Impact of access to housing on mental health and coping amongst Ukrainian refugees in England

BACKGROUND: Though the link between war-related trauma and poor mental health is well-established, less is known about stressors due to prolonged displacement, and how these relate to mental health. As the numbers of forcibly displaced persons rise worldwide, the associated mental health burden represents an urgent public health need. This qualitative paper explores housing-related stressors amongst adult female Ukrainian refugees England, mental health impacts, and coping responses. METHODS: We draw on 40 semi-structured interviews: 30 with Ukrainian refugee women, 10 with stakeholders (council staff, mental health professionals, staff/volunteers at relevant charities). Thematic analysis identified macro- and micro-level factors impacting housing access, perceived mental health and coping. RESULTS: Most of the Ukrainian sample were provided with housing for an initial 6 months. Facing the pervasive shortage in council housing, many were attempting to transfer into rented accommodation at interview time. These efforts were hindered by a lack of employment history, discrimination from landlords, and the language barrier. Interviewees linked these issues to high stress levels and deteriorating well-being, adding to their anxiety over the ongoing war. Coping centred on support-seeking (reaching out to councils, charities, other Ukrainians), distraction (exercise, volunteering), problem-solving (taking a methodical approach to problems), and cognitive restructuring (focusing on the positive). CONCLUSIONS: Ukrainian refugees face significant barriers in accessing long-term housing in England, forcing some to choose between insecure housing and returning to a war zone. This bind has compounded mental health issues attributed to the trauma of leaving Ukraine and the ongoing war. Though refugees took an active approach to coping with housing hardships, resources to support the transition to long-term housing is necessary to better safeguard their mental health from further harm. KEY MESSAGES: • Ukrainian refugees face significant barriers in accessing housing in England, forcing some to choose between insecure housing and returning to an active war zone. • Participants linked barriers to accessing housing to high stress levels and a deterioration of well-being, compounding trauma from fleeing Ukraine and anxiety over the ongoing war.