Improving the prevention, early identification, and treatment of mental health concerns among migrants and refugees
Action Leader: DG Migration and Home Affairs, European Commission
What is the specific problem?
Refugees and migrants may be especially at risk of developing mental health conditions because of stressors they are exposed to before, during, and after the migration process. They generally have a higher prevalence of mental health disorders than native populations—such as anxiety, depression, and post-traumatic stress disorder—although this may vary greatly depending on individual characteristics, the healthcare system of the host country, and the specific experiences migrants and refugees may have endured (such as trafficking, detention, and torture). The higher prevalence of mental health disorders forms an important obstacle to social integration and employment, which could, in turn, even further increase mental health issues. Despite this higher need for support, migrants and refugees often face multiple obstacles when accessing these services—such as linguistic, financial, administrative, cultural, and other barriers.
The COVID-19 pandemic even further intensifies the mental health risks for migrants and refugees, particularly for those living in insecure situations, and threatens to further exacerbate the already grave disparities in mental health between migrants and native-born individuals.
What was the goal of this action?
This action focused on identifying the bottlenecks and barriers on the early identification and treatment of mental health concerns amongst refugees and migrants, with a view to improve their treatment from the moment of arrival to their medium- and long-term integration in their destination. Given the strong links between mental health and other dimensions of inclusion (social participation, employment, etc.), the action went beyond early identification and treatment to explore factors and strategies for the prevention of mental health conditions and the overall promotion of mental health among migrants and refugees.
In 2018 the European regional office of the World Health Organization (WHO) produced guidelines on mental health promotion and mental health care for refugees and migrants. These included aspects such as: social integration; information on entitlement to care; outreach services; interpretation and cultural mediation services; integration of mental, physical and social care; training for the mental health workforce and Research and evaluation for service planning and provision. In September 2020, the European Commission’s proposal for a New Pact on Migration and Asylum announced more action on health and healthcare of migrants through the introduction of health checks that will allow an early identification of migrant’s potential needs. In addition, the Commission’s Action Plan on Integration and Inclusion acknowledges that mental health is key to migrants’ integration and encourages Member States to facilitate migrant’s access to mental health services.
This action built upon the findings and recommendations of the WHO and of other institutions who have worked on the issue on migration and mental health, such as the European Asylum Support Office (EASO), the European Network for Mental Health Promotion (ENMHP), the European Psychiatry Association (EPA), the International Organisation for Migration (IOM) EU office and the EU Health Security Committee.
First expert Roundtable
This action organized an expert roundtable on improving prevention, early identification, and treatment of mental health concerns among migrants and refugees on 15-16 October 2021.
The roundtable led to 10 recommendations,:
All actors involved in the mental health care system should be informed and trained so they can adopt a culturally sensitive approach when dealing with and treating migrant/refugee mental health
All actors involved in migrants and refugees’ mental health care should receive additional and exhaustive training on how to navigate the system and be educated on the different types of mental health disorders, traumas, and stressors.
Mental health care should be made available at each stage of migrants and refugees’ reception, assistance, and integration processes.
An evidence-based culture in migrants and refugees’ mental health programming and policymaking cycle should be promoted.
Both a multi-stakeholder partnership and a community-based approach should be established and institutionalized regarding migrants and refugees’ mental health care.
The implementation of migrants and refugees’ mental health research and best practices should be improved through a more collaborative and systematic approach.
Finances and resources allocated to migrants and refugees’ mental health care services and research should be granted through a more accessible way, with a focus on bridging between service providers, researchers, and financial institutions.
Mapping, identifying, and sharing best practices, among migrants and refugees’ mental health experts and practitioners, is valuable and should be promoted.
Migrants and refugees’ access to mental health care should be improved, based on equity and equality of access.
Beneficial conditions, awareness raising, and favourable social determinants for promoting migrants and refugees’ mental health stability in country of destination and in a resettlement setting, should be developed, and constantly monitored.
second expert roundtable
The action organized the event ‘Challenges in upholding migrants and refugees’ mental health’ on 18 October 2022.
The hybrid event, hosted by the Committe of the Regios and co-organized by the Council of Europe Development Bank (CEB), the Committee of the Regions, and the European Commission (DG HOME), brought together key stakeholders at the local, regionald national level, as well as experts to share challenges and innovations in the access, treatment and prevention of mental health issues among migrants and refugees. The event was organized jointly with the event from the action on access to healthcare, held on 19 October.
Main takeaways
Main action takeaways include:
Authorities should explore establishing multi-disciplinary public services at the welcoming stage as well as expanding healthcare entitlements, which can lead to more cost-efficient and effective migrant health outcomes.
Policymakers should invest in intercultural communicators and interpreters. as they play a key role in the delivery of mental health services
Policymakers should establish a multi-stakeholder partnership and community-based approach
Which partners?
Action leader: DG Migration and Home Affairs, European Commission
Members: European Commission’s Joint Research Centre, Malta, Dutch National Psychotrauma Centre, City of Amsterdam, City of Barcelona, Council of Europe Development Bank