Dr. Salome Mbugua:

I thank the Deputy for his question. I will try to address the supports more because he mentioned how some people do not have family networks or supports. When we talk about mental health, we must bear in mind that for people who come from a migrant community, in particular the African continent, mental health is stigmatised. Shame, and therefore stigma, come with it. In AkiDwA we have noticed that most people do not want to talk about mental health as mental health, so we had to mask the term "mental health" by saying "let's talk". When we want to talk about mental health issues we frame them by saying "let's talk" or "we need to talk" and we find people come forward. On available supports, there are many organisations and it goes back to different small groups based on where people come from. As we said at the beginning, migrants are not a homogenous group. For example, there are 54 diverse countries on the African continent. People come from different ethnic backgrounds and have different beliefs. The stigma is framed by where people come from and the beliefs they bring with them. It can sometimes be difficult for a person to go to a community or group of people from their background because of the shame and stigma that surround the topic. In AkiDwA, we try to reach people where they are and encourage them to speak and engage with the rest of society and the rest of the community. I cannot emphasise enough how important peer-led support is. In Dublin, the HSE has established peer-led supports in the community. In AkiDwA, we have always called for programmes like the ones for Travellers, such as the health promotion programmes where migrants can be their own champions in reaching out to migrants who are needy and are not able to reach out. This is needed.

Rural set-ups can be an issue because Dublin tends to be the centre of everything where most of the specialised supports are based. For example, there is only one centre for female genital mutilation, FGM, and it is in Dublin. This means that a women who has FGM issues has to come all the way from Kerry to Dublin for treatment and then has to go back there. Sometimes travel and commuting can be difficult. There are also childcare issues. For women with children who have mental health issues, it is a worry that they may end up losing their children to the care of the State. That increases mental health issues for those people. We have to take a holistic approach to working with those people and come to the point of asking how we can better serve people from different services, while they are perhaps still being served from one port.

It is important to ensure that we have a holistic approach of dealing with the needs people have but also with what they are bringing with them and their understanding of the systems we have in place.