{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T18:58:50Z","timestamp":1781636330593,"version":"3.54.5"},"reference-count":65,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T00:00:00Z","timestamp":1771977600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,3,2]],"date-time":"2026-03-02T00:00:00Z","timestamp":1772409600000},"content-version":"vor","delay-in-days":5,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Universit\u00e4tsklinikum Hamburg-Eppendorf (UKE)"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Int J Equity Health"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Over the past decade, Greece has received a high number of applications for international protection, creating an urgent need for comprehensive mental health and psychosocial support (MHPSS) systems for asylum seekers and refugees. Despite its central role in the European migration context, there is currently no synthesis of evidence on MHPSS for these populations, which limits the understanding of inequities in mental health outcomes and access to care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>This narrative review synthesizes the available evidence on major sources of distress, mental health needs, the landscape of MHPSS services, and barriers to access for asylum seekers and refugees in Greece.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>We conducted a narrative review adhering to guidance from the Inter-Agency Standing Committee (IASC) on multi-sectoral MHPSS needs and resources assessments. Literature published in English or Greek between January 2015 and May 2025 was identified through PubMed, Web of Science, Google Scholar, and targeted web searches. Twenty-five journal articles and five additional sources (situation reports, assessments, and policy documents) were included.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The reviewed literature highlights the significant mental health needs of asylum seekers and refugees in Greece. According to the available studies, at least one third of asylum seekers and refugees experience mental health problems, such as depression or PTSD. These elevated mental health needs are linked to displacement, including post-migration stressors, as a critical social determinant of health. Despite considerable efforts to improve MHPSS, access to services and their quality are limited by structural barriers that disproportionately affect asylum seekers and refugees. These include a limited public mental health system, restrictive policies hindering inclusion into national systems, insufficient workforce capacity and inadequate adaptation of services to cultural and contextual needs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Asylum seekers and refugees in Greece experience inequities in both mental health outcomes and access to adequate care. Strengthening MHPSS for asylum seekers and refugees requires a multi-layered approach that addresses social determinants, integrates MHPSS for refugees into national systems, enhances community-based support, builds workforce capacity and competence, and improves monitoring and evaluation. Equity-focused recommendations are outlined to guide policy and practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical trial number<\/jats:title>\n                    <jats:p>Not applicable.