Mental health needs of migrants and strategies to address them: a qualitative, participatory study applying a socio-ecological framework in Barcelona, Spain
5 affiliations
- 1Barcelona Institute for Global Health, Barcelona, Spain, Spain.
- 2Autonomous University of Barcelona, Spain, Barcelona, Barcelona, Spain.
- 3Medicine Solna, Karolinska Institutet, Stockholm, Stockholm, Sweden.
- 4Migrant Health, Barcelona Institute for Global Health, Barcelona, Barcelona, Spain.
- 5CIBERINFEC, ISCIII - CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Enfermedades Infecciosas, Madrid, Spain.
Abstract
Introduction Mental health among migrants represents a significant public health issue. The study aimed to explore the mental health needs and mental healthcare access barriers among migrants in Barcelona (Spain) and to co-design culturally sensitive strategies to address these challenges.Methods The study (Sept 2021–Feb 2023) has a qualitative design with reflexive thematic analysis, including adult migrants born outside the EU, North America and Oceania. First, we conducted three focus group discussions (FGD) with 21 migrant women and two FGDs with 12 migrant men (phase 1), and later, three FGDs with 19 professionals working with migrants, including migrant cultural mediators (phase 2). Thereafter, three LivingLab participatory workshops (n=24) took place in order to validate the qualitative results while encouraging the proposition of solutions to improve migrant mental healthcare (phase 3).Results A socio-ecological analysis of the qualitative findings was applied. The findings were categorised into five themes: risk factors, mental health conditions, help-seeking behaviours, barriers to mental healthcare access and actionable solutions, each analysed through a single, consistently applied socio-ecological lens across four levels (individual, family, community and structural). The individual level was understood not as the locus of deficit but as the site of embodiment, where family-level, community-level and structural-level determinants are registered. In participants’ accounts, distress was seldom framed around discrete pre-migration traumatic events; it was articulated instead through the chronic, everyday conditions of post-migration life, such as precarity, family separation and exclusion. At the structural level, the absence of migrant-sensitive assessment protocols produced a ‘diagnostic invisibility’, whereby clinically evident distress went systematically under-recognised. Participants co-designed multilevel actionable solutions spanning self-care, empowerment of informal community initiatives, peer-support systems, intercultural initiatives with host communities, cultural mediation and integrative mental health protocols across the social and health sectors.Conclusions Holding migrants’ lived experiences alongside the perspectives of first-line professionals, participatory processes translated these social patterns into a feasible agenda for action, a concrete move from documenting inequity to acting on it.
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BibTeX
@article{evangelidou2026mental,
title = {{Mental health needs of migrants and strategies to address them: a qualitative, participatory study applying a socio-ecological framework in Barcelona, Spain}},
author = {Stella Evangelidou and Laura Giménez and Eva Muñoz and Blanca Ivars and Sol Nadal Diaz and María Fusté Vidal and María-Jesús Pinazo and Ana Requena-Méndez},
journal = {BMJ Public Health},
year = {2026},
month = oct,
doi = {10.1136/bmjph-2025-003061},
url = {https://doi.org/10.1136/bmjph-2025-003061},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Mental health needs of migrants and strategies to address them: a qualitative, participatory study applying a socio-ecological framework in Barcelona, Spain
AU - Stella Evangelidou
AU - Laura Giménez
AU - Eva Muñoz
AU - Blanca Ivars
AU - Sol Nadal Diaz
AU - María Fusté Vidal
AU - María-Jesús Pinazo
AU - Ana Requena-Méndez
PY - 2026
DA - 2026/10/27
JO - BMJ Public Health
DO - 10.1136/bmjph-2025-003061
UR - https://doi.org/10.1136/bmjph-2025-003061
AB - Introduction Mental health among migrants represents a significant public health issue. The study aimed to explore the mental health needs and mental healthcare access barriers among migrants in Barcelona (Spain) and to co-design culturally sensitive strategies to address these challenges.Methods The study (Sept 2021–Feb 2023) has a qualitative design with reflexive thematic analysis, including adult migrants born outside the EU, North America and Oceania. First, we conducted three focus group discussions (FGD) with 21 migrant women and two FGDs with 12 migrant men (phase 1), and later, three FGDs with 19 professionals working with migrants, including migrant cultural mediators (phase 2). Thereafter, three LivingLab participatory workshops (n=24) took place in order to validate the qualitative results while encouraging the proposition of solutions to improve migrant mental healthcare (phase 3).Results A socio-ecological analysis of the qualitative findings was applied. The findings were categorised into five themes: risk factors, mental health conditions, help-seeking behaviours, barriers to mental healthcare access and actionable solutions, each analysed through a single, consistently applied socio-ecological lens across four levels (individual, family, community and structural). The individual level was understood not as the locus of deficit but as the site of embodiment, where family-level, community-level and structural-level determinants are registered. In participants’ accounts, distress was seldom framed around discrete pre-migration traumatic events; it was articulated instead through the chronic, everyday conditions of post-migration life, such as precarity, family separation and exclusion. At the structural level, the absence of migrant-sensitive assessment protocols produced a ‘diagnostic invisibility’, whereby clinically evident distress went systematically under-recognised. Participants co-designed multilevel actionable solutions spanning self-care, empowerment of informal community initiatives, peer-support systems, intercultural initiatives with host communities, cultural mediation and integrative mental health protocols across the social and health sectors.Conclusions Holding migrants’ lived experiences alongside the perspectives of first-line professionals, participatory processes translated these social patterns into a feasible agenda for action, a concrete move from documenting inequity to acting on it.
SN - 2753-4294
ER -