The aim of the ReachOut project is to explore needs and strategies for promoting, maintaining, or restoring mental health among the two very hard-to-reach groups of homeless persons and undocumented migrants.


  • Lead school(s) School of Health Professions
  • Institute Field of Innovation – Psychosocial Health
  • Research unit Field of Innovation – Psychosocial Health
  • Funding organisation Schweizerischer Nationalfonds SNF
  • Duration 01.03.2021 - 31.12.2022
  • Project management Prof. Dr. Eva Soom Ammann
  • Head of project Prof. Dr. Eva Soom Ammann
  • Project staff Sabrina Laimbacher
    Sabrina Gröble
    Thierry Meli
  • Keywords health literacy, psychiatry, health inequities, homelessness, undocumented migrants, ethnography, psychosocial health, access to mental health services, hard to reach groups


Health inequities also exist in affluent countries such as Switzerland. Opportunities to live a life in good physical and mental health vary depending on economic, social, and environmental factors. Persons with a low socioeconomic status suffer disproportionately often from mental health problems, and homeless persons as well as undocumented migrants are thereby exceedingly affected. Furthermore, socially disadvantaged groups face higher access barriers to mental health and other health care/health promoting services, although they often have a higher need for appropriate healthcare. Thus, there seem to be shortcomings regarding availability and utilization of mental health services among the two target groups of homeless persons and undocumented migrants, and they are considered particularly difficult to reach for health promotion initiatives. Reasons for this gap might be a lack of information or appropriate services, or affected persons distrust healthcare, feel stigmatized, or fear disadvantages when using these services. Currently, however, there is little knowledge about the reasons why mental health services are not used by individuals of these two groups.


The target groups of this project – homeless persons and undocumented migrants – are also very difficult to reach for research, and thus the project pays particular attention to this issue. ReachOut chooses an outreach approach that invests sufficient time in building relationships and trust and adapts to the living environments and habits of the target groups. An ethnographic research strategy involving careful collaboration with various key organizations and gatekeepers will help to conduct ethnographic interviews with homeless people and undocumented migrants in the urban areas of Zurich and Bern to assess their needs and strategies in the context of mental health.


To improve mental health in hard-to-reach groups, target group-specific and user-oriented services are usually recommended. This study explores the service needs and health literacies of homeless persons and undocumented migrants. Based on this, it will be possible to better understand how services and access to them have to be designed to meet the needs of particularly socially disadvantaged and hard-to-reach groups to regain, maintain, and promote mental health.


With its methodologically innovative approach, ReachOut will not only generate insights into service design, but also provide experience on how to involve particularly hard-to-reach target groups in research.