Bangladeshi domestic laws and policies address access to mental health care services for refugees. Moreover, the Government of Bangladesh, with the support of humanitarian partners, provides mental health care services to Rohingya refugees. 

The Rights and Protection of Persons with Disabilities Act, 2013 and the Mental Health Act, 2018 do not limit its application to the citizens only and theoretically can be applied to refugees and asylum seekers. The Rights and Protection of Persons with Disabilities Act, 2013 acknowledges and defines different types of disabilities (in Sections 2 to 15) including autism, physical disability, mental illness leading to disability, visual disability, speech disability, intellectual disability, hearing disability, deaf-blindness, cerebral palsy, down syndrome, multiple disability, and other disability. Section 16 of the Act contains provisions ensuring full realization of the rights of people with disabilities. It ensures nondiscrimination including the right to life and prosperity, freedom of expression, right to work, access to justice, education, health, inheritance. Similarly, the Mental Health Act, 2018 ensures the provision of health services, protection of dignity, right to property and rehabilitation, and overall welfare of persons suffering from mental problems. The Act, under Section 7, also may require the Government to establish mental hospitals with the purpose of providing treatment and services to persons suffering from mental illness at a district level. The government adopted the National Mental Health Strategic Plan 2020-2030 for the citizens, where it has considered Mental health promotion and mental health services as essential. The plan states about prevention of discrimination of persons with mental health conditions and ensure equal opportunities for health, education, employment and housing services.1

Priorities of the annual joint response plan for Rohingya refugees in Bangladesh include the improvement in Rohingya refugees’ mental health and psychosocial support and referral systems to access these services, to reduce the impact of negative coping mechanisms,2 providing mental health related services in the Health Posts and Primary Health.3 The Minimum Package of Essential Health Services for Primary healthcare facilities in the FDMN/ Refugee camps in Cox’s Bazar also contains provision for identification and referral of persons with mental health needs4, and management of mental health conditions by Mental Health Gap Action Program trained clinician.5

Despite the policies, refugees with mental health concerns can access extremely limited services. Mental health concerns amongst the Rohingya refugees are prevalent, effecting men and women, boys, and girls alike. Stigma surrounding mental health remains a significant barrier to access services in the camps, and many individuals and families hesitate to seek help due to fear of social judgment and discrimination. Lack of awareness about mental health issues and available services also contributes to underutilization of mental health care services in refugee camps. There is also an absence of rehabilitative and health care services for children with intellectual disabilities.6 All primary healthcare facilities funded by the UNHCR have integrated Mental Health and Psychosocial Support (MHPSS), with psychologists available to offer individual counseling and refugee volunteers providing basic support.7 This includes promotion and protection of wellbeing through community-based awareness on different aspects of the broader wellbeing umbrella. For example: better parenting, anger management, problem solving, etc. This is done by refugees trained in how to help fellow refugees. Other interventions include one-to-one low-intensity therapeutic sessions using Integrative ADAPT therapy methodology. In these sessions psychoeducational tips and advice are shared with refugees showing symptoms of anxiety and depression. Specialized counseling is provided by psychologists as well. To facilitate the provision of specialized MHPSS services for the host and refugee communities, one mental health inpatient wing has opened. To raise awareness of mental health issues and the availability of psychosocial care, community psychosocial volunteers and community refugee counselors lead awareness campaigns and group activities.8
 There is still a priority gap in mental health. While 37/41 PHCs offered non-specialized support MHPSS services, such as basic mental health care and basic emotional and practical support by community workers (IASC MHPSS intervention phase), only 10/43 PHCs were reported to offer clinical mental health services by Q4/2021. One of the biggest obstacles to receiving high-quality clinical mental health services is a shortage of skilled personnel. Even though 40 out of 43 PHCs had at least one employee with mhGAP training. There is little availability for clinical care follow-up due to limited supervision capacity and excessive staff turnover.9 Bottom line, MHPSS services are integrated with Health and Protection. In GBV and CBP through strengthened psychological counselling to survivors, and in public health through UNHCR’s Primary and Secondary health services.

• 1

  National Mental Health Strategic Plan 2020-2030, Government of the People’s Republic of Bangladesh

• 2

  Joint Response Plan 2024, p. 20

• 3

  Ibid, p. 42

• 4

  The Minimum Package of Essential Health Services for Primary healthcare facilities in the FDMN/ Refugee camps, Cox’s Bazar, February 2020, p. 5 

• 5

  ibid

• 6

  Health Sector Strategic Plan 2023-24, Health Sector, Cox’s Bazar. P. 8

• 7

  Public Health Factsheet - as of 31 December 2022, Rohingya Refugee Response in Bangladesh, UNHCR 

• 8

  ibid

• 9

  Ibid, p. 9