UNHCR Highlights Mental Health Needs of Displaced Communities at Global Mental Health Summit - Perth, WA

His Excellency the Hon Chris Dawson AC, Governor of Western Australia and Mrs Darrilyn Dawson

Aunty Robyn Collard, Nyungar Yorga from the Whadjuk and Ballardong groups

The Hon Meredith Hammat MLA, Minister for Health; Mental Health

Tsuyoshi Akiyama – Secretary General, World Federation for Mental Health

Ramdas Sankaran OAM – CEO, Multicultural Services Centre of WA

Deputy Commissioner Monica Taylor, Mental Health Commission.

Distinguished guests, colleagues, partners, good morning.

Like my colleagues before me, I would also like to acknowledge the Traditional Custodians of the land on which we gather today and pay my respects to Elders past and present. I also extend that respect to any First Nations people joining us here today.

I want to extend my sincere thanks to the Multicultural Services Centre of Western Australia for inviting UNHCR, the UN Refugee Agency, to speak at this Global Mental Health Summit. The theme of this conference, 'Building Resilience, Equity, and Culturally Responsive Integrated Support Systems', is not just an ambition; it is an urgent necessity for the millions of people we serve worldwide. Here in Australia, with our long and proud history of multiculturalism, Australians understand better than most that building a resilient society means supporting the well-being of every single member, especially the most vulnerable.

Today, I want to offer a big-picture view of forced displacement and its profound impact on the mental health and psychosocial well-being of refugees. This is not a niche issue; it is a global crisis. More importantly, I want to share how UNHCR is learning, adapting, and working with partners to build the very systems this summit is dedicated to creating.

To understand the challenge, we must first grasp the scale. The world is facing a displacement crisis of almost unprecedented proportions. As of June this year, a record 117.8 million people have been forcibly uprooted from their homes due to persecution, conflict, violence, and human rights violations.

Let’s break that down.

• 41.6 million refugees have crossed international borders in search of safety.
• 9 million asylum-seekers are awaiting a decision on their claim for protection.
• And a staggering 68.7 million people are internally displaced within their own countries.

These are not just numbers; they are individuals whose lives have been fractured. And the crisis is deepening. The number of people forced to flee has more than doubled in the last decade. Furthermore, displacement is no longer a temporary state. Today, 70% of refugees live in protracted situations, meaning they have been in exile for five years or more, often with no clear end in sight. The vast majority, 65%, are hosted not in high income countries, but in neighbouring countries, many of which are low or middle-income nations facing their own significant challenges.

Here in the Asia-Pacific region, millions of refugees and asylum-seekers are being hosted: the two big caseloads of Rohingya refugees from Myanmar in Bangladesh and across Southeast Asia, and Afghan refugees in Pakistan and Iran; as well as significant numbers of refugees being hosted in places like Malaysia, Indonesia and Thailand.

The journey of a refugee does not end when they reach a place of physical safety. The invisible wounds of trauma, loss, and profound uncertainty often linger, shaping their ability to rebuild their lives.

Research from the World Health Organization gives us a stark picture. In conflict-affected populations, it's estimated that 22.1% of people, more than one in five individuals, are living with a mental health condition.

• 5.1% suffer from severe disorders like schizophrenia, bipolar disorder, or severe depression and anxiety.
• 4% experience moderate disorders.
• And 13% live with mild forms of depression, anxiety, and PTSD.

And the focus cannot solely be on past traumatic events. For many refugees, the greatest source of suffering comes from the current, daily stresses of life in exile: poverty, insecure legal status, separation from family, loss of identity, and the inability to work or plan for a future.

Refugees and asylum-seekers who are subject to detention, as unfortunately is the case in many jurisdictions including Australia, face particular mental health risks as we have seen over many years. I will in fact be visiting several detention centres this week as part of UNHCR’s ongoing programme of monitoring conditions of detention across Australia. Please be assured that the mental and psychosocial wellbeing of detainees is one of our highest priorities.

So, coming back for a moment to the global level, how does UNHCR respond to the challenge of mental health at the operational level around the world?

Our approach is not a one-size-fits-all solution. It is a multi-layered system of support, as visualized in the Inter-Agency Standing Committee Pyramid for Mental Health and Psychosocial Support, or MHPSS.

