Mental Healthcare For Refugees In Lesvos: Treat The Causes Not The Symptoms.

The living situation in detention is a key factor contributing to the escalating rates of mental health issues among refugees. Moria, a reception and identification centre in Lesvos, Greek, which was originally built for 3,000 people and now hosts more than 19,000 people, was described by Human Rights Watch as an “open-air prison.”  According to France 24, Lesvos, with a population of 85,000, has more than 21,000 migrants. This has caused tensions between migrants and locals with an increase in violence and attacks on migrants by police and vigilante groups who say they want all asylum seekers to be moved to the mainland. This hostile reaction from locals in Lesvos and poor living conditions further exacerbate existing mental health issues experienced by refugees.

The increasing violence between Greek locals and refugees and experiences of xenophobia among ethnic groups within the camps have exposed refugees to discrimination and marginalization, both of which are also detrimental to mental health. According to a report from the International Rescue Committee (IRC), there is a high rate of symptoms of mental illness displayed by refugees in Moria, with sixty percent having considered suicide.

Many NGOs have reached out to provide the much-needed support as the Greek authorities have been unable to keep up with the increasing numbers of refugees. IRC is a organization that is particularly committed to delivering services for the refugees in Greece. Having started their work in July 2015, IRC currently provides the only mental health centre in Lesvos. The centre has three psychologists, but due to the high demand, their focus has been on helping refugees temporarily manage symptoms of poor mental health rather than achieving a recovery for the long-term. The other support is mainly run by volunteers who are often in Moria on a temporary basis and have little professional training.

Mental health issues in Moria are getting worse drastically. Firstly, treatment of symptoms of mental illness with short-term ‘fixes’ has been prioritized over long-term recovery. Short-term fixes are easier to measure and results are seen more quickly than with long-term approaches, in which the result is an important appeal for donors and funding. Secondly, the screening tools used for psychological first aid are based on western understandings of suffering and, therefore, ignore cultural and individual differences. Psychological first aid also lacks follow up procedures, which again leaves long-term issues to fester. The main problem with both approaches is that they ignore the structural causes of mental illness among refugees in Moria and the political complexities that these people experience.

While symptom treatment and psychological first aid are necessary, they need to be accompanied by more thorough screening tools, more specialized staff, and better coordination for follow-up procedures to assist those in long-term need. We can no longer ignore the political, social, and cultural contexts that lead to experiences of poor mental health or what Professor Arthur Kleinman calls ‘social suffering.’ Instead, long-term measures and funding should be increased in order to create a more holistic approach to mental health caregiving which addresses the political and social suffering experienced by refugees.

Responses to mental health issues in Moria should shift away from short-term crisis management to support the long-term needs of refugees. One example is community centres to address powerlessness, lack of information, and social isolation among migrants. According to a report by Médecins Sans Frontières, information-sharing, recreational, and educational activities are useful activities for a community centre to strengthen social interactions. These practical activities from NGOs have been deemed more effective in improving mental health than mental health counseling according to refugees who took part in a study by Szaflarski and Bauldry in 2019. They often preferred to engage with family and friends rather than NGOs’ employees for emotional support. The study found that the top concerns which caused poor mental health were poor living conditions, lack of community ties, and powerlessness.

Responses to mental health issues among refugees in Moria should focus on building support networks for these people. NGOs should recognize, research, and call out the political issues and causes of the conditions that Moria refugees find themselves in. We must be outspoken about the unethical circumstances experienced by refugees in the Moria camp which exacerbate poor mental health and seek to lobby governments and larger organizations to invest in long-term programmes to address these problems. But all advocacy activities should be based on the voices and needs of refugees themselves and encourage them to be involved in the process in order to combat the living situation in detention camps.

The rapidly increasing rates of mental health problems experienced by refugees living in the Moria reception centre should not be ignored and neither should the roots of these problems, trauma from fleeing conflict zones, experiences of hostility, and poor living conditions in host countries. It is impossible for human beings to be mentally resilient to these experiences, and these experiences cannot become the norm. Instead, we should strive for peace and support, long-term efforts, and resources needed to diminish the human cost of war.

Cait Jobson


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