Felix Sisenop ¹ Pallavi Chatarajupalli ¹ Paul Bain ² Hanna Kaade ³ Jutta Lindert ^1*

• ¹ University of Applied Sciences Emden Leer, Emden, Germany
• ² School of Public Health, Harvard University, Boston, United States
• ³ Brandenburg Medical School Theodor Fontane, Brandenburg an der Havel, Brandenburg, Germany

Little is known about the mental health consequences of human rights violations in forcibly displaced populations. Objective: The objectives of this systematic review are to examine: 1) the prevalence of mental health conditions among forcibly displaced persons; 2) to investigate methodological factors contributing to mental health conditions; and 3) associations between mental health conditions and human rights violations. Methods: We conducted a systematic review with meta-analyses on the prevalence of anxiety, depression, and posttraumatic stress disorder among forcibly displaced populations and factors contributing to it by searching in databases MEDLINE (Ovid), Embase, Web of Science Core Collection (Clarivate), PsycINFO (EBSCO), Sociological Abstracts (ProQuest), and PTSDPubs (ProQuest). Additionally, we assessed the Global Peace Index. Pooled associations were calculated using a random-effects meta-analysis model. Subgroup analyses were performed for the Global Peace Index, sampling methodology, also we assessed risk of bias. Results: Of the 4,175 records screened, 55 with n =31,573 participants met the inclusion criteria (n =15,714 males, females, n =15,859 females). Most studies were cross-sectional (n =49). The pooled prevalence rates were 38.90% (95% CI: 29.63; 48.17) for anxiety, 38.16% (95% CI: 32.16; 44.15) for depression and 39.62% (95% CI: 32.87; 46.36) for posttraumatic stress disorder. Analyses by level of human rights violations show anxiety, and depression prevalence rates were higher in countries with low Global Peace Index than countries with high, moderate and low Global Peace Index (39.84% versus 16.09%; 41.07% versus 26.67%). Analyses by risk of bias indicate that the prevalence rate of PTSD was higher in studies with a high risk of bias compared to those with a very high risk of bias (49.27% versus 29.79%). For anxiety, the prevalence rate was greater with random sampling compared to convenience sampling (44.71% versus 36.87%). Depression and PTSD prevalence rates were higher with convenience sampling than with random sampling (38.67% versus 37.70%; 42.83% versus 35.50%). Conclusion: Our review suggests that systematic continuous human rights violations are associated with mental health conditions in forcibly displaced persons. To prevent mental health conditions, it is necessary to reduce exposure to human rights violations in the countries forcibly displaced persons come from.