The mental health challenges faced by migrants and foreign workers are leading to so many admissions to mental health facilities that employers should consider offering support in the workplace, according to the Mental Health Commissioner.

Dr John Cachia told Times of Malta there was a growing risk of an acute mental health crisis among refugees and migrants.

Their mental health problems could often be directly linked to the trauma of migration and poor integration into a culturally different environment.

The commissioner was reacting to figures given in Parliament earlier this month showing that migrant admissions to Mount Carmel Hospital for treatment had doubled in two years.

While 53 migrants were admitted to the hospital in 2017, that figure went up to 79 last year and by this year had already reached 105 by October.

Migrants were hospitalised for a myriad of conditions, including suicide attempts, psychotic episodes, substance abuse, intentional overdoses, acute stress and adjustment disorders, Deputy Prime Minister Chris Fearne told Parliament on November 4.

The commissioner said the phenomenon was evolving to include a growing number of acute mental health admissions of foreign workers, from both the EU and other countries.

Commonly, foreigners who develop an acute mental health episode suffer social isolation and have a poor support network that could help them safely return into their communities, Dr Cachia said.

Support systems at best chaotic and in many cases non-existent

This was leading to a lower threshold for admissions into Mount Carmel and higher thresholds for discharge, particularly in situations where clinical teams judged the support available to the patient “at best chaotic and in many cases non-existent”.

“This Office has been approached for support on mental health challenges by groups from various foreign communities. The soaring admission rates among foreigners who are here for employment reasons are an indication that employers may need to consider additional workplace support,” Dr Cachia said.

He said foreigners of diverse nationalities had begun self-organising into support groups, with community leaders encouraging more discussion on mental health issues. Community groups, NGOs and Church organisations were also doing community work related to mental health among vulnerable groups.

Nationalist MP Mario Galea, who asked the question in Parliament, frequently advocates for mental health and has been candid about his own experiences with depression.

He said the figures were just the tip of the iceberg in understanding the extent of the problem, as some went through similar experiences but did not reach out for help.

“They carry a large burden, leaving their family behind for example, and perhaps we aren’t truly understanding the root of these problems.”

Integra Foundation director Maria Pisani said: “Refugees experience trauma and this trauma is protracted.

“War and conflict fractures communities, and the important source of support and security that they would normally provide. The journeys themselves are dangerous, often drawn-out, expensive and non-linear.”

Dr Pisani said the provision of refuge should include physical, emotional and material security  – mental health was a critical element of wellbeing on both an individual and societal level.

She said the increase in referrals merited further investigation. “But let us be honest. Do we really think that the prevailing context, marked by racism and discrimination, illegal detention and a camp context in dire need of financial, physical and human investment, is conducive to mental health and social wellbeing? Of course not.”

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