Starting over: Post-migration challenges experienced by refugees when integrating in a new country

Imagine being forced to leave your home because it is no longer safe. Maybe there is a war. Maybe your home has been destroyed during an earthquake. Or maybe your life is in danger because of your identity. You are now a ‘refugee’, or a displaced person.

Next, you endure the journey of reaching a place of safety. You may have the option to fly. You also may not. Instead, your journey may take months, or even years. However long this takes, imagine you finally arrive at your destination. Here, you need to build an entirely new life.

As of 2023, 110 million people were forcibly displaced from their country (UNHCR, 2023). By 2050, this statistic is projected to reach 1.2 billion people (Institute for Economics & Peace, 2020). Each part of displacement presents unique challenges and potential traumas, including experiences of war, threats to safety and poor living conditions (Mesa-Vieira et al., 2022; Taylor et al., 2024).

However, while we know these broad challenges exist, we know less about what they mean for individuals trying to rebuild their lives post-migration. Individual studies have described refugees’ stories about the difficulties of settling into a new country. However, no review has pulled these experiences together to identify shared experiences. As such, Dafni Katsampa et al. (2025) systematically reviewed the qualitative research to explore the challenges displaced people face when arriving to a new country.

The stories of people who have been displaced highlight the profound challenges they face after leaving their homes, and when trying to integrate in new countries.

Methods

15 databases were searched for peer-reviewed articles and grey literature (non-peer-reviewed) that i) used qualitative methods, ii) focused on post-migration and resettlement experiences in adult refugees, and iii) were published from 2011 onwards. The search terms were developed by looking at other relevant studies and consulting individuals with lived experience of displacement.

Titles, abstracts and full texts were double-screened by two authors, with differences discussed. Data was summarised using thematic synthesis. An iterative, whole-team approach was adopted where the themes were reviewed, discussed and refined collaboratively. Quality and risk of bias was assessed using The Critical Appraisal Skills Programme (CASP) Checklist for Qualitative Studies. All studies were of moderate to high quality.

Results

27 studies met the eligibility criteria. Studies included 490 refugees, most of whom were male (n = 247), and ranged in age from 18 to 77 years old. Participants were from the Middle East, Africa and South Asia.

Four main themes were identified, with additional subthemes.

Theme 1 – Deprived lives: Post‑migration life quality

• Exposure to poor living conditions (n = 20): Challenges reported by refugees included limited public resources, government support, access to benefits, food, accommodation or shelter, as well as exploitation.
• Emotional burdens (n = 25): Resettlement was linked with increased depression, hopelessness, post-traumatic stress disorder (PTSD), ongoing trauma, suicidal thoughts and general worry. Mental health difficulties had subsequent impacts on other areas of an individual’s life, including increased physical health difficulties and a higher risk of suicide.

Theme 2 – Shaping identities: Restrictions, changes and freedom

• Sense of powerlessness and identity loss (n = 22): Many described how refugee identity can lead to disempowerment due to limited independence, which can be difficult to accept. A loss of identity often led to further disempowerment.
• Acculturation (n = 17): Resettlement requires adaptation to new cultural mindsets and values. This process can trigger ‘cultural shock,’ often involving internal conflict, interpersonal tensions, and feelings of betrayal when new behaviours differ from an individual’s original culture.

Theme 3 – Interpersonal relationships: Loss and connection

• Family separation (n = 21): Disconnection from family and home was a common challenge. By missing important events (e.g., birthdays) displaced people felt ‘lost between’ two worlds. Refugees worried about their families’ safety and many experienced challenges with the family reunion process, such as long wait-times for outcomes and uncertainty.
• Relational losses and social isolation (n = 25): Difficulties centred around struggling to re-create social networks, with a sense of invisibility in social spaces. Isolation prevented help-seeking and perpetuated feelings of isolation. Language barriers, powerlessness, and distrust also impeded social connection.
• Navigating difference, racism and discrimination (n = 19): Discrimination, racism and Islamophobia were common experiences. Individuals described ‘negative contacts with authorities’ with consequent feelings of being illegal and unwelcome. Socio-political and media representations of displaced groups were said to exacerbate racism and insecurity. Intersecting identities, such as identifying as both a refugee and Muslim, further compounded challenges.

