The document outlines recommendations and guidance from the EPA (European Psychiatric Association) on addressing the mental health needs of migrants and refugees. It provides guidance for clinicians, service providers, and policymakers. It focuses on ensuring cultural competence training, accessible services, clear policies that address needs, and public education. It also focuses on reviewing services, promoting e-health, training curricula, research, data collection, awareness campaigns, and collaboration between psychiatric organizations to lobby for more resources and better mental health services for refugees and migrants.

1. EPA Guidance
“In the end, we will remember not the words of our
enemies, but the silence of our friends.”
Martin Luther King
1

2. Clinicians
 1. Clear information and resources be available
 2. Cultural awareness and cultural competency training should be
 a mandatory part of training and be embedded in curriculum
 3. Specialist or generalist services need to be discussed according
 to need and resources
 4. Cultural training for all health professionals
 EPA Guidance Paper Bhugra et al 2014

3. Service Providers
 1. Services should be culturally, geographically and emotionally
 accessible
 2. Separate or mainstream services should be decided according to
 local need
 3. Cultural competence and diversity training should be part of
 introduction
 4. Local needs to be determined regularly
 5. Regular audit of services
 6. Consider cultural mediation, culture brokers
 EPA Guidance Paper Bhugra et al 2014

4. Policy Makers
 1. Clear policies taking into account housing, employment and
physical and mental health needs of migrants
 2. Resources must be made available to meet their needs
 3. Appropriate resources for training of professionals across the
 spectrum be available
 4. Public mental health and public education about migrants, their
needs and obligations must be part of communication strategies
 5. Collection of accurate data and information
 EPA Guidance Paper Bhugra et al 2014

5. EPA focuses on the following:
Service level
 Review and announce “refugee and
migrant friendly” and resilience oriented
institutions and experiences.
 Review efficiency and practice of e-
mental health initiatives to overcome
shortage of resources.

6. EPA focuses on the following:
Service level
 Review efficiency and practice of health
promotion activities, psycho-educational
interventions, resilience or resource –
oriented interventions.
 Establish national service hotlines
provided by national experts in the field
for consultation purposes through the
NPAs.

7. EPA focuses on the following:
Training level
 Prepare catalogue on available courses
on cultural competence. Initiatives
encouraged to be introduced in all
European countries.
 Develop recommendations to be included
in the training curricula suited to
different levels.

8. EPA focuses on the following:
Training level
 Offer educational modules directed towards
psychiatrists, e.g. itinerant courses.
 Develop exchange programs, in collaboration
with the early career psychiatrists and NPAs,
inviting psychiatrists with migrant background
as volunteers.
 Provide web-based information toolkit.

9. EPA focuses on the following:
Research level
 Implement, encourage review of scientific
evidence on the mental health aspects of
the problem.
 Prepare guidelines to support
researchers in implementing “refugee
and migrant sensitive” issues in clinical
and community research.

10. EPA focuses on the following:
Research level
 Facilitate/support collection of
epidemiological data over Europe.
 Encourage member NPAs to facilitate
awareness / prevention campaigns in
mental health issues.

11. EPA focuses on the following:
Organizational level
 Collaboration with the EPA-NPAs, lobby at the
national levels for more resources to and better
mental health services to refugees and
migrants.
 Together with the professional organizations of
psychiatrists, mental health workers, service
users and service providers, lobby at European
level for the above.

12. EPA Stresses Importance
 Need for overview of the size of the
problem related to mental health.
 Call for an ethical, scientific and
humanistic standpoint: State & health
authorities provide political engagement,
funding and concrete acts of solidarity.

13. Thank you for your attention
If you always do
what you have always done
You will continue to get
what you have always got