There are few studies on the role of migration within sub-Saharan Africa and its relation to the development of mental illness. We investigated post-resettlement adaptation and mental health challenges of African refugees/migrants in Durban, South Africa. We interviewed 335 African help-seeking refugees/migrants for anxiety, depression (25-item Hopkins Symptom Checklist) and post-traumatic stress symptoms (30-item Harvard Trauma Questionnaire). Socio-demographic and migration history, focusing on post-migration circumstances and experiences of discrimination in the host country, were obtained. Association between migration and post-settlement factors and mental health outcomes were assessed using adjusted logistic regression models. Prevalence of mental distress was high: 49.4% anxiety, 54.6% depression and 24.9% post-traumatic stress symptoms. After adjustment for family separation since migration, recent arrival in South Africa was associated with increased risk for depression (aOR = 4.0, 95% CI:1.3–11.8) and post-traumatic stress (aOR = 5.2, 95% CI:1.7–15.9), while in unadjusted models, older age on arrival was associated with anxiety (aOR = 5.3, 95% CI:1.4–19.8) and depression (aOR = 6.2, 95% CI:1.6–24.3). History of family separation since migration was independently associated with depression and post-traumatic stress in all models. Discriminatory experiences since migration was also an independent risk factor for all three mental health outcomes. Finally, being divorced/widowed was associated with an increased risk for post-traumatic stress, while higher income earners were protected against post-traumatic symptoms, even after adjustment. Refugees/migrants in South Africa show a significant burden of mental distress that is linked to challenges of adjustment in an often hostile context. Services addressing these and other health-related, social-economic needs should be developed as a priority. © 2017, © The Author(s) 2017.

Post-traumatic stress South Africa Depression Refugees Anxiety

anxiety personal experience widowed person depression Africa south of the Sahara refugee anxiety disorder mental health human Refugees coping behavior Aged Adaptation, Psychological African ethnology South Africa interview Young Adult Humans psychology male female risk factor Harvard Trauma Questionnaire prevalence Article help seeking behavior household income adult posttraumatic stress disorder Prejudice age Stress Disorders, Post-Traumatic mental disease assessment Hopkins Symptom Checklist 25 divorced person disease burden social discrimination exposure