It was evident that a multimodal approach to care, addressing the adolescent’s complex biopsychosocial needs, parental mental health, and cultural issues, was needed (1–3). Amed’s treatment was finally started at a day center providing culturally competent mental health services to migrants. The program was run by a nongovernmental organization taking actions to combat the double stigma of mental illness and migration in low-income neighborhoods in Athens and its urban environs.
It can be assumed that the economic and migrant crises in Greece define, through enduring stressors, two overlapping and interacting contexts that influence vulnerable individuals or groups. Unemployment, poverty, job insecurity, and increasing social inequalities have led the majority of natives into situations causing deep psychological pain and distress. At the same time, thousands of migrants, who are mostly traumatized refugees fleeing war or persecution, experience family separation, inadequate housing, complicated legal procedures for migration, cultural differences, and other major stressors (4).
Social capital is not indefinite, and social coherence faces great challenges. Negative attitudes toward immigration are intensified, and prejudice among ethnic groups may be traceable to economic anxieties of the native population. Immigrants, too, feel alienated from a severely affected society that cannot respond sufficiently to their needs and does not offer economic opportunities or meet their expectations.
The demand for public mental health services has increased considerably, while the migrant influx brings new needs, which must be addressed by already heavily burdened services, especially at the primary health care level. Economic constraints, lack of personnel, organizational dysfunctions, and cultural limitations affect the provision of, and access to, quality mental health services, for both natives and immigrants. Also, negative attitudes and distrust toward mental health services by both natives and immigrants may reflect to some extent their experiences of being deprived, punished, or excluded as a result of state policies.
Mental health professionals have to evaluate the complexity of ongoing challenges for natives and immigrants in order not only to support them through effective treatments, but also to stand up for them as advocates for their rights, antidiscriminatory policies, service development, and social justice.
References
1.
Martin-Carrasco M, Evans-Lacko S, Dom G, et al: EPA guidance on mental health and economic crises in Europe. Eur Arch Psychiatry Clin Neurosci 2016; 266:89–124
Anagnostopoulos DC, Triantafyllou K, Xylouris G, et al: Migration mental health issues in Europe: the case of Greece. Eur Child Adolesc Psychiatry 2016; 25:119–122
From the Department of Child Psychiatry, National and Kapodistrian University of Athens, School of Medicine, Aghia Sophia Children’s Hospital, Athens, Greece; University of Nottingham and Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, U.K.
From the Department of Child Psychiatry, National and Kapodistrian University of Athens, School of Medicine, Aghia Sophia Children’s Hospital, Athens, Greece; University of Nottingham and Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, U.K.
From the Department of Child Psychiatry, National and Kapodistrian University of Athens, School of Medicine, Aghia Sophia Children’s Hospital, Athens, Greece; University of Nottingham and Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, U.K.
The authors report no financial relationships with commercial interests.
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