Psychosocial health needs of mediterranean vulnerable migrants settling in Europe: A systematic review of contributing factors

Background

Irregular migration via the Mediterranean Sea has risen significantly in recent years, with approximately 353,300 migrants entering Europe in, 2023 alone. Mediterranean migrants, often fleeing conflict, persecution, or extreme poverty, face multidimensional vulnerabilities throughout the migration journey, including pre-migration trauma, perilous transit conditions, and post-migration challenges like social exclusion, poor living conditions, and limited access to healthcare. These factors collectively impair their psychosocial health, defined as the dynamic interplay between psychological, social, cultural, and environmental determinants, and increase their level of vulnerability. Despite extensive studies exploring mental health conditions, social isolation, and cultural barriers among migrants, the evidence remains fragmented.

Objective

To synthesize evidence on the social, psychological, cultural, and environmental factors affecting the psychosocial health of Mediterranean vulnerable migrants settling in European countries after crossing the Mediterranean routes irregularly.

Design

A systematic review adhering to PRISMA guidelines was conducted, focusing on studies published between 2004 and, 2023. Searches were performed in databases such as PubMed, CINAHL, Scopus, APA PsycArticles, APA PsycInfo, and the Psychology and Behavioral Sciences Collection. A convergent qualitative synthesis approach was applied, integrating findings from qualitative, quantitative, and mixed-method studies into qualitative themes. Methodological quality was assessed using Joanna Briggs Institute (JBI) tools.

Findings

Seventeen articles were included after the selection process. The review identified five key themes shaping the psychosocial health of Mediterranean vulnerable migrants: sociodemographic physical, social, psychological, cultural, and environmental factors. Sociodemographic factors included age, gender, education level, and marital status. Physical factors included pre-existing physical health conditions, the impact of the migration journey on physical health, and long-term health trajectories. Social factors included family dynamics, social isolation, and economic instability. Psychological factors included mental health challenges and coping mechanisms. Cultural factors included acculturation, language barriers, discrimination, and spirituality. Environmental factors included living conditions, access to healthcare, and duration of migration. Protective factors were also found, including strong family and community networks, religious involvement, and a sense of continuity in unfamiliar environments.

Discussion and conclusions

The findings highlighted the complexity of psychosocial health determinants among Mediterranean VM, emphasizing the need for integrative approaches that address these intersecting challenges. This review provided a holistic understanding of psychosocial health among vulnerable migrants and underscored areas for targeted intervention. Healthcare providers, including nurses, should prioritize culturally competent care. Policymakers must address systemic barriers, including housing, legal uncertainties, and healthcare access. Future research should explore long-term health trajectories and evaluate the effectiveness of tailored interventions. Collaborative action among healthcare providers, policymakers, and community organizations is essential to improving outcomes for this vulnerable population.