Theme 4 – Living in limbo: New country, new rules

1. Asylum process and sense of safety (n = 17): Understanding the asylum system proved challenging, with long wait times on outcomes when applying for sanctuary. Once applications are accepted, receiving leave to remain still did not promise security. Worries around deportation were common. Nevertheless, some participants were grateful to be in countries where human rights were protected.
2. Access to services and social integration (n = 25): The lack of adequate resources and information posed significant difficulties, including accessing healthcare. Language problems, a lack of legal documents, long waiting times, complex pathways or services and inaccessible information worsened difficulties. The stigma of mental health within cultures further prevented help seeking.

Resettlement for displaced individuals is riddled with numerous challenges such as isolation, disempowerment, and barriers (e.g., language) which prevent social integration.

Conclusions

Challenges to resettlement are multifaceted and multilayered among displaced groups. Difficulties include poor living conditions, mental health difficulties, loss of identity and power, social isolation, discrimination and racism, confusing asylum processes and accessing services. Language and communication, limited knowledge and cultural differences worsen difficulties. The authors concluded that:

Addressing these barriers requires a multi-sectoral response, where immigration policies, mental health frameworks and community-based programmes align to facilitate refugee well-being and societal cohesion.

A multi-sector approach is needed to help mitigate challenges and improve resettlement for displaced people, including mental health, social care, communities, and policy.

Strengths and limitations

Strengths

• This is the first qualitative systematic review on psychosocial post-migration living difficulties. The findings bring together the perspectives of over 450 refugees, an otherwise ‘hard-to-reach population’, to present a comprehensive overview of the varying difficulties and barriers to integration. The large sample ensures recommendations are not based on a small population. Instead, the results provide an enriched representation of the challenges faced by displaced people across contexts.
• The review was conducted in a robust manner which gives credibility to the findings. The study incorporated not only peer-reviewed literature but the grey literature, which represents a wider inclusion of literature, including those from non-Western settings and studies which may not have had the opportunity to be published. This ensures a range of perspectives are included and not biased to Western academic settings.
• The methodology and search strategy were developed with experts in the field, alongside those with lived experience, ensuring the review captured elements relevant to refugees and subsequently more applicable to real life. A further rigorous whole-team approach to study selection and analysis adds to the strengths of the paper, minimising bias (e.g., selection bias).

Limitations

• The review excluded non-English papers, which means that relevant studies (and perspectives) from non-Western cultures and areas in the Global South may have been omitted. This reduces how representative these findings are.
• Although the review presented its results using a figure and textual descriptions, it notably omitted a summary table in the main text. While this was available in supplementary materials, an easily accessible table detailing the characteristics and findings of each study would have offered a clearer, more consolidated overview and greatly facilitated comparison across the studies. However, this could be an issue with journal guidelines and limited space, therefore out of the authors’ control.
• The review did not report on inter-rater reliability. All systematic reviews should be replicable and therefore, all decisions should be consistent and transparent. Without such scores reported on, therefore it is hard to assess the reliability and consistency of the methods (Belur et al., 2021).

Stakeholders were consulted when designing this systematic review, which aids alignment with real-world priorities and increases the likelihood of meaningful recommendations being developed.

Implications for practice

The study’s findings have some important implications for policy, practice and future research.

