INTRODUCTION:
In 2025, approximately 166900 migrants entered the European Union via Mediterranean routes, with around 1,700 deaths during attempted sea crossings (1). Despite declining arrival numbers, the human toll remains severe, underscoring the urgent need to address irregular migration. On the Greek island of Lesbos, Mavrouvouni refugee camp housed 3777 migrants as of December 2025 (2), primarily from Afghanistan (59%) and Sudan (9%) (3). Boat Refugee Foundation is a non-governmental organisation providing acute medical and psychological care within the camp.

METHODS:
We propose an integrated model combining Mental Health and Psychosocial Support Services (MHPSS) with medical care, aligned with the internationally validated Development Model for Integrated Care (4). MHPSS delivers psychotherapy and psychosocial support to preserve mental health and promote wellbeing (5) and is staffed by experienced clinical psychologists or psychotherapists. MHPSS works alongside doctors and nurses; multidisciplinary teams assess patient needs and coordinate referrals to MHPSS and/or medical services. All staff participate in daily debriefs and case discussions, while MHPSS staff lead weekly training in psychological trauma and group reflection sessions.

RESULTS:
Typically, a daily average of 45 medical patients and 4 MHPSS patients were seen. Camp outreaches were frequently due to mental health issues (dissociation, panic attacks, somatization disorders). MHPSS work comprised psychological first aid and crisis support with follow-up appointments available.

CONCLUSIONS:
Refugees have complex mental health needs and experience higher rates of conditions such as anxiety and post-traumatic stress disorder than host populations (6). An integrated MHPSS and medical service improves identification of vulnerable patients, increases service uptake, and enables personalised, culturally sensitive care through regular staff training. Flexible, referral-free models enhance access, equity, and holistic care. Further research and development of integrated MHPSS approaches are needed to reduce healthcare burdens on host countries, achieve cost savings, and improve refugee health and wellbeing.