Provision of Mental Health Services for Refugees and Migrants: The European and Greek Approach


Published: Feb 20, 2025
Keywords:
Mental Health NGOs EU World Health Organization European Psychiatric Association
Christina Karatzikou
Abstract

This paper analyzes the health migration policy implemented in Europe and Greece, as well as the role of Civil Society in meeting the mental and psychological needs of migrants and refugees. More specifically, its aim is to highlight common or different policies, measures, and the overall approach to the issue of access to mental health for refugees/migrants within a European framework. In this way, it becomes evident that there is a common directive set by the European Union for the protection of the rights of refugees/migrants, applicable across all member states. However, each country applies its own policies and rules. The institutions of the European Union and Civil Society on a broader European level play a significant role in the provision of mental health care for refugees/migrants. In conclusion, for the most part, the European space has the policies, legislative frameworks, and both state and European mechanisms to support the mental health of those in need. However, when it comes to implementing these in practice, many problems arise in the functioning of the mechanisms, resulting in less effective or even nonexistent mental health care provided by the states, with the burden falling on the work of NGOs.

Article Details
  • Section
  • Research Articles
Downloads
Download data is not yet available.
References
Andersson, L. M. C., Hjern, A., & Ascher, H. (2018). Undocumented adult migrants in Sweden: Mental health and associated factors. BMC Public Health, 18(1). https://doi.org/10.1186/s12889-018-6294-8
Athens Coordination Center for Migrant & Refugee Issues (n.d.a). Social support and Psychological Support/Counseling. Kyclos. https://www.accmr.gr/en/services/diapolitismika-mathimata/
Athens Coordination Center for Migrant & Refugee Issues (n.d.b). Mental Health services to Adults and Minors- Babel. https://www.accmr.gr/en/services/3266-ypiresies-psychikis-ygeias-se-enilikes-kai-anilikous/
Babel (2020a). What we do/ services for adults. https://babeldc.gr/en/mental-healthcare/services-for-adults/
Babel (2020b). What we do/ Services for minors. https://babeldc.gr/en/mental-healthcare/services-for-minors/
Bhugra, D., Gupta, S., Schouler-Ocak, M., Graeff-Calliess, I., Deakin, N. A., Qureshi, A., Dales, J., Moussaoui, D., Kastrup, M., Tarricone, I., Till, A., Bassi, M., Carta, M. (2014). EPA Guidance mental health care of migrants. European Psychiatry, 29(2), 107–115. https://doi.org/10.1016/j.eurpsy.2014.01.003
Cabral Iversen, V., & Morken, G. (2003). Acute admissions among immigrants and asylum seekers to a psychiatric hospital in Norway. Social Psychiatry and Psychiatric Epidemiology, 38(9), 515–519. https://doi.org/10.1007/s00127-003-0664-x
City of Athens (n.d.). Athens Coordination Center for Migrant and Refugee Issues. https://www.cityofathens.gr/who/kentro-syntonismoy-gia-themata-metanaston-amp-amp-prosfygon/
Directorate-General for Health and Food Safety (2021). Migration and Health related Initiatives. https://health.ec.europa.eu/document/download/d5685828-b0df-4619-bfad-bf7e25019efd_en?filename=migrants_projects_en.pdf
Economou (2015). Barriers and facilitating factors in access to health services in Greece, WHO Regional Office for Europe, [positional paper]. https://www.who.int/publications/m/item/barriers-and-facilitating-factors-in-access-to-health-services-in-greece.
Efthymiou, I. P., Efthymiou Egleton, T. W., Chatzivasileiou, S., Emmanouil-Kalos, A. (2023). Artificial Intelligence and the Future for Charities. International Journal of Non-Profit Sector Empowerment, 2(1), e35345. https://doi.org/10.12681/npse.35345
EPAPSY (n.d.a). ABOUT EPAPSY. https://www.epapsy.gr/en/epapsy/about-epapsy/
EPAPSY (n.d.b). Community Based Intervention for Mental Health Care of Asylum-seekers and Refugees in Greece. https://www.epapsy.gr/en/cpw-community-based-intervention-for-mental-health-care-of-asylum-seekers-and-refugees-in-greece/
EU-MiCare (2024a). Work Package II: Conceptual Framework and Co-Created Training. Scheme for covering mental health needs of migrants and refugees. Country Profile. Country: GERMANY. https://projectmicare.eu/wp-content/uploads/2024/02/Country_Profile_Germany_Website_Version_2024-1.pdf
EU-MiCare (2024b). Work Package II: Conceptual Framework and Co-Created Training Scheme for covering mental health needs of migrants and refugees. Country Profile. Country: GREECE. https://projectmicare.eu/wp-content/uploads/2024/01/Country-profile-GREECE_EU-MiCare_Website.pdf
EU-MiCare project (2024). The project. https://projectmicare.eu/the-project/
European Commission & Consumers, Health, Agriculture and Food Executive Agency (2018). Migration and Vulnerable Groups – Improving Health Care for Migrants. Publications Office. https://data.europa.eu/doi/10.2818/41388.
