Divergent Systems, Convergent Challenges: A Comparative Analysis of Health Policies and Forced Migrant Mental Health in Germany and the UK

• Applicant: Dr. Khatia Antia
• Subject Area: Public Health, Healthcare Research, Social and Occupational Medicine
• Term: since 2026
• Project identifier: Deutsche Forschungsgemeinschaft (DFG) - Project number 587408173

Forced migrants in Europe experience high rates of mental health problems such as post-traumatic stress, depression, and anxiety, yet often lack access to appropriate support. Germany and the United Kingdom (UK), two major European migrant-receiving countries with broadly similar economic capabilities but different health and social systems, both recognise mental health as a critical but unmet need among forced migrants. These divergent policy approaches provide a valuable case for comparative analysis. Project aim: This two-year postdoctoral project examines how legal and policy frameworks act as structural determinants of mental health for forced migrants in Germany and the UK. It assesses whether existing policies address social determinants of mental health and develops a theoretical model showing how legal, institutional, and contextual factors interact to shape mental health outcomes across different welfare systems. Key objectives are to: (i) identify and map national and regional policies addressing forced migrants' mental health in Germany and the UK, using social determinants frameworks; (ii) understand lived experiences of refugees about how policies may influence their access to care and mental well-being both during the asylum process and after recognition of refugee status; (iii) examine stakeholder perspectives (policymakers, academics, service providers) on legal influences and policy-practice gaps; and (iv) co-create a practice-oriented model can explain how legal and contextual factors interact to influence mental health outcomes. Methods: This project is organised into three interrelated work packages (WPs). WP1: a systematic scoping review will analyse peer-reviewed literature, grey literature, and policy documents, provide a thematic overview of identified policies, and clarify policy gaps; WP2: qualitative fieldwork will use in-depth qualitative interviews in both countries with forced migrants, service providers, and policymakers to capture lived experiences of how policies translate (or fail to translate) into everyday access to care and mental wellbeing. WP3: Theory of Change (ToC) Workshop: this participatory work package will synthesise findings from the scoping review and qualitative research and will co-create a theory- and practice-oriented model by holding one ToC workshop per country with stakeholders (migrants, academics, policymakers, service providers). The project will produce peer-reviewed publications, a policy brief for German and UK audiences, and conference presentations. It will also strengthen research collaboration between the School of Public Health at Bielefeld University (host institution) and the Department of Health Services Research and Policy at the London School of Hygiene & Tropical Medicine, LSHTM, leading institutions in health systems and migrant health research.

• DFG Programme: Position