Investigating the Effect of the Asylum Decision on Refugees’ Mental Health in Germany

A large body of quantitative and qualitative research links legal precarity with mental health challenges (e.g., Morgan et al., 2017; Nickerson et al., 2019). Refugees with insecure visa status live in a state of protracted uncertainty, blocked mobility, fears of deportation, and other aspects of “legal violence” that can impact psychological well-being (Abrego & Lakhani, 2015). An asylum status decision should therefore lead to positive mental health outcomes. However, few quantitative studies – largely with small samples – have gone so far as to demonstrate a causal relationship between the asylum decision and mental health outcomes (e.g., Silove et al., 2007). As such, this study sets out to test the causal relationship between the asylum decision and self-reported mental health status using a large sample of refugees that arrived in Germany between the years 2013 and 2018. We use a synthetic difference in differences approach in order to account for differences between treatment (i.e., asylum-receiving) and control groups, with a staggered treatment adoption design. Our data, the German Socio-Economic Panel, includes 8,833 refugees in our final sample. Results indicate a dynamic treatment effect; while the positive effects of receiving asylum on mental health are not immediately visible, they emerge over several years. As we control for the typical predictors of poor mental health in our models, we are fairly confident in the causal nature of this relationship. In light of the significant long-term effect of secure legal status on mental health, as well as differences in likelihood of receiving asylum by demographic background that we observe in the data, we discuss the role of asylum policies and “legal violence” in public health.