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12939-026-02786-2","type":"journal-article","created":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T09:04:30Z","timestamp":1772010270000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Mental health and psychosocial support for asylum seekers and refugees in Greece: a narrative review of stressors, needs, services, and barriers"],"prefix":"10.1186","volume":"25","author":[{"given":"Lars","family":"Dumke","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eleni","family":"Maousidi-Ziganou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Penny","family":"Kalpaxi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ledia","family":"Lazeri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Hall","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joao","family":"Breda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,2,25]]},"reference":[{"key":"2786_CR1","unstructured":"Casalis M, Hangartner D, Hartman A, S\u00e1nchez R. Home for good? Obstacles and opportunities for refugees and asylum seekers in Greece. IPL; 2023."},{"key":"2786_CR2","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1186\/s12916-018-1028-4","volume":"16","author":"JB Farhat","year":"2018","unstructured":"Farhat JB, Blanchet K, Juul Bjertrup P, et al. Syrian refugees in Greece: experience with violence, mental health status, and access to information during the journey and while in Greece. BMC Med. 2018;16:40. https:\/\/doi.org\/10.1186\/s12916-018-1028-4.","journal-title":"BMC Med"},{"key":"2786_CR3","doi-asserted-by":"publisher","unstructured":"Giannopoulou I, Mourloukou L, Efstathiou V, Psychiatriki et al. https:\/\/doi.org\/10.22365\/jpsych.2022.074","DOI":"10.22365\/jpsych.2022.074"},{"key":"2786_CR4","unstructured":"UNHCR. (2016) More than one million refugees travel to Greece since 2015. In: UNHCR Greece. https:\/\/www.unhcr.org\/gr\/en\/news\/more-one-million-refugees-travel-greece-2015. Accessed 28 Apr 2025."},{"key":"2786_CR5","unstructured":"Hellenic Republic Ministry of Migration & Asylum. (2025) Consolidated Reports on International Protection - February 2025 - Appendix A."},{"key":"2786_CR6","unstructured":"UNHCR. (2024) Refugee Data Finder. In: UNHCR. https:\/\/www.unhcr.org\/refugee-statistics\/download\/?url=8aIO97. Accessed 22 Aug 2024."},{"key":"2786_CR7","doi-asserted-by":"publisher","first-page":"e1003337","DOI":"10.1371\/journal.pmed.1003337","volume":"17","author":"R Blackmore","year":"2020","unstructured":"Blackmore R, Boyle JA, Fazel M, et al. The prevalence of mental illness in refugees and asylum seekers: A systematic review and meta-analysis. PLOS Med. 2020;17:e1003337. https:\/\/doi.org\/10.1371\/journal.pmed.1003337.","journal-title":"PLOS Med"},{"key":"2786_CR8","doi-asserted-by":"publisher","first-page":"1295","DOI":"10.1007\/s00787-018-1215-z","volume":"28","author":"C Kien","year":"2019","unstructured":"Kien C, Sommer I, Faustmann A, et al. Prevalence of mental disorders in young refugees and asylum seekers in European Countries: a systematic review. Eur Child Adolesc Psychiatry. 2019;28:1295\u2013310. https:\/\/doi.org\/10.1007\/s00787-018-1215-z.","journal-title":"Eur Child Adolesc Psychiatry"},{"key":"2786_CR9","doi-asserted-by":"publisher","unstructured":"Dumke L, Wilker S, Hecker T, Neuner F. Barriers to accessing mental health care for refugees and asylum seekers in high-income countries: A scoping review of reviews mapping demand and supply-side factors onto a conceptual framework. Clin Psychol Rev. 2024;113. https:\/\/doi.org\/10.1016\/j.cpr.2024.102491.","DOI":"10.1016\/j.cpr.2024.102491"},{"key":"2786_CR10","doi-asserted-by":"publisher","DOI":"10.1007\/s00787-025-02833-3","author":"L Dumke","year":"2025","unstructured":"Dumke L, Nagraj S, Yusuf S, et al. Quality of mental health care for forcibly displaced children and adolescents in the WHO European region: A scoping review of barriers and facilitators. Eur Child Adolesc Psychiatry. 2025. https:\/\/doi.org\/10.1007\/s00787-025-02833-3.","journal-title":"Eur Child Adolesc Psychiatry"},{"key":"2786_CR11","volume-title":"WHO global action plan on promoting the health of refugees and migrants, 2019\u20132030","author":"WHO","year":"2024","unstructured":"WHO. WHO global action plan on promoting the health of refugees and migrants, 2019\u20132030. Geneva: World Health Organization; 2024."