“A beacon of hope": a qualitative study on migrants' mental health needs and community-based organisations' responses during the COVID-19 pandemic in Antwerp, Belgium

Abstract

Background: The COVID-19 pandemic has highlighted the need for structurally informed mental health services that are sensitive to social inequalities and cultural differences. Community-level services and organisations are often referred to as having the potential to play a key role in providing such services to migrants, yet not many studies have documented how these types of services have been organised and experienced during the COVID-19 pandemic. The objective of our case study in Antwerp’s districts of Borgerhout and Antwerpen-Noord (Belgium) was to explore how community-level responses to the mental health impact of the COVID-19 crisis were organised and experienced by first-generation migrants and members of community-level organisations. Methods: Semi-structured qualitative interviews were conducted with first-generation migrants in Borgerhout and Antwerpen-Noord (n = 19) and with professionals in the local psycho-social care sector (n=13). Results: Our findings highlight the complex drivers of migrants’ mental health and the unique value and indispensability of local-level services and organisations in providing mental-health related services, particularly in a crisis context like the COVID-19 pandemic. Qualities that emerged to be particularly important included organisations’ awareness of local needs; their flexible nature which allows them to address bottlenecks and fill gaps left by other services; their capacity to respond holistically to a broad spectrum of needs; their ability to offer culturally sensitive care and support; and their physical accessibility. However, our findings also demonstrate the fragility and fragmentation of these local-level services and initiatives. In the face of the COVID-19 crisis, this related to serious challenges to the necessary physical accessibility of organisations’ services; services and initiatives becoming overloaded; and widespread fragmentation and lack of oversight of the available services forming a real barrier for both service users and providers. Conclusions: This study underlines the importance of prioritising physical accessibility of mental health services at the community level, improving cultural sensitivity through training and employing professionals with a shared background or language proficiency with migrants, and promoting stronger collaborations between community-level organizations and city governments. The findings are informative to guide mental health policy and future crisis responses in similar communities and neighbourhoods.