Migration constitutes a major public health challenge, with meta-analytic evidence demonstrating that first- and second-generation migrants face an almost twofold increased risk of developing psychotic disorders compared to native populations. The persistence of this elevated risk in the second generation indicates that environmental factors in host societies, rather than migration itself, play a crucial role. Trauma exposure across multiple phases of the migration journey—pre-migration persecution and violence, peri-migration dangers and family separation, and post-migration discrimination and social isolation—constitutes a particularly potent risk constellation for psychosis development. Meta-analytic findings indicate a significantly increased likelihood of psychosis in individuals with traumatic and adverse childhood experiences (OR = 2.8), with dose–response relationships demonstrating cumulative risk. The social defeat hypothesis proposes that chronic experiences of subordinate or outsider status lead to sensitization of the mesolimbic dopamine system, a neurobiological pathway shared by both trauma-related and migration-related stress. Mentalization—the capacity to understand behavior in terms of underlying mental states—emerges as a critical mediating mechanism linking trauma, migration adversity, and psychosis vulnerability. Impaired self-mentalizing has been identified as a key pathway through which early adversity increases psychosis risk, while chronic threat activation in discriminatory environments progressively erodes mentalizing capacities, creating vulnerability to paranoid ideation. Dissociative processes developed as protective mechanisms following severe trauma may further increase susceptibility to psychotic experiences when triggered by ongoing post-migration stressors. Refugees face independent risk beyond general migration-related factors (relative risk 2.5), reflecting cumulative adversities compounded by asylum-related uncertainty. Culturally adapted and trauma-focused interventions, as well as mentalization-based treatments, offer theoretically aligned therapeutic approaches for this population. However, effective prevention must address socio-political determinants, including discrimination, social exclusion, and structural barriers that perpetuate conditions of chronic stress and social defeat.