Mental health and structural injustice: a qualitative investigation of interlocking patterns of disadvantage among displaced populations in Nairobi, Kenya

Abstract

Background Urban refugees face systemic disadvantages that significantly impact their mental health and overall wellbeing. Research on refugee mental health often examines risk factors in isolation, overlooking broader systemic patterns. This study applies a structural injustice framework to investigate how interconnected disadvantages shape the mental health of urban refugees. Methods A thirteen-month study examined the wellbeing of Somali and Congolese refugees in Nairobi, employing ethnographic methods, including 69 in-depth interviews, field notes, and observations. Findings were interpreted using Powers and Faden’s structural injustice theory. Results Analysis revealed a systemic pattern linking immigration status, sexual and gender-based violence, and limited access to livelihoods. These interconnected factors impact all six elements of wellbeing identified by Powers and Faden and exhibit the theorized characteristics of structural injustice: pervasive, profound, asymmetric, and near-inescapable. Discussion The study highlights the structural nature of challenges faced by urban refugees in Nairobi, emphasizing the need to address interconnected systemic barriers. Understanding these patterns is essential for identifying effective interventions and mitigating risks to refugee mental health and overall wellbeing. Conclusion The theory as used in this study sheds new light on the interconnected nature of the environment urban refugees live in. This holistic approach to wellbeing provides clarity on vulnerabilities related to specific social groups.