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Hintergrund: Refugees are at high risk of emotional distress due to multifactorial stressors they experience in their country of origin, during their flight and upon arrival in their host country. Yet Germany restricts access to health care for refugees. In combination with other barriers, this leads to high unmet needs, especially in terms of mental health care. Knowledge and data on the treatment gap of emotional distress and perceived barriers in Eastern Germany are scarce.

Zielsetzung/Fragestellung: Our aim was to measure the prevalence of emotional distress among refugees living in shelters in different parts of Eastern Germany and to examine the proportion of refugees who receive adequate health care. Additionally, data on perceived barriers to accessing health care was collected.

Material & Methoden: In a cross-sectional study, an online survey was conducted in seven languages with refugees accommodated in sixteen randomly selected shelters in three German federal states (Saxony-Anhalt, Brandenburg, Mecklenburg-Western Pomerania). Emotional distress was measured using the Refugee Health Screener-13 (RHS-13). Data on contact to the health care system and the amount of care as well as perceived barriers were collected by self-report.

Ergebnisse: RHS-13 screening showed that 75.8% (n = 249) of participants in the study presented emotional distress above the cut-off value and therefore an objective need for further assessment. In contrast, only 14.9% (n = 37) of distressed refugees received an adequate amount of care. 60.2% (n = 150) of distressed refugees presented severe emotional distress and required urgent treatment, yet only 1.3% (n = 2) of them received minimally adequate treatment (as defined by WMH Survey Initiative). The most frequently cited barriers to health care in Germany were language barriers (70.3%, n = 215), followed by missing information about the German health care system (63.5%, n = 197) and long waiting times for appointments (63.1%, n = 195).

Diskussion: In our sample of refugees in Eastern Germany, a high prevalence of emotional distress was observed while access to health care remained markedly low. Systematically imposed barriers such as limited health care entitlements, administrative obstacles and language barriers restrict their access to health care. To address this, these barriers must be removed and accessible, low-threshold health care services established.

Take Home Message für die Praxis: Refugees in Eastern Germany show high emotional distress yet remain seriously undertreated. Urgent action is needed to improve their access.

Competing interests: Die Forschung wurde im Rahmen des Projekts „Hürden nehmen – Psychosoziale Versorgung für Geflüchtete“ (Laufzeit: 01.03.2023–31.05.2026) durchgeführt. Das Projekt wird aus Mitteln des Asyl-, Migrations- und Integrationsfonds (AMIF) der Europäischen Union kofinanziert und in Kooperation mit KommMit – für Migrant*innen und Geflüchtete e. V. umgesetzt.