European Commission (2020a). Communication From the Commission to the European Parliament, the Council, the European Economic and Social Committee and the Committee of the Regions on a New Pact on Migration and Asylum. Brussels, 23.9.2020 COM(2020) 609 final. https://eur-lex.europa.eu/legal-content/EN/TXT/?uri=CELEX%3A52020DC0609
European Commission (2020b). COMMUNICATION FROM THE COMMISSION TO THE EUROPEAN PARLIAMENT, THE COUNCIL, THE EUROPEAN ECONOMIC AND SOCIAL COMMITTEE AND THE COMMITTEE OF THE REGIONS Action Plan on Integration and Inclusion 2021-2027. Brussels, 24.11.2020 COM(2020) 758 final. https://eur-lex.europa.eu/legal-content/EN/TXT/?uri=CELEX%3A52020DC0758
European Commission (2022). EU4Health Projects to Provide Mental Health Support to Ukrainian Refugees. https://hadea.ec.europa.eu/news/eu4health-projects-provide-mental-health-support-ukrainian-refugees-2022-12-21_en.
European Commission (2023a). EU4Health Programme 2021-2027 – A Vision for a Healthier European Union. https://health.ec.europa.eu/funding/eu4health-programme-2021-2027-vision-healthier-european-union_en.
European Commission (2023b). COMMUNICATION FROM THE COMMISSION TO THE EUROPEAN PARLIAMENT, THE COUNCIL, THE EUROPEAN ECONOMIC AND SOCIAL COMMITTEE AND THE COMMITTEE OF THE REGIONS on a Comprehensive Approach to Mental Health. Brussels, 7.6.2023 COM(2023) 298 final.https://eur-lex.europa.eu/legal-content/EN/TXT/?uri=COM%3A2023%3A298%3AFIN
European Commission (2024). Migrants' Health. https://health.ec.europa.eu/social-determinants/migrants-health_en
European Migration Network (2022). Mapping of Mental Health Policies for Third-Country National Migrants. https://migrant-integration.ec.europa.eu/system/files/2022-07/EMN_Mental-health_INFORM_final.pdf.
European Psychiatric Association (2015). EPA Position Paper on Psychiatric Care of Refugees in Europe. https://www.europsy.net/app/uploads/2019/02/EPA-statement-on-Refugees-20151102_FINAL.pdf
European Psychiatric Association. The European Psychiatric Association. Retrieved 16/05/2024 from https://www.europsy.net/the-european-psychiatric-association/
Fachinger, T., Stiller, M. & Hoffmeyer-Zlotnik, P. (2023). Mapping Asylum Procedures, Reception Conditions, Detention and Content of Protection in Europe. Country Report: Germany. https://asylumineurope.org/wp-content/uploads/2024/06/AIDA-DE_2023-Update.pdf
Fouskas, T. (2023). Sociological Perspectives of Migrant Health Disparities and Access to Healthcare Services during and beyond the COVID-19 Pandemic: Voices of Immigrant and Refugee Women in Greece. International Journal of Non-Profit Sector Empowerment, 2(1) 2023, e32592. https://doi.org/10.12681/npse.32592
Fylatos, D., Efthymiou, I. P., Sidiropoulos, S., Emmanouil-Kalos, A., & Vozikis, A. (2022). Greece 2.0, Health Economics and Outcome Research and the Rise of Artificial Intelligence: Another Missed Opportunity or it's Time for Brilliance?. Journal of Politics and Ethics in New Technologies and AI, 1(1), e31452. https://doi.org/10.12681/jpentai.31452
Iliadi-Vagena, E. (2022). Civil Society Organizations in the Protection of Female Refugees: The Case of Greece. International Journal of Non-Profit Sector Empowerment, 1(1), e31685. https://doi.org/10.12681/npse.31685
Klimaka (n.d.). "Iolaos" Day Center for refugees & asylum seekers with mental disorders. https://www.klimaka.org.gr/kentro-imeras-iolaos-gia-prosfuges/
Koch, A., Biehler, N., Knapp, N. & Kipp, D. (2023). Integrating Refugees: Lessons from Germany since 2015–16. Background Paper to the World Development Report 2023: Migrants, Refugees, and Societies. https://thedocs.worldbank.org/en/doc/d3bf052f21b05b8b5f87f38b921dfd7e-0050062023/original/WDR-German-case-study-FINAL.pdf.
