Rooted in Resilience: Mental Health Determinants and Coping Strategies Among South Sudanese Older Refugees and Refugees with Disabilities in Urban Nairobi

Nairobi, Kenya hosts a significant number of South Sudanese refugees, many who have fled years of continued conflict and instability. As of January 2025, 110,859 South Sudanese refugees and asylum seekers live in Kenya and are one of the largest refugee populations in the country. This paper explores the mental health perceptions, challenges, and coping strategies of older South Sudanese refugees and South Sudanese refugees living with disabilities in Nairobi. Using a Social Determinants of Health (SDOH) framework, a Community-Based Participatory Research (CBPR), and Exploratory Descriptive Qualitative (EDQ) approaches, the paper analyze how economic hardship, social marginalization, political instability, and cultural displacement contributes to their mental health challenges. This paper helps to address a major research and literature gap, as older refugees and refugees with disabilities continue to be underrepresented in mental health research, especially within low-and middle-income country (LMIC) urban areas like Nairobi. A thematic analysis of five focus group discussions (FGDs) uncovers that barriers such as unemployment, discrimination, and legal uncertainty intersect with cultural stigma to worsen mental health. Yet, participants also demonstrate resilience, relying on community support, faith, and cultural traditions to cope. These findings highlight the crucial need for inclusive, culturally sensitive mental health and psychosocial support (MHPSS) interventions that engage refugee communities in their design. The paper concludes with recommendations for future interventions across individual, community, and policy levels to better support these underrepresented populations.