally trigger distress, particularly for those who may not feel comfortable discussing their experiences (10). Children, too, may avoid discussing trauma, mimicking their parents’ emotional responses. All refugees, regardless of age, need to feel heard and validated without pressure to share their stories. Providing psychosocial support, when done thoughtfully and with awareness of potential triggers, can offer a vital source of hope and help counteract the stigma and isolation many refugees face.

Another way to help is by supporting charities like Refugee Action, Refugee Council, and the British Red Cross, which advocate for government and social action to support refugee settlement. These organisations also help refugees access essential services such as healthcare, housing, and employment—support they often struggle to receive.

By becoming informed about PTSD and the challenges refugees face, welcoming them into our communities, challenging stigma, and supporting organisations that advocate for their well-being, we can contribute to fostering a supportive environment that promotes recovery and integration for refugees.

You can find out more about the struggles faced by refugees at Mental health support for refugees and people seeking asylum – Refugee Council.