Lambrou, L., Liapi, A., Roussou, M., Koumpou, A. (n.d.). Do the Human Right Thing. Right to Health, Right to Life. An Assessment of Access to Health Care Services for Asylum Seekers and Beneficiaries of International Protection in Greece. Center “Diotima”.https://diotima.org.gr/wp-content/uploads/2022/06/DTHRT-DikaiomastinYgeia_Report-GR.pdf
Lebano, A., Hamed, S., Bradby, H., Gil-Salmerón, A., Durá-Ferrandis, E., Garcés-Ferrer, J., … Linos, A. (2020). Migrants’ and Refugees’ Health Status and Healthcare in Europe: A Scoping Literature Review. BMC Public Health, 20(1), 1039. https://doi.org/10.1186/s12889-020-08749-8
Ministry of Health, Law 4368/2016. Subsection E1, MEASURES TO RELIEVE HUMANITARIAN CRISIS AND ENSURE UNIVERSAL HEALTH COVERAGE OF THE POPULATION, Article 33, Health coverage for uninsured and vulnerable social groups. https://www.moh.gov.gr/articles/health/anaptyksh-monadwn-ygeias/3999-prosbash-twn-anasfalistwn-sto-dhmosio-systhma-ygeias?fdl=10014
Ministry of Migration and Asylum (2023). National Action Plan 2024 (executive summary), General Secretariat for Coordination, 15/12/2023. https://gsco.gov.gr/wp-content/uploads/2023/12/%CE%A5%CE%9C%CE%91_%CE%95%CF%80%CE%B9%CF%84%CE%B5%CE%BB%CE%B9%CE%BA%CE%AE_%CE%A3%CF%8D%CE%BD%CE%BF%CF%88%CE%B7_%CE%95%CE%A3%CE%94-2024-1.pdf
Open Government (2021). Article 17 – Provisions for the Temporary Insurance and Health Care Number of Foreigners (P.A.A.Y.P.A.) – Replacement of Paragraph 2 of Article 55 of Law 4636/2019. http://www.opengov.gr/immigration/?p=1521
Priebe, S., Giacco, D., & El-Nagib, R. (2016). 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. Health Evidence Network (HEN) Synthesis Report 47. Copenhagen: WHO Regional Office for Europe. https://www.ncbi.nlm.nih.gov/books/NBK391045/
Sidiropoulos, S., Emmanouil-Kalos, A., Kanakaki, M. E., & Vozikis, A. (2021). The Rise of NGOs in Global Health Governance and Credibility Issues in the 21st Century. HAPSc Policy Briefs Series, 2(2), 278-288. https://doi.org/10.12681/hapscpbs.29516
SolidarityNow (n.d.). Athens Solidarity Center. https://www.solidaritynow.org/athens-solidarity-center/
Stevenson, K., Antia, K., Burns, R., Mosca, D., Gencianos, G., Rechel, B., … Blanchet, K. (2024). Universal health coverage for undocumented migrants in the WHO European Region: A long way to go. The Lancet Regional Health - Europe, 41, 100803. https://doi.org/10.1016/j.lanepe.2023.100803
Suess, A., Ruiz Perez, I., Ruiz Azarola, A., & March Cerda, J. C. (2014). The right of access to health care for undocumented migrants: A revision of comparative analysis in the European context. The European Journal of Public Health, 24(5), 712–720. https://doi.org/10.1093/eurpub/cku036
World Health Organization (2018). Mental health promotion and mental health care in refugees and migrants. Technical guidance on refugee and migrant health. Copenhagen: WHO Regional Office for Europe. https://iris.who.int/handle/10665/342277
World Health Organization (n.d.). About WHO. https://www.who.int/about
World Health Organization. (2023). Mental health of refugees and migrants: risk and protective factors and access to care. Geneva. (Global Evidence Review on Health and Migration (GEHM) series). https://www.ncbi.nlm.nih.gov/books/NBK597270/