},{"key":"2786_CR12","volume-title":"Mental health of refugees and migrants: risk and protective factors and access to care","author":"WHO","year":"2023","unstructured":"WHO. Mental health of refugees and migrants: risk and protective factors and access to care. Geneva: World Health Organization; 2023."},{"key":"2786_CR13","doi-asserted-by":"publisher","first-page":"414","DOI":"10.4300\/JGME-D-22-00480.1","volume":"14","author":"J Sukhera","year":"2022","unstructured":"Sukhera J. Narrative Reviews: Flexible, Rigorous, and Practical. J Grad Med Educ. 2022;14:414\u20137. https:\/\/doi.org\/10.4300\/JGME-D-22-00480.1.","journal-title":"J Grad Med Educ"},{"key":"2786_CR14","first-page":"1","volume-title":"Encyclopedia of Evidence in Pharmaceutical Public Health and Health Services Research in Pharmacy","author":"D Thomas","year":"2023","unstructured":"Thomas D, Zairina E, George J. Methodological Approaches to Literature Review. Encyclopedia of Evidence in Pharmaceutical Public Health and Health Services Research in Pharmacy. Cham: Springer International Publishing; 2023. pp. 1\u201315."},{"key":"2786_CR15","unstructured":"IASC MHPSS Reference Group. Multi-sectoral mental health and psychosocial support assessment toolkit -. Draft Version for Field Testing; 2024."},{"key":"2786_CR16","unstructured":"IASC. (2007) IASC Guidelines on Mental Health and Psychosocial Support in Emergency Settings."},{"key":"2786_CR17","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1186\/1475-9276-12-18","volume":"12","author":"J-F Levesque","year":"2013","unstructured":"Levesque J-F, Harris MF, Russell G. Patient-centred access to health care: conceptualising access at the interface of health systems and populations. Int J Equity Health. 2013;12:18. https:\/\/doi.org\/10.1186\/1475-9276-12-18.","journal-title":"Int J Equity Health"},{"key":"2786_CR18","unstructured":"IOM. (2024) IPPOKRATIS I - Provision of medical and psychosocial services to | IOM Greece. https:\/\/greece.iom.int\/ippokratis-i-provision-medical-and-psychosocial-services-residents-accommodation-facilities-under-responsibility-reception-and-identification-service. Accessed 28 Apr 2025."},{"key":"2786_CR19","doi-asserted-by":"publisher","first-page":"1413","DOI":"10.3390\/children11121413","volume":"11","author":"I Giannopoulou","year":"2024","unstructured":"Giannopoulou I, Papanastasatos G, Vathakou E, et al. Mapping Psychosocial Challenges, Mental Health Difficulties, and MHPSS Services for Unaccompanied Asylum-Seeking Children in Greece: Insights from Service Providers. Children. 2024;11:1413. https:\/\/doi.org\/10.3390\/children11121413.","journal-title":"Children"},{"key":"2786_CR20","doi-asserted-by":"publisher","first-page":"6972","DOI":"10.3390\/ijerph17196972","volume":"17","author":"L Joseph","year":"2020","unstructured":"Joseph L, Ismail SA, Gunst M, et al. A Qualitative Research Study Which Explores Humanitarian Stakeholders\u2019 Views on Healthcare Access for Refugees in Greece. Int J Environ Res Public Health. 2020;17:6972. https:\/\/doi.org\/10.3390\/ijerph17196972.","journal-title":"Int J Environ Res Public Health"},{"key":"2786_CR21","unstructured":"Hellenic Republic Ministry of Migration & Asylum. (2020) Applying for Asylum. https:\/\/migration.gov.gr\/en\/gas\/diadikasia-asyloy\/. Accessed 28 Apr 2025."},{"key":"2786_CR22","unstructured":"UNHCR. (2025) Greece: Key Findings on 2024 Protection Monitoring of Refugees. In: UNHCR. https:\/\/www.unhcr.org\/media\/greece-key-findings-2024-protection-monitoring-refugees. Accessed 25 Nov 2025."