One billion people were classified as migrants in 2020, including 26.4 million refugees and 4.1 million asylum seekers – many driven from their homes by political conflict and climate crises.

But migrants and refugees seldom get access to mental health services, despite being amongst the most at-risk people. 

On World Mental Health Day on Tuesday, the World Health Organization (WHO) released a new report outlining the latest global evidence on factors influencing the mental health of refugees and migrants and their access to care. 

“Refugees and migrants face many unique stressors and challenges. This report sets out the urgent need for robust policies and legislation, rooted within stronger health systems, to meet the mental health care needs of refugees and migrants,” said Dévora Kestel, WHO Director for Mental Health and Substance Use. 

Muska is a psychosocial counselor working with Ghoryan Mobile Health Team (MHT). She is one of the 8 female staff of MHT assigned to Khuskak Village to support #HeratEarthquake response. She provides counseling & comfort to victims in quickly assembled temporary tents. pic.twitter.com/hq8Bqq3nb1

— WHO Afghanistan (@WHOAfghanistan) October 10, 2023

Common mental disorders such as depression, anxiety and post-traumatic stress disorder (PTSD) tend to be higher among migrants and refugees, particularly girls and women, according to the WHO.

The report summarises different risk factors and barriers refugee and migrant groups experience and outlines five key themes to be addressed in order to improve their access to mental health care.

The first is community support. Evidence shows that being part of a community with a shared background and attending school are associated with better mental health for children. Policies that promote social integration and strengthen family bonds and community networks may benefit refugees and migrants of all ages.

The second theme focuses on basic needs and security, characterising risk factors for mental health conditions such as insecure income, unemployment, and a lack of housing, food and legal status. 

“Deportation, imprisonment and resettlement are realities for many migrants without legal status and for asylum seekers. Therefore, guaranteeing the basic needs (food security and nutrition, protection, accommodation and general subsistence) of these populations should be the first level of intervention,” according to the report.

The third theme covers stigma and cultural barriers to mental health services. 

“Experiences of racism and discrimination are consistently associated with adverse mental health outcomes,” according to the WHO.

“Locating mental health services outside the health system (e.g. in community centres, women’s groups and schools), matching therapists or other helpers to clients (e.g. based on gender, language or cultural background), mobilising communities to support themselves (e.g. training lay workers and peer supporters) and offering a variety of individual, group and tele-mental health care supports could help to improve the acceptability of services and reduce stigma-related barriers,” the report suggests.

Theme four addresses exposure to adversity and trauma, including detention for refugees.

“Human rights-based policies and criminal justice measures are needed to protect refugees and migrants from adversities and potentially traumatic events, including by providing safe migration channels, limiting the use of detention (especially for vulnerable groups), ensuring that detention is used only as a last resort, and improving the health of detained refugees, migrants and asylum seekers,” according to the report.

The fifth theme addresses access to services, including those for mental health. Barriers raised include those of language, lack of access to online information and refugees and migrants’ lack of knowledge about their entitlements. 

The report suggests services that offer translators, practical support with immigration and registration documents and language and digital literacy programmes.“Good mental health and well-being is a right for all, including for refugees and migrants,” said Dr Santino Severoni, Director of the WHO’s Department of Health and Migration.

“This report will support and strengthen health systems’ responses to the mental health needs of refugees and migrants so that they can receive quality mental health care and support in ways they find accessible, acceptable, and affordable.”

Image Credits: Maria Teneva/ Unsplash.