The Atypical Setting: The Challenging Care of Migrants

Introduction

Psychological care for migrants poses significant challenges. Many arrive with severe psychopathological conditions such as PTSD, complex PTSD, depression, and psychosis, often stemming from trauma related to war, violence, persecution, or extreme socio-economic hardship. Upon first contact, migrants frequently show profound distrust toward healthcare professionals, associating therapeutic settings with past hostile experiences. Many are unfamiliar with psychological concepts, often confusing therapy with medical examinations. This distrust is heightened when mental health referrals come without clear explanation, making patients feel unprepared or threatened by potentially judgmental or legal situations, like child welfare interventions. Additionally, cultural differences deeply influence diagnosis, as definitions of mental illness vary widely. Western diagnostic models like the DSM-5-TR may pathologize behaviors seen as normal or adaptive in other cultures. Furthermore, psychological research predominantly reflects WEIRD (Western, Educated, Industrialized, Rich, Democratic) perspectives, limiting its relevance and risking cultural misinterpretations in migrant care.