Abstract

The increasing number of refugees, asylum seekers and irregular migrants poses a challenge for mental health services in Europe. This review found that these groups are exposed to risk factors for mental disorders before, during and after migration. The prevalence rates of psychotic, mood and substance use disorders in these groups are variable but overall are similar to those in the host populations; however, the rates of post-traumatic stress disorder in refugees and asylum seekers are higher. Poor socioeconomic conditions are associated with increased rates of depression five years after resettlement. These groups encounter barriers to accessing mental health care. Good practice for mental health care includes promoting social integration, developing outreach services, coordinating health care, providing information on entitlements and available services, and training professionals to work with these groups. These actions require resources and organizational flexibility.

Contents

• ABBREVIATIONS
• CONTRIBUTORS
• FOREWORD
• SUMMARY
• 1. INTRODUCTION
  • 1.1. Background
• 2. RESULTS
  • 2.1. Risk factors for mental disorders in refugees, asylum seekers and irregular migrants
  • 2.2. Prevalence of mental disorders
  • 2.3. Barriers to mental health care
  • 2.4. Good practice for mental health care provision
  • 2.5. Policies relevant to access to mental health care for refugees, asylum seekers and irregular migrants
  • 2.6. Outcomes considered
• 3. DISCUSSION
  • 3.1. Strengths and limitations of the review
  • 3.2. Policy options and implications
  • 3.3. Resources for implementing policy options
  • 3.4. Challenges for future research and documentation
• 4. CONCLUSIONS
• REFERENCES
• ANNEX 1. SEARCH STRATEGY
• ANNEX 2. STUDIES INCLUDED IN THE EVIDENCE SYNTHESIS

Suggested citation:

Priebe S, Giacco D, El-Nagib R. Public health aspects of mental health among migrants and refugees: a review of the evidence on mental health care for refugees, asylum seekers and irregular migrants in the WHO European Region. Copenhagen: WHO Regional Office for Europe; 2016 (Health Evidence Network (HEN) Synthesis Report 47).

This HEN – the Health Evidence Network – synthesis report is the result of cross-divisional work in the Regional Office between the Migration and Health programme in the Division of Policy and Governance for Health and Well-being, the Mental Health and Mental Disorders programme of the Division of Noncommunicable Diseases and Promoting Health through the Life-course, the Evidence and Information for Policy-making Unit of the Division of Information, Evidence, Research and Innovation, and the Department of Mental Health and Substance Abuse, WHO headquarters.

The Health Evidence Network

HEN is an information service for public health decision-makers in the WHO European Region, in action since 2003 and initiated and coordinated by the WHO Regional Office for Europe under the umbrella of the European Health Information Initiative (a multipartner network coordinating all health information activities in the European Region).

HEN supports public health decision-makers to use the best available evidence in their own decision-making and aims to ensure links between evidence, health policies and improvements in public health. The HEN synthesis report series provides summaries of what is known about the policy issue, the gaps in the evidence and the areas of debate. Based on the synthesized evidence, HEN proposes policy options, not recommendations, for further consideration of policy-makers to formulate their own recommendations and policies within their national context.

The Health Evidence Network and the Migration and Health programme of the WHO Regional Office for Europe

At the fifth meeting of the WHO European Advisory Committee on Health Research (EACHR), which took place in July 2004, EACHR agreed to form a subcommittee on migration and health to review the strategic framework of the work of the WHO Regional Office for Europe on migration and health, and to commission a series of HEN synthesis reports targeting policy-makers. In 2015, three HEN reports were published, tackling the challenges of three distinct migrant groups: irregular migrants, labour migrants, and refugees and asylum seekers.

In 2016, three new HEN reports are being published, aimed at synthesizing the available evidence in order to improve policy-makers’ understanding of the following specific issues related to migration: maternal health, mental health and the public health implications of the different definitions available for migrants.

The various HEN reports on migration and health have been used as an evidence base for the development of the Strategy and Action Plan for Refugee and Migrant Health in the WHO European Region.

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ISSN 2227-4316

ISBN 978 92 890 5165 1

© World Health Organization 2016

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