},{"key":"2786_CR23","doi-asserted-by":"publisher","first-page":"580","DOI":"10.1007\/s10903-022-01425-6","volume":"25","author":"E Farmakioti","year":"2023","unstructured":"Farmakioti E, Pylli M, Giannakou K. Access to Healthcare Services and Essential Medicines in GREEK Migrant Camps: an Online Cross-Sectional Study. J Immigr Minor Health. 2023;25:580\u20138. https:\/\/doi.org\/10.1007\/s10903-022-01425-6.","journal-title":"J Immigr Minor Health"},{"key":"2786_CR24","doi-asserted-by":"publisher","first-page":"818","DOI":"10.1016\/j.healthpol.2019.06.003","volume":"123","author":"M Gunst","year":"2019","unstructured":"Gunst M, Jarman K, Yarwood V, et al. Healthcare access for refugees in Greece: Challenges and opportunities. Health Policy. 2019;123:818\u201324. https:\/\/doi.org\/10.1016\/j.healthpol.2019.06.003.","journal-title":"Health Policy"},{"key":"2786_CR25","doi-asserted-by":"publisher","first-page":"757","DOI":"10.1177\/00207640241303029","volume":"71","author":"K Kotsis","year":"2025","unstructured":"Kotsis K, Marchionatti LE, Simioni A, et al. The state of mental health in Greece: An international comparative analysis using data from the Global Mental Health Countdown 2030. Int J Soc Psychiatry. 2025;71:757\u201369. https:\/\/doi.org\/10.1177\/00207640241303029.","journal-title":"Int J Soc Psychiatry"},{"key":"2786_CR26","doi-asserted-by":"publisher","first-page":"119","DOI":"10.1007\/s00787-015-0806-1","volume":"25","author":"DC Anagnostopoulos","year":"2016","unstructured":"Anagnostopoulos DC, Triantafyllou K, Xylouris G, et al. Migration mental health issues in Europe: the case of Greece. Eur Child Adolesc Psychiatry. 2016;25:119\u201322. https:\/\/doi.org\/10.1007\/s00787-015-0806-1.","journal-title":"Eur Child Adolesc Psychiatry"},{"key":"2786_CR27","doi-asserted-by":"publisher","first-page":"89","DOI":"10.1192\/S2056474000001410","volume":"13","author":"GN Christodoulou","year":"2016","unstructured":"Christodoulou GN, Abou-Saleh MT. Greece and the refugee crisis: mental health context. BJPsych Int. 2016;13:89\u201391. https:\/\/doi.org\/10.1192\/S2056474000001410.","journal-title":"BJPsych Int"},{"key":"2786_CR28","doi-asserted-by":"publisher","first-page":"1790","DOI":"10.3390\/ijerph15081790","volume":"15","author":"OS Kotsiou","year":"2018","unstructured":"Kotsiou OS, Kotsios P, Srivastava DS, et al. Impact of the Refugee Crisis on the Greek Healthcare System: A Long Road to Ithaca. Int J Environ Res Public Health. 2018;15:1790. https:\/\/doi.org\/10.3390\/ijerph15081790.","journal-title":"Int J Environ Res Public Health"},{"key":"2786_CR29","unstructured":"International Rescue Committee. (2022) People in Greece are going hungry, as over one third of those living in refugee camps are denied food. https:\/\/www.rescue.org\/press-release\/people-greece-are-going-hungry-over-one-third-those-living-refugee-camps-are-denied. Accessed 30 Dec 2025."},{"key":"2786_CR30","doi-asserted-by":"publisher","first-page":"437","DOI":"10.1007\/s10903-021-01199-3","volume":"24","author":"S Beza","year":"2022","unstructured":"Beza S, Mavrodi AG, Kyratso G, Aletras VH. Health-Related Quality of Life Among Refugees and Asylum Seekers in Northern Greece. J Immigr Minor Health. 2022;24:437\u201344. https:\/\/doi.org\/10.1007\/s10903-021-01199-3.","journal-title":"J Immigr Minor Health"},{"key":"2786_CR31","doi-asserted-by":"publisher","first-page":"38","DOI":"10.1186\/s13031-018-0172-y","volume":"12","author":"C Eleftherakos","year":"2018","unstructured":"Eleftherakos C, Van Den Boogaard W, Barry D, et al. I prefer dying fast than dying slowly, how institutional abuse worsens the mental health of stranded Syrian, Afghan and Congolese migrants on Lesbos island following the implementation of EU-Turkey deal. Confl Health. 