Migrant populations, including children, at higher risk of mental health disorders
Refugees, asylum seekers and irregular migrants are at heightened risk for certain mental health disorders, including post-traumatic stress, depression and psychosis. Since 2015, over 1.3 million refugees and migrants have arrived to European countries by the Mediterranean Sea. In addition, almost 3 million Syrian refugees are living in Turkey.
Numbers continue to increase as people flee their homelands due to human rights violations, persecution, poverty and conflict. Many come to Europe in search of economic and personal opportunities for growth. Once in host countries, they are often met with substandard conditions, uncertainty and instability. The combined result is a growing trend of mental health disorders and attempted suicides among the very populations hoping to escape their challenging situations.
The Strategy and action plan for refugee and migrant health in the WHO European Region lists addressing and improving the mental health of refugees and migrants as a priority. This comes in response to evidence suggesting higher rates of mental distress among refugee and migrant populations. There is increased risk of mental distress among women, older people and those who have experienced trauma, and further risk caused by lack of social support and higher levels of stress after migration.
According to a study by the Swedish Red Cross, 1 in 3 Syrian refugees suffers from depression, anxiety and symptoms of post-traumatic stress disorder. Moreover, rates of depression, anxiety and poor well-being are at least 3 times higher among refugees than the general population.
In addition to being exposed to various risk factors for mental disorders, migrants often encounter barriers to accessing appropriate health care to address these problems. Some of the greatest challenges for migrant populations within host countries include: lack of knowledge regarding health care entitlements and health care systems; poor command of the language; differing belief systems and cultural expectations for health care; and a general lack of trust in professionals and authorities.
Rates of depression and anxiety disorders tend to increase with time, and poor mental health is associated with deprived socioeconomic conditions – in particular social isolation and unemployment.
Dr Santino Severoni, Coordinator of WHO/Europe’s Migration and Health Programme, cautions against victimizing members within migrant populations: “Once their basic needs for security, support and safety are met, these groups of people have shown inspiring resiliency.”
Child refugees traumatized and among those most at risk
Child refugees, especially those unaccompanied by a parent or guardian, face intense psychological trauma as a result of fleeing their homelands and entering into states of uncertainty, physical danger and distress.
According to the European Commission, nearly 90 000 unaccompanied children applied for asylum in countries of the European Union in 2015. Figures from the United Nations Children’s Fund indicate that 25 800 unaccompanied or separated children arrived by sea to Italy alone in 2016 – more than double the 12 360 children who arrived in the previous year.
Of the unaccompanied child refugees arriving into Europe, many of them, both boys and girls, are suffering sexual and physical abuse. These atrocities have lasting effects that should be of concern to the countries where they will eventually settle.
Solutions for better migrant mental health
WHO/Europe has identified the pressing need to develop good practices for the provision of mental health care, and to provide support for Member States to address the mental health needs of migrants. In a Health Evidence Network synthesis report, WHO/Europe defined a series of good practices that include:
supporting social integration through education, housing and employment;
providing outreach services to facilitate access to care;
coordinating different services within the health care system to ensure the integration of physical and mental health care and appropriate care pathways;
providing information on care entitlements and available services to migrants and health care professionals; and
training health care professionals to ensure that they are open towards migrant groups, aware of their barriers to accessing care and interacting with health services, and skilled in overcoming language problems.
WHO/Europe is launching new initiatives to support Member States in their efforts to improve the care of migrant populations and to integrate them into the local cultural fabric. The recently developed Knowledge Hub on Health and Migration will provide a forum to promote the exchange of knowledge, information and good practices related to priority aspects of migrant health, with specific attention on mental health. In collaboration with the European Commission, WHO/Europe will offer technical guidance materials, interactive online seminars and migrant health toolkits on mental health topics.
This first-of-its-kind Knowledge Hub will bridge the existing gap between science, policy and practice in the area of migration and health to meet the needs of countries on the front lines of mass influxes of migrants and refugees.