In our Tshwane Migrant Project, which supports migrants and asylum seekers to access primary healthcare, mental health services and social work assistance our teams have seen how mental health needs have increased in the communities we serve during COVID-19. For our mental healthcare teams, COVID-19 might have affected the way they work but not the work itself. Since the onset of the pandemic, our teams across South Africa have had to adapt how they treat and serve patients. Technology has had to fill in several gaps where face-to-face contact is not possible in order to avoid increasing risk for those we assist.

Olga, MSF mental health counsellor, facilitates discussion groups at Bossangoa hospital, helping people through stress management, family planning and coping with bad and sad thoughts. “Most of the participants are women: they come to the groups to talk about their conditions... Many of them come from very far away, and they have left their other children at home. They’re worried, and with no vision for their future. Many of them are victims of domestic violence, but they don’t dare to talk about it within their community. Nobody asks these women how they feel, and what would make them feel better."

Nearly two thirds of patients consulting with MSF’s mental health team in Beirut are showing symptoms related to anxiety and depression. More than half of them attribute their symptoms to the explosion that took place on 4 August. For others with pre-existing mental health issues, 82 per cent admit their symptoms increased in severity after the explosion. 

“Two months after the blast, we are seeing an increase in number of consultations. Even though many people have by now treated their physical wounds, secured their external environment and basic needs – like housing, electricity, water – many still cry at night, or they are startled by any slight sound, like that of a pen dropping. They can feel that something isn’t right,” says Rima Makki, MSF’s mental health manager in Beirut. 

Mental healthcare is often provided as part of ongoing care for other medical issues. In Belarus, where there is a high burden of multi-drug resistant tuberculosis, MSF teams provide support in four tuberculosis facilities in Minsk. Together with the Ministry of Health, MSF provides a harm-reduction program helping patients with drug-resistant tuberculosis and alcohol-use problems to manage their dependency on alcohol and other substances in order to finish their treatment successfully

MSF’s Centre for Integral Action, known by its Spanish acronym El CAI, provides care for migrants living in Mexico City, who have suffered from torture and other forms of extreme violence. The centre offers long-term care including psychological and psychiatric treatment and social services – including support with applying for asylum, education and job-training services. On average patients stay with the program for up to four months before they are ready to start the next chapter in their lives. Pictured here, a child at El CAI participates in a piñata-making activity during a psycho-social session in November 2019.