Hazardous substance use and mental health among refugees in shared accommodations – a mixed-methods study

Background
Due to their experiences before, during and after their flight, refugees are at special risk for experiencing traumas and might use substances in a hazardous way to cope with their psychosocial distress. For this reason refugees are particularly vulnerable for mental health issues and hazardous substance use. In spite of this vulnerability, refugees are an underrepresented population in addiction prevention, addiction aid and mental health services. The purpose of this presentation is to present results from a mixed-methods study which assessed hazardous substance use and the psychosocial situation among refugees living in shared accommodations in Germany after their flight. This research may provide a more comprehensive understanding of the challenges refugees are facing and give indications for designing a more health-promoting setting for them. 
Methods
The study followed an exploratory sequential mixed-methods research design which included qualitative interviews and a quantitative survey. Qualitative data were examined by structured content analysis and used to prepare the quantitative research design. Further on quantitative data were assessed by multilingual questionnaires containing different aspects regarding the psychosocial living situation, hazardous substance use and mental health. Quantitative data were then analysed with correlation analyses and multivariate logistic regression. The qualitative and quantitative results were then matched in joint displays.
Results 
The study provided information about the distress situation of refugees living in shared accommodations and the interrelationships between living situation, mental health and hazardous substance use. Refugees are exposed to several risk factors which make them vulnerable for hazardous substance use. Significant predictors for hazardous substance use were duration of residence in shared accommodations, substance use due to flight and suicidal plans. 
Conclusions
The study results show intersections between refugees’ mental health and hazardous substance use. A crucial time period for addiction prevention measures is the arrival situation in which refugees are potentially exposed to different risk factors and face cumulative experience of stress. This research points out the need for the further development of evidence-based programs for refugees and the urgency to address this population with setting- and target group-specific prevention and intervention.