Some people live their entire lives within a circle of 1 kilometre radius – born at the local hospital, went to the local primary and then secondary school, met their spouse at the local pub, worked at a local office or business and buried in the local cemetery. I met a lot of people like that in Northern Ireland and their level of contentment never ceased to amaze me.

At present, many countries are in a state of utter chaos. Multitudes of people are leaving their homes and countries to be somewhere better and safer even if it costs them their lives. Some venture out with their children. They step into the unknown with hardly any belongings or certainty. I wonder how desperate one has to be to do that!

One of the social factors well known to predispose individuals to psychosis is migration. There are 3 main reasons for it:

• Family break-up
• Adjust to living in large urban areas
• Social inequalities in the new country

A Dutch study has shown that the risk of psychotic disorders is higher for non-Western immigrants to the Netherlands than for Dutch citizens. The risk of psychotic disorders in the Hague was highest among those who migrated between ages 0 and 4, but in those who migrated after age 29 the risk was no higher than that for Dutch citizens. Ethnic minority-related environmental exposures such as social disadvantage, exclusion and adversity after migration may explain the higher risk of psychotic disorder among younger migrants.

More than 2000 people have already died this year while attempting to cross the Mediterranean. Many more are missing or in camps. The refugee numbers in the Middle East run into millions of which thousands are children. Not only is the present state of affairs lamentable, it does not bode well for their mental well-being.