# Mental health trajectories and Peer Refugee Helper engagement, among Afghan, Iranian and Syrian refugees and asylum seekers in Greece

## TL;DR

This study explores how being a paid or unpaid Peer Refugee Helper affects mental health outcomes like anxiety and depression among Afghan, Iranian, and Syrian refugees in Greece.

## Contribution

The study introduces new insights into how PRH status and sense of coherence influence mental health trajectories in refugee populations.

## Key findings

- Unpaid PRHs were less likely to follow a low depression trajectory.
- Paid PRHs were more likely to follow a low anxiety trajectory.
- Higher sense of coherence was linked to lower depression and anxiety trajectories.

## Abstract

Peer Refugee Helpers (PRHs) support peers in humanitarian settings, which may influence their own mental health. This longitudinal study examined anxiety and depression trajectories among Afghan, Iranian and Syrian refugees and asylum seekers in Greece, focusing on how PRH status (paid/unpaid) and sense of coherence influence trajectory membership. The study included 176 adult, PRHs and non-helpers. The following scales were administered three times at ~4-month intervals: Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder (GAD-7), Social Provisions Scale (SPS-24), Sense of Coherence (SOC-13), Perceived Ability to Cope With Trauma (PACT) and Brief Trauma Questionnaire (BTQ). Using latent growth mixture modeling, we identified two depression (high and low) and three anxiety (high, moderate and low) trajectories. The adjusted logistic and multinomial regression models indicated that unpaid PRHs were significantly less likely to follow a low depression trajectory (odds ratio [OR] = 0.55, p = 0.037), while paid PRHs were more likely to follow a low anxiety trajectory (OR = 3.17, p = 0.009). Higher SOC was associated with low depression (OR = 1.03, p = 0.012) and low anxiety trajectories (OR = 1.06, p = 0.002). Our findings suggest PRH mental health may be associated with working conditions, including financial compensation.