Mental Health and Psychosocial Support: Critical to Integrating Forcibly Displaced and Stateless Persons

The global emergency crisis has placed millions of forcibly displaced and stateless persons (FDSPs) in vulnerable situations, facing both physical and psychological hardships. These populations face unique challenges that significantly impact their mental health and psychosocial well-being. The United Nations High Commissioner for Refugees (UNHCR) has recognized the critical need for Mental Health and Psychosocial Support (MHPSS) services to address these challenges.

Malta is a frontline country and at the centre of the crossroads of world migration.  FDSPs, by definition, are people who have been forced into displacement for fear of persecution or an event seriously affecting public order. In other words, they are facing harsh conditions that put their mental health under significant stress. This article explores the reasons why MHPSS services are critical for forcibly displaced and stateless individuals, with a focus on UNHCR policies and their implementation in Malta.

The psychological impact of displacement on FDSPs in Malta

Mental Health and Psychosocial Support encompasses a range of services aimed at protecting and promoting psychological well-being. These services include preventive measures to reduce distress and targeted interventions for those experiencing mental health conditions such as anxiety, depression, and post-traumatic stress disorder (PTSD). Providing adequate MHPSS is essential to ensure that FDSPs can regain stability and integrate effectively in the host communities.

FDSPs arriving in Malta have often endured severe traumas, including those leading to their forced displacement, such as violence, persecution, loss of loved ones, as well as dangerous journeys. However, their struggles do not end upon reaching safety. Several ongoing stressors continue to affect their mental health, such as lengthy asylum application processes and uncertainty regarding legal status, which cause anxiety and distress. Delays in obtaining residence permits can limit access to essential services like education and healthcare.

Many asylum seekers and refugees live in temporary accommodation or overcrowded housing, and these conditions may exacerbate feelings of stress and insecurity. Language barriers, cultural differences, and societal discrimination can increase social isolation and feelings of loneliness and marginalisation, which can cause a further decline in mental health and well-being.

While Malta’s mental health system may be under strain due to a high demand for MHPSS services, the very nature of the traumas experienced by FDSPs also necessitates the availability of specialized services that focus on addressing these traumas and the related conditions. Outreach efforts also need to be made to ensure FDSPs are informed about their mental health needs, especially because stigma and prejudice on mental health issues can also prevent individuals from seeking help and receiving the support they need.

In a 2019 UNHCR report about the agency’s approach to mental health and psychosocial support in displacement, the impact of these stressors on mental health is described as potentially profound. The report highlights how displacement increases the risk of developing mental health conditions, including depression, anxiety, PTSD, and substance use disorders. These conditions can hinder individuals’ ability to function, cope with daily life, and integrate into new communities. Therefore, providing MHPSS services is essential to help displaced individuals rebuild their lives and achieve a sense of normalcy.

In fact, communities play a vital role in the lives of FDSPs. Establishing and strengthening community-based support systems through community centres and peer-support networks can foster a sense of belonging and resilience. These centres can facilitate access to legal assistance and promote social inclusion through language courses and employment and cultural orientation programs, which can help FDSPs integrate more effectively in Maltese society. In other words, these communities can also act as a safety net through which FDSPs at risk can be identified.

Existing initiatives and their impact at a national level

The UNHCR’s approach to MHPSS is comprehensive and multi-sectoral, integrating various programs and systems related to health, community-based protection, child protection, gender-based violence prevention, education, and nutrition. Key elements of this approach include the strengthening of family and community support systems, the promoting of positive coping mechanisms and resilience, and the integrating of mental health care into general health systems to ensure accessibility of mental health care for FDSPs.  Other key elements are also to provide targeted psychological interventions for individuals with prolonged emotional distress, and to facilitate intersectoral coordination through multi-sectoral technical working groups.

Malta has taken some steps in addressing the mental health needs of FDSPs through collaborations between government agencies and NGOs. Programmes such as the ‘I Belong’ by the Human Rights Directorate, aim to provide a holistic approach to integration through language learning and improving cultural awareness of FDSPs on Malta’s cultural and historical context. The Migrant Health Unit (MHU) also provide medical and mental health assessments, counselling, and referrals for specialized care.

Organizations like the Jesuit Refugee Service (JRS) also offer psychological support, legal assistance, and community-based activities to promote well-being. NGOs such as Blue Door English, Hal Far Outreach and Spark 15, run literacy and language classes for FDSPs, as well as offering get-togethers, a point of information and employment assistance.

At UNHCR, the Durable Solutions team held various thematic meetings with FDSPs in Malta to discuss the various challenges they have been experiencing in Malta. Following these meetings, a number of information sessions were provided, in collaboration with government actors, to provide information on access to health, social benefits, education, housing and employment. These actors included the Jobsplus agency, the Social Security Department, the Housing Authority, the Malta College of Arts, Science and Technology and the Health Promotion Unit. These initiatives have supported government actors in building trust with the FDSP communities, identifying their needs and solving several problems related to the lack of understanding and correct information.

The Path Forward

Towards the end of October 2024, UNHCR Malta and the Agency for the Welfare of Asylum Seekers (AWAS), held a workshop to discuss challenges and access to MHPSS for FDSPs. The event gathered various stakeholders, including community members, national agencies and service providers, and NGOs working in the field of mental health, asylum, and refugee services.

The workshop laid the groundwork for more effective and inclusive MHPSS initiatives. Those in attendance discussed how service providers, agencies and communities can work together and inform each other to develop complimentary services where FDSPs can find it safe to approach service providers and seek support. Continued discussions and collaborative efforts are essential to support the well-being and integration of these vulnerable populations. For a more detailed report on the workshop please go to this link: MHPSS Workshop Report

 

Significant challenges remain in ensuring adequate mental health care for FDSPs in Malta. The island’s limited resources and infrastructural constraints pose significant challenges in addressing their mental health and psychosocial needs. Sustainable solutions require increased funding, inter-agency cooperation, and policy reforms that prioritize mental health as a core component of humanitarian aid and integration policies.

Addressing the trauma and mental health needs of FDSPs is not only a humanitarian obligation but also a crucial step in fostering inclusive and resilient communities. By committing to comprehensive MHPSS strategies, Malta can ensure that displaced individuals receive the support they need to rebuild their lives with dignity and hope and be active members of the host community.

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