2018;12:38. https:\/\/doi.org\/10.1186\/s13031-018-0172-y.","journal-title":"Confl Health"},{"key":"2786_CR32","doi-asserted-by":"publisher","first-page":"125","DOI":"10.1186\/s12888-023-04613-2","volume":"23","author":"M Lavdas","year":"2023","unstructured":"Lavdas M, Guribye E, Sandal GM. Of course, you get depression in this situation: Explanatory Models (EMs) among Afghan refugees in camps in Northern Greece. BMC Psychiatry. 2023;23:125. https:\/\/doi.org\/10.1186\/s12888-023-04613-2.","journal-title":"BMC Psychiatry"},{"key":"2786_CR33","doi-asserted-by":"publisher","first-page":"26","DOI":"10.5455\/msm.2021.33.26-29","volume":"33","author":"M Maria","year":"2021","unstructured":"Maria M, Dimitra T, Mary G, et al. Depression, Resilience and Post Traumatic Stress Disorder (PTSD) in Asylum-seeker War Refugees. Mater Socio-Medica. 2021;33:26\u20139. https:\/\/doi.org\/10.5455\/msm.2021.33.26-29.","journal-title":"Mater Socio-Medica"},{"key":"2786_CR34","doi-asserted-by":"publisher","first-page":"i22","DOI":"10.1093\/jrs\/fez034","volume":"32","author":"T Stathopoulou","year":"2019","unstructured":"Stathopoulou T, Avrami L, Kostaki A, et al. Safety, Health and Trauma among Newly Arrived Refugees in Greece. J Refug Stud. 2019;32:i22\u201335. https:\/\/doi.org\/10.1093\/jrs\/fez034.","journal-title":"J Refug Stud"},{"key":"2786_CR35","doi-asserted-by":"publisher","first-page":"908","DOI":"10.1186\/s12889-018-5822-x","volume":"18","author":"DN Poole","year":"2018","unstructured":"Poole DN, Hedt-Gauthier B, Liao S, et al. Major depressive disorder prevalence and risk factors among Syrian asylum seekers in Greece. BMC Public Health. 2018;18:908. https:\/\/doi.org\/10.1186\/s12889-018-5822-x.","journal-title":"BMC Public Health"},{"key":"2786_CR36","doi-asserted-by":"publisher","first-page":"100365","DOI":"10.1016\/j.ssmmh.2024.100365","volume":"6","author":"M Lavdas","year":"2024","unstructured":"Lavdas M, Sandal GM, B\u00f8e T. Factors associated with mental health outcomes among peer refugee helpers in Greece: Results from a cross-sectional study. SSM - Ment Health. 2024;6:100365. https:\/\/doi.org\/10.1016\/j.ssmmh.2024.100365.","journal-title":"SSM - Ment Health"},{"key":"2786_CR37","volume-title":"Migrants\u2019 journey, vulnerabilities, access to information and endured violence during the journey and in refugee camps in Ioannina","author":"JB Farhat","year":"2017","unstructured":"Farhat JB, Bouhenia M, Bjertrup P, et al. Migrants\u2019 journey, vulnerabilities, access to information and endured violence during the journey and in refugee camps in Ioannina. Greece: Attica, Athens and Samos; 2017."},{"key":"2786_CR38","doi-asserted-by":"publisher","first-page":"837","DOI":"10.1007\/s10389-021-01622-x","volume":"31","author":"A Gordon","year":"2023","unstructured":"Gordon A, O-Brien C, Balen J, et al. A cross-sectional survey of sociodemographic characteristics, primary care health needs and living conditions of asylum-seekers living in a Greek reception centre. J Public Health. 2023;31:837\u201347. https:\/\/doi.org\/10.1007\/s10389-021-01622-x.","journal-title":"J Public Health"},{"key":"2786_CR39","doi-asserted-by":"publisher","first-page":"1179756","DOI":"10.3389\/fpubh.2023.1179756","volume":"11","author":"F Knappe","year":"2023","unstructured":"Knappe F, Filippou K, Hatzigeorgiadis A, et al. Psychological well-being, mental distress, metabolic syndrome, and associated factors among people living in a refugee camp in Greece: a cross-sectional study. Front Public Health. 2023;11:1179756. https:\/\/doi.org\/10.3389\/fpubh.2023.1179756.","journal-title":"Front Public Health"},{"key":"2786_CR40","doi-asserted-by":"publisher","first-page":"911642","DOI":"10.3389\/fpsyt.2022.911642","volume":"13","author":"D Theofanidis","year":"2022","unstructured":"Theofanidis D, Karavasileiadou S, Almegewly WH. Post-traumatic stress disorder among Syrian refugees in Greece. Front Psychiatry. 