Abstract
BACKGROUND: 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. AIMS: 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. METHOD: 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. RESULTS: 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. CONCLUSIONS: 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. CLINICAL TRIAL NUMBER: Not applicable.