Assisting Refugees to Access Psychological Support (ARAP)

Between 1953 and 2025, the Federal Office for Migration and Refugees (BAMF) recorded a total of 7.3 million asylum applications, of which around 4.8 million were lodged in North Rhine-Westphalia. People fleeing from crisis and conflict zones often endure life-threatening journeys and, in the vast majority of cases, are exposed to considerable stress. According to estimates, around 80 per cent of these individuals have experienced potentially traumatic events.

Such experiences rarely fail to have psychological consequences. They frequently result in persistent psychological distress and can contribute to the development of mental health conditions. Various studies show that around 40–50 per cent of people with refugee backgrounds have mental health conditions requiring treatment. Without adequate care, there is an increased risk of these conditions becoming chronic, which significantly complicates and prolongs subsequent treatment.

In addition to the already severely strained outpatient psychotherapeutic services, there are further structural barriers for people with refugee backgrounds. In particular, the lack of funding for language and cultural mediation (SKM), as well as the scarcity of expertise in migration and trauma-related issues among healthcare professionals, hinders access to appropriate care. This results in a significant treatment deficit, which can, not least, have a lasting negative impact on integration processes.

The ARAP (Assisting Refugees to Access Psychological Support) project aims to specifically address the gaps in care described above. External funding has enabled Witten/Herdecke University to implement this project in North Rhine-Westphalia.

The service is aimed, on the one hand, directly at people with refugee backgrounds who require treatment. On the other hand, it involves both psychotherapists in private practice who are registered with health insurance funds and psychotherapists in training (PiA).

• For people experiencing psychological distress, we provide access to qualified, culturally sensitive and compliant psychotherapeutic care. To begin with, we offer structured assessment interviews (clearing) in which we jointly clarify needs and the scope of treatment – either online or on-site at Witten/Herdecke University. In doing so, we take into account any prior assessments carried out by specialist organisations (e.g. psychosocial centres for survivors of torture, war and displacement).
• For psychotherapists registered with health insurance funds and psychotherapists in training (PiA), we offer further training and supervision regarding migration- and trauma-specific expertise and are available as points of contact. To support successful treatment, the project team organises and funds language and cultural mediation services (SKM) for the duration of the therapy. Particularly complex cases, such as those involving difficult immigration status, are managed directly by the project team.
• For professionals who are in regular contact with children and young people (e.g. teachers, staff in after-school care programmes), we offer training courses and educational materials on the manifestations of mental health disorders, as well as guidance on addressing related issues in a culturally sensitive manner. This enables those affected to be identified at an early stage and referred to the project in a targeted manner.

We then bring those affected and practitioners together: where necessary and upon request, we refer them to a regional network of practising psychotherapists.