2022;13:911642. https:\/\/doi.org\/10.3389\/fpsyt.2022.911642.","journal-title":"Front Psychiatry"},{"key":"2786_CR41","doi-asserted-by":"publisher","first-page":"49","DOI":"10.3390\/psych4010004","volume":"4","author":"I Fylla","year":"2022","unstructured":"Fylla I, Fousfouka E, Kostoula M, Spentzouri P. The Interventions of a Mobile Mental Health Unit on the Refugee Crisis on a Greek Island. Psych. 2022;4:49\u201359. https:\/\/doi.org\/10.3390\/psych4010004.","journal-title":"Psych"},{"key":"2786_CR42","first-page":"2020","volume":"20","author":"International Rescue Committee","year":"2020","unstructured":"International Rescue Committee. The cruelty of containment: The mental health toll of the EU\u2019s \u2018Hotspot\u2019approach on the Greek Islands. Retrieved Sept. 2020;20:2020\u201312.","journal-title":"Retrieved Sept"},{"key":"2786_CR43","doi-asserted-by":"publisher","first-page":"1290","DOI":"10.1186\/s12889-021-11301-x","volume":"21","author":"W Van De Wiel","year":"2021","unstructured":"Van De Wiel W, Castillo-Laborde C, Francisco Urz\u00faa I, et al. Mental health consequences of long-term stays in refugee camps: preliminary evidence from Moria. BMC Public Health. 2021;21:1290. https:\/\/doi.org\/10.1186\/s12889-021-11301-x.","journal-title":"BMC Public Health"},{"key":"2786_CR44","doi-asserted-by":"publisher","first-page":"851","DOI":"10.1007\/s10654-017-0269-4","volume":"32","author":"MPJ Hermans","year":"2017","unstructured":"Hermans MPJ, Kooistra J, Cannegieter SC, et al. Healthcare and disease burden among refugees in long-stay refugee camps at Lesbos, Greece. Eur J Epidemiol. 2017;32:851\u20134. https:\/\/doi.org\/10.1007\/s10654-017-0269-4.","journal-title":"Eur J Epidemiol"},{"key":"2786_CR45","doi-asserted-by":"publisher","first-page":"818","DOI":"10.1186\/s12888-024-06255-4","volume":"24","author":"M Lavdas","year":"2024","unstructured":"Lavdas M, Sandal GM, Bendixsen S. It was really helpful for me, and at the same time it was really tough: a qualitative study among Afghan peer refugee helpers in Greece. BMC Psychiatry. 2024;24:818. https:\/\/doi.org\/10.1186\/s12888-024-06255-4.","journal-title":"BMC Psychiatry"},{"key":"2786_CR46","doi-asserted-by":"publisher","first-page":"24","DOI":"10.1186\/s13031-018-0158-9","volume":"12","author":"R H\u00e9mono","year":"2018","unstructured":"H\u00e9mono R, Relyea B, Scott J, et al. The needs have clearly evolved as time has gone on.: A qualitative study to explore stakeholders\u2019 perspectives on the health needs of Syrian refugees in Greece following the 2016 European Union-Turkey agreement. Confl Health. 2018;12:24. https:\/\/doi.org\/10.1186\/s13031-018-0158-9.","journal-title":"Confl Health"},{"key":"2786_CR47","doi-asserted-by":"publisher","unstructured":"Kousoulis AA, Ioakeim-Ioannidou M, Economopoulos KP. Access to health for refugees in Greece: lessons in inequalities. Int J Equity Health. 2016;15. https:\/\/doi.org\/10.1186\/s12939-016-0409-6.:122, s12939-016-0409\u20136.","DOI":"10.1186\/s12939-016-0409-6"},{"key":"2786_CR48","doi-asserted-by":"publisher","first-page":"163","DOI":"10.1186\/1471-244X-13-163","volume":"13","author":"P Skapinakis","year":"2013","unstructured":"Skapinakis P, Bellos S, Koupidis S, et al. Prevalence and sociodemographic associations of common mental disorders in a nationally representative sample of the general population of Greece. BMC Psychiatry. 2013;13:163. https:\/\/doi.org\/10.1186\/1471-244X-13-163.","journal-title":"BMC Psychiatry"},{"key":"2786_CR49","doi-asserted-by":"publisher","first-page":"297","DOI":"10.1177\/0706743717746666","volume":"63","author":"M Hynie","year":"2018","unstructured":"Hynie M. The Social Determinants of Refugee Mental Health in the Post-Migration Context: A Critical Review. Can J Psychiatry. 