Doras report highlights lack of mental health supports for people in direct provision

Doras report highlights lack of mental health supports for people in direct provision

Asylum seekers in Ireland with mental health difficulties are having their problems “exacerbated” due to living in direct provision. This is the finding of Doras, a Limerick-based organisation that works with asylum seekers. According to the group, the government and operators of direct provision centres are failing to respond to the “urgent mental health needs of residents”.

Because of this, the result has been “ongoing distress” for asylum seekers. And it’s “increased the risk of further psychological damage or suicide”.

A report from the Ombudsman for Children’s Office (OCO) earlier this year found that children in direct provision regularly feel “isolated” and experience racism. 

The impact of direct provision

Doras published the report yesterday, on Monday 23 November. In laying out the problems facing asylum seekers, Doras highlighted that they “experience a disproportionately high rate of mental health difficulties”. Such issues are then “exacerbated by the negative mental health impact of living in Direct Provision centres”. 

The group also drew attention to what it sees as “five key issues” affecting the mental health of asylum seekers in direct provision. Doras argued that unsuitable accommodation, delays in processing asylum applications, substance abuse and addiction, a lack of proper supports for residents, and the pandemic all have serious negative effects asylum seekers.

The state has also consistently failed to carry out vulnerability assessments on asylum seekers. Such assessments would let the state “identify people in need of specialised accommodation and supports”. But such assessments “are not systematically conducted” even though Ireland has “a legal obligation to do so”.

No space, nothing to do, and substance abuse

Accommodation in direct provision, Doras pointed out, is “overcrowded” and “communal”. Asylum seekers have said that such an arrangement is “a cause of anxiety, conflict, fear, distress”. And it worsens pre-existing mental health conditions. 

Also noted is the absence of “gender-sensitive accommodation” for asylum seekers. This “is a particular concern” for those fleeing sexual violence and exploitation as well for members of the LGBTQI+ community.

Delays in processing asylum applications cause similar problems. Doras pointed out:

It is widely documented that mental health difficulties deteriorate according to the length of time people spend living in Direct Provision.

Quoting the Day Report on the direct provision system, it’s underlined that the current system “is not fit for purpose”. And that the amount of time asylum seekers spend in direct provision should be limited to six months, as per the Day Report’s suggestion.

Related to this is what Doras describes as the “forced idleness” of people in direct provision. This has resulted in substance abuse and addiction for many. A number of “risk factors” for such health issues are known, including “stressors associated with migration and traumatic experiences” and “long-term unemployment”. 

Lack of support and COVID

Doras went on to declare that the lack of support services for asylum seekers is “a key failure of the system”. Support that does exist comes in the form of members of staff with “insufficient experience or training” in treating mental health issues. Although asylum seeks can technically avail of the same mental health services as Irish citizens, “limited knowledge of how to access these services” is a problem.

On top of this, issues such as a “language barriers” and the lack of “multilingual health services” worsen the problem. And the fact that many direct provision centres are in “isolated locations” makes it difficult to physically access any services that are available. 

COVID-19 has aggravated all of this. Doras points to multiple studies that show a “three-fold increase in mental health difficulties” since the start of the pandemic. It also revealed that it’s “witnessing, through our direct support services” the impact of the pandemic on the mental health of asylum seekers. 


To tackle the problems Doras made a number of suggestions. It argued that single rooms should be made available to those “particularly vulnerable” in direct provision. Support services need to be implemented to a greater degree alongside “early and ongoing vulnerability assessments”.

John Lannon, CEO of Doras argued that:

Ending direct provision in line with the Day Advisory Group recommendations is essential to ensure the wellbeing of international protection applicants in the medium to long term. But the government mustn’t lose sight of the urgent need to improve mental health supports and services for people in direct provision today.

And the group called for a “long-term strategy” to ensure the mental well-being of asylum seekers. This would mean the introduction of a “national strategy and programme of mental healthcare” for people in direct provision.

Featured image via Screenshot

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