Mental Health Experiences of African Refugees in the United States: A Scoping Review

Background and Purpose: Recent studies in the U.S. show that in 2020, an estimated 19.2% of adults received mental health services, including 15.2% who received prescription drugs and 9.5% who received counseling or therapy. Additionally, studies highlight a gap between mental health needs and the capacity of the U.S. healthcare system to meet those needs. Among those most impacted are African refugees in the U.S. who face mental health challenges shaped by cumulative experiences of displacement and trauma. Post-migration stressors such as unemployment, discrimination, and cultural differences can exacerbate psychological stress. Previous studies have highlighted high rates of post-traumatic stress disorder, depression, and anxiety among refugee populations, but few studies have specifically examined the unique mental health experiences of African refugees in the U.S. This study aims to explore the mental health experiences of African refugees in the U.S.

Methods: The study utilized George Engel’s (1977) biopsychosocial framework, which conceptualizes mental health as influenced by biological, psychological, and environmental factors. A comprehensive search used keywords such as mental health conditions, mental health, African refugees, mental health disorders AND (trauma intervention), and African counties. Databases searched included Medline, APA PsycINFO, ProQuest, Web of Science, MeSH, PubMed, EBSCO, and Google Scholar. Zotero bibliographical software was used to collect and manage the studies that were later screened using Covidence. The included studies had to be published between 2014 and 2025, conducted in the U.S, examined African refugee mental health, and written in English. The search yielded 1922 studies. The review identified 795 studies after removing duplicates, the title and abstract review yielded 30 studies, and the final full-text review yielded 16 studies that met the inclusion criteria. The final 16 studies were assessed using the Critical Appraisal Skills Program (CASP) checklist, and a PRISMA flow chart was used to report on the selection process. An inductive analytical approach was used to develop a comprehensive codebook and analyze data using Nvivo14 software.

Results: A thematic analysis of the 16 studies identified three major themes on the experiences of African refugees in the U.S. They included: a) trauma across migration phases: pre-migration, during, and post-migration; b). mental health stressors, including racism, discrimination, gendered experiences, youth identity conflict, and social marginalization; and c). barriers to mental health services that included mistrust of western mental health services, culture, and religion. The study identified communal and family support as critical protection factors. Other sources of resilience included religion and culture. Many participants highlighted the need for culturally appropriate and accessible mental health support.

Conclusions and Implications: Results show the need for culturally responsive, trauma-informed mental health services tailored to the experiences of African refugees. African refugees emphasized that Western models of care often overlook the role of culture and religion in understanding and dealing with distress, leading to underutilization of services. Interventions must integrate community-based approaches centered on cultural identity, spiritual support mechanisms, and trusted support networks. Practitioners and policymakers should prioritize linguistic accessibility, gender sensitivity, and anti-racist training to reduce stigma and systemic barriers among refugee populations.