Trauma, experiences of sexual violence and mental health in LGBTIQ+ refugees seeking psychosocial support in Germany.

Aims: Only little empirical evidence exists on mental health in LGBTIQ+ refugees. In the present study, trauma exposure, experiences of sexual violence and current treatment needs for physical and mental health were investigated in association with symptoms of anxiety, depression, post-traumatic stress disorder (PTSD) and somatic symptom burden in LGBTIQ+ asylum-seekers resettled in Germany and seeking psychosocial support.

Methods: Data was collected in cooperation with a counselling centre for LGBTIQ+ asylum-seekers between Mai 2018 and March 2024, with a total of 120 completed questionnaires of adult clients. The questionnaire (11 different languages) included sociodemographic and flight-related questions as well as standardized instruments for assessing PTSD (PCL-5), depression (PHQ-9), somatic symptom burden (SSS-8), and anxiety (HSCL-25). Prevalence rates were calculated according to the cut-off scores of each questionnaire. Four logistic regression analyses were conducted to test for potential associations between being screened positive for anxiety, depression, somatic symptom burden or PTSD and the number of traumatic events, experiences of sexual violence as well as current treatment needs for physical and mental health.

Results: The great majority, 74.2% (95% CI: 66-82) of the respondents, screened positive for at least one of the mental disorders investigated, with 45% (95% CI: 36-54) suffering from somatic symptom burden, 44.2% (95% CI: 35-53) from depression, 58.3% (95% CI: 50-67) from PTSD, and 62.5% (95% CI: 54-71) from anxiety; 69.5% participants reported having been exposed to sexual violence. Current treatment needs for physical health problems were reported by 47% and for mental health problems by 56.7%. Participants with experiences of sexual violence were more likely to be screened positive for depression (OR: 6.787, 95% CI: 1.45-31.65) and PTSD (OR: 6.121, 95% CI: 1.34-27.95).

Conclusions: The study provides initial insights on mental health and associated factors in a highly burdened and hard-to-reach population. The findings are important for healthcare systems and political authorities in terms of assuring better protection and healthcare for LGBTIQ+ refugees and asylum-seekers.