2018;63:297\u2013303. https:\/\/doi.org\/10.1177\/0706743717746666.","journal-title":"Can J Psychiatry"},{"key":"2786_CR50","doi-asserted-by":"publisher","first-page":"1055","DOI":"10.1007\/s10903-020-01025-2","volume":"22","author":"S Jannesari","year":"2020","unstructured":"Jannesari S, Hatch S, Prina M, Oram S. Post-migration Social\u2013Environmental Factors Associated with Mental Health Problems Among Asylum Seekers: A Systematic Review. J Immigr Minor Health. 2020;22:1055\u201364. https:\/\/doi.org\/10.1007\/s10903-020-01025-2.","journal-title":"J Immigr Minor Health"},{"key":"2786_CR51","doi-asserted-by":"publisher","first-page":"e1438","DOI":"10.1002\/ppi.1438","volume":"16","author":"RK Papadopoulos","year":"2018","unstructured":"Papadopoulos RK, Gionakis N. The neglected complexities of refugee fathers. Psychother Polit Int. 2018;16:e1438. https:\/\/doi.org\/10.1002\/ppi.1438.","journal-title":"Psychother Polit Int"},{"key":"2786_CR52","doi-asserted-by":"publisher","first-page":"1415","DOI":"10.1038\/s44220-024-00336-9","volume":"2","author":"A Nickerson","year":"2024","unstructured":"Nickerson A, Mai V, Keegan D, et al. A systematic review of protective and promotive factors in refugee mental health. Nat Ment Health. 2024;2:1415\u201328. https:\/\/doi.org\/10.1038\/s44220-024-00336-9.","journal-title":"Nat Ment Health"},{"key":"2786_CR53","doi-asserted-by":"publisher","first-page":"101930","DOI":"10.1016\/j.cpr.2020.101930","volume":"83","author":"F Scharpf","year":"2021","unstructured":"Scharpf F, Kaltenbach E, Nickerson A, Hecker T. A systematic review of socio-ecological factors contributing to risk and protection of the mental health of refugee children and adolescents. Clin Psychol Rev. 2021;83:101930. https:\/\/doi.org\/10.1016\/j.cpr.2020.101930.","journal-title":"Clin Psychol Rev"},{"key":"2786_CR54","doi-asserted-by":"publisher","first-page":"e86","DOI":"10.1002\/mhs2.86","volume":"2","author":"C Papathanasiou","year":"2024","unstructured":"Papathanasiou C, Kougioumtzi A. Peer-provided problem management plus (PM+) and case management for Arabic\u2010speaking and Farsi\u2010speaking refugees and asylum seekers in Greece. Ment Health Sci. 2024;2:e86. https:\/\/doi.org\/10.1002\/mhs2.86.","journal-title":"Ment Health Sci"},{"key":"2786_CR55","doi-asserted-by":"publisher","first-page":"176","DOI":"10.1177\/13634615211067360","volume":"60","author":"E Pe\u00f1uela-O\u2019Brien","year":"2023","unstructured":"Pe\u00f1uela-O\u2019Brien E, Wan MW, Edge D, Berry K. Health professionals\u2019 experiences of and attitudes towards mental healthcare for migrants and refugees in Europe: A qualitative systematic review. Transcult Psychiatry. 2023;60:176\u201398. https:\/\/doi.org\/10.1177\/13634615211067360.","journal-title":"Transcult Psychiatry"},{"key":"2786_CR56","doi-asserted-by":"publisher","first-page":"509","DOI":"10.3390\/bs14060509","volume":"14","author":"B Ghafoori","year":"2024","unstructured":"Ghafoori B, Triliva S, Chrysikopoulou P, Vavvos A. Resilience, Coping Self-Efficacy, and Posttraumatic Stress Symptoms among Healthcare Workers Who Work with Refugees and Asylum Seekers in Greece. Behav Sci. 2024;14:509. https:\/\/doi.org\/10.3390\/bs14060509.","journal-title":"Behav Sci"},{"key":"2786_CR57","doi-asserted-by":"publisher","first-page":"90","DOI":"10.1111\/tmi.13845","volume":"28","author":"A MacFarlane","year":"2023","unstructured":"MacFarlane A, Puthoopparambil SJ, Waagensen E, et al. Framework for refugee and migrant health research in the WHO European Region. Trop Med Int Health. 2023;28:90\u20137. https:\/\/doi.org\/10.1111\/tmi.13845.","journal-title":"Trop Med Int Health"},{"key":"2786_CR58","unstructured":"WHO. (2025) Guidance on policy and strategic actions to protect and promote mental health and well-being across government sectors."