Policy and practice implications

• The findings underscore the need for a holistic support approach for displaced individuals, where practical aid with employment, housing, asylum processes, and skill-based training is crucial for successful resettlement.
• Current restrictive family reunification policies pose significant challenges, as individuals’ intense worry for their separated families is linked to worsened mental health. Policymakers should reform these policies to create more humane reunification pathways. To improve policy, it is essential to ease restrictions and expand the number of safe, legal, and accessible pathways for family reunification.
• Enhancing access to information, including translated documents, is also vital for aiding adaptation and service navigation.
• Mental health issues, notably PTSD, are significant among this population. Clinicians should address these by considering the broader post-migration challenges identified in this study when developing treatment plans and designing assessment interviews (see a 2024 blog written by UCL MSc students on this topic).
• Adopting trauma-informed approaches in all interactions is essential. Trauma-informed approaches involve awareness of trauma, collaboration, building trust and creating a sense of safety (read Aneta’s 2022 blog to learn more about trauma-informed mental healthcare).
• Professionals working with displaced people should receive comprehensive training on post-migration complexities. Services must also actively work to mitigate barriers to access, for example, by building trust with service users, providing mental health education, and implementing linguistically and culturally appropriate support.

Research implications

• Additional qualitative research should focus on how these challenges can be overcome. By exploring the narratives of key stakeholders (including those with lived experiences and clinicians), evidence-based interventions and support can be developed and tested.
• Future research needs to incorporate a range of perspectives, particularly those of refugees residing in low- and middle-income countries or the Global South. Current recommendations may reflect the needs and contexts of Western societies, which may not be universally applicable.
• Additionally, future studies should adopt gender-specific and gender-sensitive methodologies, ensuring the inclusion of LGBTQIA+ perspectives to better capture the complexity of refugee experiences.

Overall, from my experience working with displaced groups both in refugee camps and during the post-migration period, life can be incredibly challenging. The narratives in these studies are reflected in the perspectives and stories I have heard throughout my work. Many individuals have often described significant struggles with their mental health, difficulties in accessing support, the navigation of the asylum process, and the profound worry for their family back home. I therefore advocate for the implications of these findings – emphasising the need for better family reunification processes and improved support that is holistic, culturally adapted, equitable and accessible.

This systematic review highlights the importance of improving family unification pathways, which seem key to resettlement and the improvement of mental health difficulties for refugees.

Statement of interests

Alex was not involved with the current study or the authors, but is working on a PhD exploring the relationship between mental health, trust, perception and social functioning in displaced groups.

Links

Primary paper

Katsampa, D., Spira, J., Stamatopoulou, V., & Chapman, D. (2025). ‘I’m facing everything by myself’: Post-migration Difficulties and Barriers to Integration Among Refugees. Journal of International Migration and Integration, 1-23.

Other references

Belur, J., Tompson, L., Thornton, A., & Simon, M. (2021). Interrater reliability in systematic review methodology: exploring variation in coder decision-making. Sociological Methods & Research, 50(2), 837-865.

Institute for Economics & Peace. (2020). Over one billion people at threat of being displaced by 2050 due to environmental change, conflict and civil unrest.

Mesa-Vieira, C., Haas, A. D., Buitrago-Garcia, D., Roa-Diaz, Z. M., Minder, B., Gamba, M., … & Franco, O. H. (2022). Mental health of migrants with pre-migration exposure to armed conflict: a systematic review and meta-analysis. The Lancet Public Health, 7(5), e469-e481.

Taylor, S., Charura, D., Williams, G., Shaw, M., Allan, J., Cohen, E., Meth, F., & O’Dwyer, L. (2024). Loss, Grief, and Growth: An Interpretative Phenomenological Analysis of Experiences of Trauma in Asylum Seekers and Refugees. Traumatology, 30(1), 103-112.

UCL Psychiatry MSc (2024).  Trauma affects how refugees feel about themselves and others, but how can clinicians help? The Mental Elf.

UNHCR (2023). Refugee Data Finder. The UN Refugee Agency.

Zarska, A. (2022). Trauma-informed care in mental health: why we need it and what it should look like. The Mental Elf.

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