"A beacon of hope": a qualitative study on migrants' mental health needs and community-based organisations' responses during the COVID-19 pandemic in Antwerp, Belgium

The COVID-19 pandemic has highlighted the need for structurally informed mental health services that are sensitive to social inequalities and cultural differences. Community-level services and organisations are often referred to as having the potential to play a key role in providing such services to migrants, yet not many studies have documented how these types of services have been experienced during the pandemic. The objective of our case study in Antwerp's districts of Borgerhout and Antwerpen-Noord (Belgium) was to explore how community-level responses to the mental health impact of the COVID-19 crisis were organised and experienced by first-generation migrants and members of community-level organisations. Our findings highlight the complex drivers of migrants' mental health and the unique value and indispensability of local-level services and organisations in providing mental-health related services, particularly in a crisis context like the COVID-19 pandemic. Qualities that emerged to be particularly important included organisations' awareness of local needs; their flexible nature which allows them to address bottlenecks and fill gaps left by other services; their capacity to respond holistically to a broad spectrum of needs; their ability to offer culturally sensitive care and support; and their physical accessibility. Our findings also demonstrate the fragility and fragmentation of these local-level services and initiatives. In the face of the COVID-19 crisis, this related to serious challenges to the necessary physical accessibility of organisations' services; services and initiatives becoming overloaded; and widespread fragmentation and lack of oversight of the available services forming a barrier for both service users and providers.