},{"key":"2786_CR59","volume-title":"Guidance on Community Mental Health Services: Promoting Person-Centred and Rights-based Approaches","author":"WHO","year":"2021","unstructured":"WHO. Guidance on Community Mental Health Services: Promoting Person-Centred and Rights-based Approaches. 1st ed. Geneva: World Health Organization; 2021.","edition":"1"},{"key":"2786_CR60","volume-title":"Psychological Interventions Implementation Manual: Integrating Evidence-Based Psychological Interventions into Existing Services","author":"WHO","year":"2024","unstructured":"WHO. Psychological Interventions Implementation Manual: Integrating Evidence-Based Psychological Interventions into Existing Services. 1st ed. Geneva: World Health Organization; 2024.","edition":"1"},{"key":"2786_CR61","unstructured":"Camila Perera M Lavdas. Cultural and Contextual Adaptation of a Problem Management Plus for Afghan Refugees and Asylum Seekers in Greece. Terre des hommes; 2020."},{"key":"2786_CR62","unstructured":"WHO Regional Office for Europe. (2025) Quality standards for child and youth mental health services: for use in specialized community or outpatient care across the WHO European Region."},{"key":"2786_CR63","volume-title":"mhGAP humanitarian intervention guide (mhGAP-HIG): clinical management of mental, neurological and substance use conditions in humanitarian emergencies","author":"WHO, UNHCR","year":"2015","unstructured":"WHO, UNHCR. mhGAP humanitarian intervention guide (mhGAP-HIG): clinical management of mental, neurological and substance use conditions in humanitarian emergencies. Geneva: World Health Organization; 2015."},{"key":"2786_CR64","doi-asserted-by":"publisher","first-page":"67","DOI":"10.1016\/S2215-0366(24)00183-4","volume":"12","author":"BA Kohrt","year":"2025","unstructured":"Kohrt BA, Pedersen GA, Schafer A, et al. Competency-based training and supervision: development of the WHO-UNICEF Ensuring Quality in Psychosocial and Mental Health Care (EQUIP) initiative. Lancet Psychiatry. 2025;12:67\u201380. https:\/\/doi.org\/10.1016\/S2215-0366(24)00183-4.","journal-title":"Lancet Psychiatry"},{"key":"2786_CR65","volume-title":"Culture, Context and the Mental Health and Psychosocial Wellbeing of Syrians: A Review for Mental Health and Psychosocial Support staff working with Syrians Affected by Armed Conflict","author":"G Hassan","year":"2015","unstructured":"Hassan G, Kirmayer L, Mekki-Berrada A, et al. Culture, Context and the Mental Health and Psychosocial Wellbeing of Syrians: A Review for Mental Health and Psychosocial Support staff working with Syrians Affected by Armed Conflict. Geneva: UNHCR; 2015."}],"container-title":["International Journal for Equity in Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12939-026-02786-2","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12939-026-02786-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12939-026-02786-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T18:51:08Z","timestamp":1781635868000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12939-026-02786-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,25]]},"references-count":65,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["2786"],"URL":"https:\/\/doi.org\/10.1186\/s12939-026-02786-2","relation":{},"ISSN":["1475-9276"],"issn-type":[{"value":"1475-9276","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,25]]},"assertion":[{"value":"26 November 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 February 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 February 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"There are no human participants in this article and informed consent is not required.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"Not applicable.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"59"}}