1. To identify issues relevant to provision of mental health care for forcibly displaced people, refugees and migrants across the world and to develop recommendations for WPA’s involvement in forcibly displaced people, refugee and migrant mental health research, education and mental health system development.
2. To identify member societies, institutions and individuals interested and willing to participate in WPA’s programs of forcibly displaced people, refugee and migrant mental health research, education and mental health system development.
3. To liaise with the other WPA Action Plan Working Groups with a view to promoting the inclusion of forcibly displaced people, refugee and migrant mental health in the work of these groups. For further background information about the working group, see below

1. Symposium, workshop, forum, other type of meeting:
1. Symposia at the WPA scientific meetings (all 3 years)
2. Courses at the WPA scientific meetings (all 3 years)
3. Thematic congress on forcibly displaced people, refugee and migrant mental health (2nd year)
2. Webinar(s): all 3 years
1. Working with migrants and refugees - why do we need cultural competence? This webinar took place on the 4th November and focused on cultural competence and discussed why it is needed in working with migrant and refugee patients. You can read the webinar report here.
3. Position papers, reports, guidelines:
1. Identification and implementation of a comprehensive review of existing guidelines on provision of mental health services for forcibly displaced people, refugees and migrants (to be finalized by the end of 2nd year)
2. Guidelines for psychiatrists and mental health workers (to be finalized by the end of 3rd year)
4. Digital/online, print version documents:
1. All material produced to be uploaded on the special section of the WPA website (e.g., “Forcibly Displaced People, Refugee and Migrant Mental Health”)
5. Articles in journals, books:
1. Article: Review of studies focusing on provision of mental health services for forcibly displaced people, refugees and migrants (to be finalised by the end of 1st year)
2. Article: Report on the published research on existing service provision guidelines (to be finalised by the end of the 2nd year)
3. A WPA Book on provision of mental health services for forcibly displaced people, refugees and migrants (to be delivered to the publishing house by the end of the 3rd year)
6. Research protocols and studies:
1. Research: A questionnaire-based research project with the contribution of the WPA Member Societies to reveal the current global situation concerning provision of mental health services for forcibly displaced people, refugees and migrants (to be finalised by the end of 1st year)
7. Training programmes:
1. Preparing educational material for WPA membership
8. Collaboration with other organisations working in this field:
1. Joint publications with relevant professional associations
2. Joint symposia at the WPA scientific meetings

Due to expanding globalisation and a growing number of intra-national and international conflicts, the number of people moving across national and international borders is rapidly increasing. It is crucial that policymakers, mental health professionals, and other service providers address the health and psychosocial needs of these people for whom they are responsible, including their mental health.

Migration is an important risk factor for mental disorders. People moving across national and international borders may face adverse conditions before, during, and after migration(1-7). Prior to migration, they may have been exposed to deprivation, persecution, violence, imprisonment, human rights violations, including sexual harassment and even torture(2, 8). Greater exposure to pre-migration traumatic experiences is consistently associated with depression, PTSD, and anxiety among migrants and refugees. Post-migration stress factors, including poor socio-economic resources, may have an even greater impact on mental health than pre-migration factors; these include lack of integration, unemployment, absent educational opportunities, family separation, language difficulties, limited social networks, and unclear residence status. These factors are particularly associated with depression risk(9) and may have greater impact on psychosis risk than pre-migratory stressors(10). Further risk factors in new communities can include social exclusion, stigma and discrimination(11). Post-migratory stressors also contribute to the development of trauma sequelae(12). The rate of mental disorders was described as twice as high among refugees than among economic migrants(13). Thus, there is an urgent need for large-scale interventions to address psychiatric disorders in refugees and forcibly displaced persons after displacement(14)

The situation of forcibly displaced persons and migrants are worsened by the COVID-19 pandemic, which is having a major impact on public mental health. Fear of infection, the physical and mental sequelae of being infected, as well as grief and posttraumatic reactions upon the loss of loved ones increase the risk for mental health problems. The quarantine, physical distancing, and lockdown measures used to combat the epidemic also result in additional stresses that can worsen mental health, including social isolation, loneliness, loss of employment, financial crises, changes in the working environment, and concern over an uncertain future(15). Worry and uncertainty can precipitate or worsen acute depressive and anxiety symptoms and can increase the risk for serious mental illness, including panic and other anxiety disorders, mood disorders, and trauma-induced disorders(16, 17).

Individuals with mental illness are one of the most vulnerable groups to COVID-19 because of the limitations imposed by their mental illness and their limited access to quality health care. They often are at increased risk of infection because their living conditions do not allow them to maintain basic hygiene and social distancing(18). Refugees and forcibly displaced persons with mental health problems are at especially high risk. As many as 80% of refugees live in low- and middle-income countries, where their access to quality mental health care is even more limited than before their displacement. They need enormous global support to cope with a rapidly evolving crisis(19), including in accessing physical and mental health care and in carrying out adequate preventive measures against infection. Elevated risk of adverse psychological effects including among healthcare workers, particularly those exposed to infected patients, was one of the key findings of a recent meta-analysis(20). The SARS-CoV-2 virus disregards all borders.

Our global response must not overlook forcibly displaced people, refugees and migrants(19).

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15. Danuta Wasserman , Rutger van der Gaag , Jan Wisee. The term "physical distancing" is recommended rather than "social distancing" during the COVID-19 pandemic for reducing feelings of rejection among people with mental health problems. Eur Psychiatry 2020 Jun 1;63(1):e52.
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19. The Lancet. COVID-19: protecting health-care workers. Lancet 2020 Mar 21;395(10228):922.
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