Access to mental health and psychosocial support among migrants in transit in Colombia.

Extended periods of transit have become a defining feature of migration, driven by restrictive externalization policies globally and under-resourced health and social protection systems in transit countries. Migrants in transit-individuals actively migrating between their place of origin and intended destination-are disproportionately exposed to violence, exploitation, and other adversities that increase their risk for mental health problems. Migrants in transit remain underserved by systems ill-equipped to support mobile populations. To investigate the factors influencing access to mental health and psychosocial support (MHPSS) among migrants in transit, this study used a community-participatory system dynamics approach in Colombia, a key transit country in the Americas. We facilitated 10 group model building workshops in migrant shelters situated along key migration routes to co-develop causal loop and stock-and-flow diagrams illustrating the dynamic processes shaping access to MHPSS. Results revealed three critical delays in the care continuum: barriers to MHPSS awareness, seeking help, and initiating MHPSS. These delays are driven by structural barriers such as legal status, mobility, discrimination, and costs, but may be mitigated through community outreach, leveraging social networks to disseminate information and provide direct support, increasing access to information, providing basic needs and services along migration routes, and improving inter-agency coordination. Findings underscore the urgent need for flexible, low-threshold MHPSS delivery models responsive to migrants' mobility and realities. This study identifies actionable leverage points for multisectoral policy and program innovation to reduce inequities in access to MHPSS for migrants in transit, a growing but underserved population in Latin America and globally.