Mental health promotion and mental health care among refugees and migrants: policy brief – Global
Policy issues and context
For all refugees and migrants, the migration process can be complex and stressful as it involves leaving the country of origin and adapting to a different environment, culture and living situation. In addition, refugees and migrants may be exposed to stressful events before departure, during transit and after arrival, and they may find it difficult to integrate fully into the social context of host countries. All can lead to mental health disorders, although the prevalence varies greatly between studies and population groups.
Post-traumatic stress disorder is the only disorder for which substantial and consistent differences in prevalence among host populations have been reported, although this specifically concerns refugees; however, it is not the most common disorder among refugees and migrants in general (mood disorders being the most common). Refugees living in a host country for more than five years tend to have higher rates of depression and anxiety disorders than host country populations. Higher prevalence rates of mental disorders among refugees and long-term migrants are associated with lack of social integration, and in particular unemployment. While prevalence is an important factor, the total number of refugees and migrants in a country is also critical. If the total number is very high, there are likely to be many with overt mental disorders, posing challenges to the capacity of the health system.
Promote initiatives that increase social inclusion and integration, including access to employment and educational opportunities, as they promote good mental health.
Encourage collaborations between health care and social services, as well as with legal and employment support providers.
Consider school programs for children, especially if they are unaccompanied or separated.
Encourage voluntary initiatives or the training of refugees and migrants as peer helpers.
Information on the right to care
Design and publish clear information on the rights to care for each category of migrants in order to facilitate appropriate access to care.
Adopt communication strategies that are adapted and accessible to all groups.
Provide health professionals, including in primary care and emergency services, with information to help them make appropriate referrals to refugees and migrants.