PurposeThe purpose of this study is to examine and highlight the conditions and limitations that caseworkers at the Public Employment Service experience when considering the mental health and opportunities for social participation of newly arrived refugees and asylum seekers within the framework of the establishment program. The establishment program aims to help newly arrived individuals learn Swedish, find employment and become self-supporting.Design/methodology/approachThe study is based on 10 qualitative interviews with caseworkers at the Public Employment Service who meet newly arrived individuals in their daily work. The empirical data is analyzed using Lipsky's theory of street-level bureaucrats to understand the experiences and challenges faced by the caseworkers when considering newly arrived refugees' mental health and social participation within the establishment program.FindingsThe results of the study can be summarized into four themes: "barriers to speaking openly," "same demands but different conditions," "limited expertise, limited time," and "external actors." In summary, the results show that caseworkers felt that consideration for the mental health and opportunities for social participation of newly arrived refugees was very limited within the framework of the establishment program. Despite the good intentions of the program, the special vulnerability of the newcomers was not sufficiently taken into account. The caseworkers recognized themselves in the description of street-level bureaucrats who are influenced by routines and legislation but simultaneously face complex cases that require discretion, although this freedom is hindered by time constraints and lack of knowledge.Originality/valueThe originality of the study primarily lies in its focus on the experiences of the caseworkers who work directly with newly arrived refugees within the framework of the Swedish establishment program. Previous research has focused more on legislation, policy or the refugees' own experiences. This study contributes an important perspective from those who actually implement the program and interpret the guidelines in their interactions with individuals. It also focuses on a specific program and context, the Swedish establishment program and the administrative support documents used within it. By examining the caseworkers' experiences within this specific national context, the study provides context-specific knowledge that is relevant to Swedish integration policy and practice.

Many newly arrived refugees suffer from mental health problems due to trauma. Research has shown that social participation after migration, such as taking part in social activities, networks and community work, is important for mental health and well-being. In Sweden, many civil society organisations, such as the Church of Sweden, take great responsibility for the establishment and integration of new arrivals. At the same time, the role of civil society organisations in the welfare society is not obvious, and the place of religious communities is sometimes challenged. Due to today’s growing secular and globalised society, the role of the Church of Sweden has changed. Its power has decreased, and the indications are that this will continue. There are also circumstances that point to the church having to adapt to the norms of secular society to have an impact. As the Church of Sweden fulfils an important function as a provider of welfare services, not least in work with newly arrived refugees, this article studies how the employees of the Church of Sweden feel about their conditions for this work and what guides it. It is based on a qualitative study of 19 interviews with employees in 4 different parishes.

As the number of refugees in the world is increasing and it is known that social inequality negatively impacts mental health, it is important to study integration policies, such as labour market measures. In this article, the strategic interventions of the Swedish Public Employment Service are analysed to determine how the agency’s management handled and implemented the legal changes in the new support document for its case workers. The focus is on the effects of the changes in the legal text that transferred the responsibility for establishment initiatives for newly arrived migrants to the agency and, as a result, changed the conditions for newly arrived refugees’ mental health in the new establishment programme. Eight people representing different management functions at the agency were interviewed. The results show that the intention in the new programme to view newly arrived refugees in the same way as all other unemployed people, rather than as a special category, has meant that less attention is paid to the refugees’ mental health, and the opportunities for the agency’s street-level bureaucrats to help clients have decreased. In the face of predicted growing numbers of people having to abandon their homes due to conflicts and climate changes, governmental strategies such as these needs to be revisited in order for societies worldwide to be better prepared for that challenge.

Newly arrived refugees and asylum seekers constitute a vulnerable population in terms of health and social conditions due to lived trauma and experiences of loss, as well as factors in the host country such as not speaking the language, not having employment and social exclusion. Studies have shown that many newly arrived refugees find it difficult to establish a sustainable position in the host country’s labour market due to a lack of connections, low levels of education and politi-cal, social and cultural barriers. The Swedish Public Employment Service runs an establishment programme aimed at helping newly arrived refugees to find employment quickly and manage their own livelihoods. In this study, we analyse the administrator support document used by Swedish Public Employment Service case workers in their work with the programme to explore whether and how it considers the participants’ mental health and conditions for social participation. The results show that despite newly arrived refugees being especially vulnerable in terms of mental health, little attention is paid to these aspects, the possible effects they may have on the programme, the participants’ integration into the labour market and Swedish society as a whole.

Purpose In general, newly resettled refugees have poorer physical and mental health than native-born Swedes. This indicates that the society must make special efforts to enable refugees to attain health that is on a par with the rest of the population. The challenges rest primarily with employees in the public sector. But what resources do professionals need to meet the refugees' health needs? This paper is about the need to develop strategies for professionals working with diversity and health, with a focus on the establishment of newly resettled refugees in Sweden. Thus, the purpose of this paper is to identify the needs and obstacles in working with diversity and health for the newly resettled. Design/methodology/approach The paper is based on focus group interviews with 40 professionals working in three large municipalities and one County Administrative Board, all of whom work with challenges related to migration and health on a daily basis. Findings The needs expressed by the interviewees are primarily about developing and improving communications. Three important areas of communication were expressed: how information can be transferred from sender to receiver, institutionalization and interactions at different levels. Originality/value This paper identifies important needs and obstacles when working with diversity and health in Sweden, with a focus on the establishment of newly resettled refugees. It is an important contribution because refugees in general have poorer physical and mental health than native-born Swedes and strategies to improve their health, therefore, need to be further developed.