With today marking International Migrants Day, we are highlighting the urgent need to acknowledge the specialised mental health requirements of refugees, asylum seekers and migrants.
Many of those seeking asylum have been witness to war, atrocities, persecution, natural disasters and grinding poverty, leaving many with complex psychological needs that can only be addressed by easily accessible and culturally sensitive services.
A position paper published by the College of Psychiatrists of Ireland on the Mental Health Service Requirements for Asylum Seekers, Refugees and Migrants from Conflict Zones makes key recommendations for addressing the ongoing trauma that can often affect this vulnerable population.
Refugees, asylum seekers and migrants have been identified as suffering up to ten times the rate of post-traumatic stress disorder (PTSD) compared to the indigenous population. For many refugees, asylum seekers and migrants the term post-traumatic stress disorder is not appropriate. This is because the process of migration into an alien and frequently hostile culture can mean that the trauma is still ongoing. It has not yet reached the “post” stage.
These recommendations recognise the need for early assessment and intervention for both pre-existing and ongoing mental health problems associated with mass-migration:
Recommendation #3: Psychological assessment at point of arrival should be carried out, appropriate treatment given and relevant information communicated to mental health services.
The paper lays out the need for services that are specifically equipped to deal with those seeking asylum in Ireland, the needs of whom are often significantly different from the general population. The acute mental health difficulties of asylum seekers cannot be adequately addressed without additional expertise, training or funding for Consultant-led multidisciplinary teams. Treatment services should also be delivered in a culturally sensitive and appropriately resourced manner.
Recommendation #5: The necessary mental health skills and appropriate training along with protected time should be provided in mental health services to care for the unique needs of refugees, asylum seekers and migrants.
Issues, such as trust; language; different cultural mores; stigma; religious beliefs; fear for the future; and the use of interpreters need to be tackled.
Also highlighted is the percentage of children who make up the refugee population – over 51% worldwide in 2015. The mental health care of children is unique and requires specialised services. Failure to deal with mental health concerns can result in serious problems for these children in the future.
Recommendation #8: The needs of children involved in this process must be included in all plans for service delivery and they must never be required to act as interpreters
It is vital to acknowledge that the mental health requirements of refugees,migrants and asylum seekers can differ greatly from that of the general population. It is likely that their needs cannot be adequately addressed by generic mental health services, without additional expertise, training , funding.
