Ms Emilia Marchelewska:

Again, these are very insightful questions. I just wanted to thank the Deputy for already having insight and understanding of some of the issues of the populations we work with. The first question was about the ways of conveying different messages. As Ms Coyle said, a digital barrier exists, but it is also an opportunity. Some of the examples include videos that are produced by the HSE on various health topics but the issue is how we disseminate that information and how this information reaches our communities. At Cairde, we have developed a platform called HealthConnect. It is a multilingual platform that is designed with a mobile user in mind, because our research shows that migrants may not have access to computers but almost everyone has a phone. We have various information there and we work with some health departments to devise messages around chronic illnesses or sexual health. We do not work as much with mental health services yet on this. That will be crucial and is something we would like to develop further. With HealthConnect, we also work with migrant communities, with leaders and with ethnic media. We reach the communities where they are and where they obtain information, like through Ukrainian Telegram channels, Arabic-speaking WhatsApp groups and things like that. There are also communities like Roma where it is empowering because our Roma programme actually delivers an educational programme online. In a way, there are enormous barriers. There is also an opportunity, however, because we teach the women how to use digital devices. Because of the large families and other commitments they have, they can actually avail of the information from home.

We need to remember that a living message alone is not enough. We say physical activity is beneficial for mental health, but what does it look like for me and who is there for each of us? We need to convey how people can implement the advice of having more physical activity in their lives. What do self-care practices look like for me? Who is helping me to build my support systems? The messages are there, but they are not as effective if there is no support to personalise them. That is where healthcare is going now. It includes a coaching approach to health behaviours. The Deputy made another great point about the lack of supports. This is the story of migration, loss and having to rebuild, develop and maintain new support systems. We know from research that if we develop formal and informal support systems, health outcomes are much better so it is a good investment. At Cairde, we promote peer support and advocacy services not only in the health services but also on the ground in the community. We need patient empowerment, patient education and the coaching approach to help people to imagine what it looks like, to do health planning and to craft stress control programmes. We need to do cultural adaptation of these programmes and help people to manage their health and create healthy environments.