Migration Op-Ed Series: We Must Address the Humanitarian Crisis of Inadequate Mental Health Care

We Must Address the Humanitarian Crisis of Inadequate Mental Health Care. The Power of Storytelling: The EU Refugee Crisis

by Jessica Aldrich Strassman

I sat in a café in the remote village of Skamnias on the Greek island of Lesvos, listening to Kostas, a local fisherman, tell his story—an emotional firsthand account of the two-year period beginning in 2015 when he quit his job to continually rescue thousands of refugees from the sea. At night, he agonized that while he slept people would drown, and by day, in addition to pulling men, women, and children from the sea – alive and dead – he risked his life to protect those he saved from hostile smugglers. He recounted his experiences in Greek, a language I don’t understand, but I could read the emotion on his face. When I asked if he or others in this small village had been offered mental health support, he said they had not, even though they clearly suffered – and were still suffering – from the trauma of these horrific experiences. I hoped his storytelling would provide a small amount of healing or, at the very least, an audience to validate and empathize with his experiences.

I had been traveling for three weeks in Greece in a joint program between Harvard University’s FXB Center for Health and Human Rights and the National and Kapodistrian University of Athens to better understand the refugee crisis that has been a political focal point in Greece and across the EU since 2015. Our group of international students, including refugees, met with politicians, professors, lawyers, and NGO leaders, and visited local NGOs and refugee camps in Athens and Lesvos. But in Skamnias, we heard reports directly from those impacted by the tragic circumstances of this crisis. These and other firsthand accounts were the most poignant of our meetings.

Mental health is a fundamental human right, and nowhere is this more urgent than in survivors of forced migration and displacement who experience trauma pre-migration, during migration, and at resettlement. Elevated rates of anxiety, depression, and post-traumatic stress disorder were first diagnosed in the 1970s with survivors of the Holocaust and continue to present day with those who experience forced displacement. Subsequent studies have also researched the intergenerational impact on children and grandchildren who have not themselves been exposed to trauma. Those on the ground, like the local fishermen of Skamnias, also require access to this support.

In 2023, The World Health Organization (WHO) released its fifth report outlining refugee and migrant mental health risk, protective factors, and access to care. WHO called for urgent action from policymakers to provide adequate support in five areas including training health workers, safeguarding refugee human rights, and strengthening community capacity to provide mental health services to refugees.

Despite these and other calls to action, I was not surprised that psychological support had not been provided in Greece. At every meeting, I inquired as to mental health provision, barriers, and access, and I was frequently provided unsatisfactory, evasive, or untruthful answers. One camp manager proclaimed psychological issues to be the biggest crisis faced by those in his refugee camp. A 2022 study identified mental health conditions to be the most common problem of refugees residing in Greek refugee camps. A 2024 scoping review, outlining obstacles to mental health access for refugees and asylum seekers, went further by identifying a troubling lack of research regarding supply side barriers. These included insufficient mental health prioritization, fragmented care, long wait times, and accessibility (especially in refugee accommodations).

Our group heard from presenters about inadequate government provided mental health support. While NGOs step in to meet this critical need, inconsistent funding and restrictive policies undermine reliability of services. A 2022 scoping review on migrant health care access highlighted challenges such as language barriers, lack of culturally sensitive care, and inadequate pathways to treatment – issues well known before the 2015 migrant crisis. In October, Médecins Sans Frontières (MSF), an NGO we partnered with on Lesvos, published A Mental Health Crisis Among Refugees and Migrants in Greece, which outlines the ongoing, complex unmet mental health needs exacerbated by these barriers.

My visit to Greece has profoundly impacted my mental health work and research in the U.S. While I am deeply concerned about the obstacles to mental health access faced by refugees, migrants, and local communities – compounded by increasingly restrictive migration policies – I am inspired by the work of NGOs like MSF. MSF’s global outreach includes its recent initiative along the Mexico-US border, where it provides psychological first aid to traumatized refugees. MSF highlights critical mental health support needed for these populations and advocates for workers experiencing vicarious trauma in their work.

Compelling firsthand accounts, like Kostas’s, serve as a powerful reminder of the importance of mental health support for all and the urgent need for research to drive impactful policy changes. As Kostas said when asked what he took away from his experience, “I want peace for all.” This will only be possible when we uphold mental health access as a fundamental human right for all those impacted by this escalating crisis.

Featured photo: Ajdin Kamber / Shutterstock