Mental Health and Direct Provision (2020)

International Protection applicants face high rates of mental health difficulties. This briefing addresses key issues and urges prompt action to support vulnerable residents.


International Protection applicants experience a disproportionately high rate of mental health difficulties. They are up to fifteen times more likely to be diagnosed with depression, anxiety or post-traumatic stress disorder and five times more likely to be diagnosed with a psychiatric illness.

Experiences of forced migration include trauma, torture, war and conflict, human trafficking, violence, exploitation, grief and loss. Pre-existing conditions and mental health difficulties are exacerbated by the negative mental health impact of living in Direct Provision centres. This negative impact has been repeatedly expressed by residents and extensively reported and has resulted in consequences up to and including people taking their own lives.

Vulnerability assessments to help identify people in need of specialised accommodation and support, including people at risk and with mental health conditions, are not systematically conducted in Ireland, despite having a legal obligation to do so since the transposition of the EU recast Reception Condition directive in July 2018. Early and ongoing vulnerability assessments are required in order to identify pre-existing as well as new or ongoing difficulties.

The recent Government-commissioned Advisory Group report asserts that the system of Direct Provision is not fit for purpose and should be replaced with a system that limits time spent in reception centres to three months.

In the interim, Doras urges the Government to ensure that staff and management of Direct Provision centres appropriately respond to the urgent mental health needs of residents, including people at high risk of suicide and people in need of crisis intervention support. The Government must also ensure that recommendations made by medical professionals and support services about the vulnerability of individuals living in Direct Provision with regard to mental health difficulties and risk of suicide are acted upon.

This briefing note outlines five key issues regarding mental health difficulties and Direct Provision:

  1. Unsuitable accommodation
  2. Delays in case processing
  3. Substance misuse and addiction
  4. Lack of support services
  5. COVID-19