Ms Emilia Marchelewska:

A good practice example with regard to people coming here seeking international protection or temporary protection, at least in the area where we work in Cairde, is that we collaborate with the HSE on health assessments and health screenings of refugees. Carrying out these assessments at least provides a way to identify people who may need additional supports and link them with those supports. There is a need for a more in-depth psychological distress assessment and this is being piloted at Citywest. Nonetheless, even with this structured system people fall through the gaps because mental health is a specific area of health and people need to have willingness and readiness to engage with supports.

For Ukrainian refugees in particular, Ukraine Civil Society Forum members collaborate with us and we have a mental health subcommittee. We have put together a list of services that have been specifically established to support the mental health needs of Ukrainian refugees. The issues are culture, language and the accreditation of people.

That is only when we talk about specific and tailored psychological or mental health supports.

On access to mainstream services, bureaucracy, forms and delays put people off. Some prefer to seek support in what they see as a more culturally appropriate way, for instance, back in Ukraine, especially if they face barriers here. My colleagues already mentioned the community development approach. Mental health is not only being resolved on the mental healthcare level. The emotional support provided in the community, the provision of safe spaces and opportunities to interact with colleagues, neighbours and other refugees and resolving practical matters are important determinants in the context of building resilience. It is interpersonal and intrapersonal. I emphasise that we need to look at gaps in services and provide targeted solutions and that person-centred care is underpinned by social determinants of health.