Refugee Week this month focused on the theme ‘Courage’ – highlighting the resilience and bravery of those fleeing persecution and starting a new. Dr Arlinda Cerga Pashoja, Associate Professor in Psychology at St Mary's, reflects on the week and shares insight into the unique mental health barriers migrants face.
It was Refugee Week this month, which the UK marked with events, arts projects and community activities celebrating the contributions, stories and resilience of people forced to flee. Yet only a few weeks earlier, the public conversation around migration was dominated by protests and political messaging in which migrants were cast as problems to be “managed” or deterred, rather than neighbours to be supported. Across Europe and beyond, we are seeing a hardening of political rhetoric in which refugees and migrants are increasingly used as convenient scapegoats for housing shortages, pressures on services and wider governance failures.
Migrants and refugees are not only service users; they are workers, neighbours, artists, politicians, students, carers, and community leaders who help sustain the UK’s economy and public services, often with higher labour‑force participation than the UK‑born population. Their creativity, skills and resilience enrich arts, culture, education and local civic life, which is exactly what Refugee Week seeks to celebrate each year.
Against this backdrop, it becomes even more important to talk honestly about migrant mental health – and about the structural conditions that make distress more likely.
Why migrant communities can face unique mental health barriers
Migration is often discussed through the lens of economics, politics or public services. Headlines focus on numbers, policy debates and integration. Far less attention is paid to the psychological experience of migration itself.
Yet moving to a new country is one of the most significant life changes a person can experience. Whether someone relocates for work, education, family reasons or safety, migration involves leaving behind familiar environments, support networks and ways of life. It requires adapting to new systems, new cultures and, often, new expectations. While migration can bring opportunities and positive outcomes, it can also create pressures that affect mental wellbeing long after arrival.
As conversations around mental health become more prominent, it is important that we recognise the unique challenges migrant communities can face when accessing support.
The hidden psychological impact of migration
Migration is not a single event. It is a process that begins before a person leaves their home country and continues long after they arrive in a new one.
Many migrants experience significant uncertainty during this transition. They may be navigating unfamiliar healthcare systems, finding employment, learning a new language, adapting to different cultural norms or building entirely new social networks. Even positive life changes can create stress, and when multiple changes occur simultaneously, the psychological impact can be substantial.
For some individuals, feelings of isolation and loneliness can emerge as family members, friends and established support systems are left behind. Others may struggle with a sense of belonging, balancing connections to their culture of origin while adapting to a new society.
These experiences are not universal, and many migrants thrive in their new environments. However, they highlight why migration should also be considered a mental health issue, not simply a demographic or political one.
Why support is not always accessed
Across global and European studies, refugees and migrants consistently show higher rates of depression, anxiety, post‑traumatic stress disorder and suicide than host populations. Recent pooled estimates suggest that around one in three forcibly displaced people may be affected by PTSD or depressive disorders, and yet the majority of those with significant symptoms do not receive formal mental health care. In one survey of Syrian refugees, for example, treatment gaps were estimated at nearly 90% for PTSD, anxiety and depression despite the presence of services.
These figures are not only about individual distress; they reveal how hard it can be for migrants to access timely, appropriate help. Evidence from the UK and elsewhere shows that migrant mental health is shaped less by “migrant status” itself and more by what happens after arrival – insecure housing, low income, disrupted social networks, discrimination and legal uncertainty. In our recent UK study with adults born in non‑Western countries, we focused specifically on post‑migration living difficulties such as financial hardship, problems with immigration authorities, barriers to services and experiences of discrimination, alongside resilience and sense of community, to understand how these structural stressors are linked to psychological wellbeing.
In some cultures, mental health remains heavily stigmatised. Emotional difficulties may be viewed as private matters that should be managed within the family or community. In others, there may be limited awareness of mental health services or uncertainty about how they work.
Trust also plays an important role. People who are unfamiliar with healthcare systems may not know where to seek help or may feel uncertain about engaging with services. Concerns around confidentiality, language barriers and previous experiences with institutions can further influence whether someone feels comfortable asking for support.
The result is that many individuals delay seeking help until difficulties have become more severe, by which point structural stressors and prolonged uncertainty may already have eroded psychological resources over time.
The growing challenge of digital exclusion
At the same time, health systems across Europe, including the NHS, are undergoing rapid transformation. Services are increasingly organised around complex pathways, eligibility criteria and commissioning arrangements that can be difficult to navigate even for long‑term residents. For migrants dealing with language barriers, unfamiliar systems and competing demands on time and resources, this complexity adds another layer of exclusion.
We are seeing this first‑hand in London in our current work on digital mental health access for migrants, funded by UKRI Research England. This project maps existing services, consults with commissioners, public health teams and community organisations, and traces treatment‑seeking journeys across different migrant subgroups by legal status, ethnicity and language. While the white paper will focus specifically on digital pathways, the underlying message is broader: if services are designed without migrant experiences in mind, structural and procedural barriers will continue to prevent many people from getting help when they most need it.
Building services that work for everyone
Improving migrant mental health does not require entirely separate healthcare systems. It requires services that are designed with diverse populations in mind.
This includes culturally sensitive approaches to care, clear and accessible communication, meaningful community engagement and greater efforts to build trust. It also means recognising that accessibility is about more than availability: a service can exist on paper, but if people do not feel able or safe to use it, barriers remain.
A structural lens suggests that policy change is itself a mental health intervention. Shortening periods of legal uncertainty, ensuring adequate material support, tackling discrimination and making sure that migrants can register with a GP and access talking therapies without fear or bureaucratic obstruction are all ways of promoting wellbeing.
As societies become increasingly diverse and healthcare systems continue to evolve, understanding the experiences of migrant communities will become even more important.
Mental health is shaped by our environments, our relationships and our opportunities. For migrants, these factors often change dramatically in a short period of time. Recognising those realities is the first step towards ensuring that support reaches those who need it most.
The conversation around migrant mental health is only beginning. But it is a conversation that healthcare providers, policymakers and researchers cannot afford to ignore.
Want to know more about Psychology?
Dr Arlinda Cerga Pashoja is an Associate Professor in Psychology at St Mary's University, with over two decades of experience across the NHS and academia. A leading researcher in digital and global mental health, she has secured £1.7 million in funding and currently leads three international studies developing digital interventions to improve mental health across Europe and Australia.
At St Mary's University, we offer undergraduate and postgraduate Psychology degrees taught by academics engaged in real-world research and practice, preparing graduates for careers across mental health, research and beyond.