At the very foundation of this pyramid, we work with partners to ensure that basic services and security are in place. A safe place to live, access to food, clean water, and education are the non-negotiable foundations of psychosocial well-being. Without them, no other intervention can be truly effective.

The next layer is strengthening community and family supports. This is where resilience is truly built. We foster social networks, empower refugee-led community organizations, and help preserve cultural identity and social fabrics that give people a sense of belonging and purpose.

For those who need more, we provide focused, non-specialized support. These are scalable psychological interventions, like 'Problem Management Plus' or 'Group Interpersonal Therapy' that can be delivered by trained and supervised non-specialists within the community, making support accessible and less stigmatizing.

And at the top of the pyramid are specialized clinical services for the 5% of individuals with severe mental health conditions who require psychiatric or advanced psychological care.

This pyramid is a conceptual framework, not a rigid sequence. People may need support from multiple layers at once, and our goal is to build an integrated system that can provide it.

Building this system requires a skilled and supported workforce. UNHCR invests heavily in capacity building. Between 2021 and 2025, with our partners, we have supported the training of over 6,000 healthcare staff through the mhGAP program to identify and manage mental health conditions in refugee settings, as well as over 4,000 people in 26 countries in scalable psychological interventions.

Critically, we recognize the tension between standardized, evidence-based global packages and the need for locally grounded, culturally situated approaches. True equity and cultural responsiveness mean adapting our methods, co-designing programs with affected communities, and empowering local actors. We must avoid the risk of 'model imposition,' where Western psychiatric assumptions are applied without adaptation.

A brilliant example of this principle in action is our work right here in the Pacific. In New Zealand, UNHCR has partnered with experts from the University of New South Wales to deliver specialized training for the government’s refugee status determination (RSD) decision-makers. This program, guided by our 'Guidance Note on the Psychologically Vulnerable Applicant,' helps officials become more trauma-informed. It equips them to understand how trauma can affect memory, behavior, and communication, ensuring that some of the most vulnerable people seeking protection can participate meaningfully and fairly in the asylum process. This is a perfect example of building a more equitable and responsive system from the inside out.

I must, however, be frank about the challenges. Humanitarian work is being severely affected by funding cuts. Since 2025, agencies like WHO, UNICEF, and UNHCR have seen reduced funds for programming, forcing a hyper-prioritization of services. This crisis threatens to undo hard-won gains in MHPSS.

But this crisis also presents an opportunity to get it right, at last. It forces us to be smarter, more integrated, and more collaborative. The future of humanitarian MHPSS lies in two key shifts:

1. Strengthening Local Capacities: We must shift from top-down models to community-driven approaches that empower local and refugee-led organizations. They are the true first responders and the most sustainable source of support.
2. Integration and Partnership: We must move away from fragmented, standalone projects and toward government-led approaches that integrate MHPSS into national service delivery systems—in health, protection, and education, but also in livelihoods, shelter, and peacebuilding.

A powerful example is the Greentree Acceleration Plan in Chad, which supports over a million Sudanese refugees. Initiated by the UN Deputy Secretary-General and the Wellcome Trust, this plan brings together the government, UN agencies, NGOs, and refugee-led organizations to strengthen the national mental health system, deliver psychological support with livelihoods for women, and provide psychosocial support for children through structured play. This is what an integrated, multi-stakeholder support system looks like in action.

Building resilience, equity, and culturally responsive support systems is a collective responsibility. It requires us to see the whole person, not just their trauma. It requires us to listen to and empower displaced communities as the primary agents of their own recovery. And it requires everyone: governments, service providers, civil society, academics, and the private sector, to work together across sectors and silos.

Here in Western Australia, I know you are fortunate that you have a strong network of organizations working alongside refugees and people seeking asylum, both specifically on mental health issues and more broadly. I want to acknowledge in particular ASeTTS and its vital work supporting survivors of torture and trauma; the refugee health teams within WA Health and Perth Children’s Hospital; and organizations such as the Multicultural Services Centre and CARAD, which work every day with refugee and asylum-seeking communities. Together, these services remind us that mental health and psychosocial wellbeing cannot be separated from health, settlement, inclusion and a sense of belonging.

I wish you well in the discussions this week, and on behalf of UNHCR, thank you for your work.