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Working paper title: Transnational Trauma: Mental Health Effects of War on Expatriates

By: Mounir Karadja, Akib Khan, Linna Martén & Jimena Romero Pinto

Abstract

We investigate the impact of the 2022 Russian invasion of Ukraine on the mental health of Ukrainian migrants living abroad, leveraging comprehensive administrative data on medical prescriptions in Sweden. Despite the physical distance from danger, expatriates may still be affected by home-country conflict through the social, economic, or national ties they have to their homeland. To isolate the causal effect of indirect war exposure, we use the synthetic control method, comparing the outcomes of Ukrainians to a weighted average of other migrant groups in Sweden. Our results indicate an immediate deterioration in the mental health of Ukrainian expatriates following the invasion, with a marked increase in the take-up of anti-anxiety and insomnia medications. Furthermore, the uptake of anti-depressants rises significantly in the third quarter, indicating a potential shift towards medications for more long-term conditions. These effects are driven by women, although it is possible that men face mental health challenges without seeking medical care. We find little evidence that family situation, legal status, or economic conditions are important mediators of the effect.