Journal Article > ResearchFull Text
Torture. 1 August 2018; Volume 28 (Issue 2); 38-55.; DOI:10.7146/torture.v28i2.106921
Spissu C, De Maio G, Van der Bergh R, Ali E, Venables E, et al.
Torture. 1 August 2018; Volume 28 (Issue 2); 38-55.; DOI:10.7146/torture.v28i2.106921
BACKGROUND
Access and linkage to care for migrant torture survivors is contingent on their identification and appropriate referral. However, appropriate tools for identification of survivors are not readily available, and the (staff of) reception systems of host countries may not always be equipped for this task. This study explores practices in the identification and case management of torture survivors in the reception structures and in the public health sector in Rome, Italy.
METHOD
Data were analysed manually and codes and themes generated.
RESULTS
A non-homogeneous level of awareness and experience with torture survivors was observed, together with a general lack of knowledge on national and internal procedures for correct identification of torture survivors. Identification and case management of torture survivors was mainly carried out by non-trained staff. Participants expressed the need for training to gain experience in the identification and management of torture survivors’ cases, as well support and increased resources at both the reception and public health system levels.
CONCLUSIONS
The crucial process of identification and prise en charge of survivors of torture among migrant and refugee populations is relegated to nontrained and inexperienced professionals at different levels of the reception system and public health care sector, which may carry a risk of non-identification and possible harm to survivors. Additional resources and structured interventions are urgently needed, in the form of developing procedures, training, and adapted multidisciplinary services.
Access and linkage to care for migrant torture survivors is contingent on their identification and appropriate referral. However, appropriate tools for identification of survivors are not readily available, and the (staff of) reception systems of host countries may not always be equipped for this task. This study explores practices in the identification and case management of torture survivors in the reception structures and in the public health sector in Rome, Italy.
METHOD
Data were analysed manually and codes and themes generated.
RESULTS
A non-homogeneous level of awareness and experience with torture survivors was observed, together with a general lack of knowledge on national and internal procedures for correct identification of torture survivors. Identification and case management of torture survivors was mainly carried out by non-trained staff. Participants expressed the need for training to gain experience in the identification and management of torture survivors’ cases, as well support and increased resources at both the reception and public health system levels.
CONCLUSIONS
The crucial process of identification and prise en charge of survivors of torture among migrant and refugee populations is relegated to nontrained and inexperienced professionals at different levels of the reception system and public health care sector, which may carry a risk of non-identification and possible harm to survivors. Additional resources and structured interventions are urgently needed, in the form of developing procedures, training, and adapted multidisciplinary services.
Journal Article > ResearchFull Text
Int J Migr Health Soc Care. 1 August 2021; Volume 17 (Issue 3); 241-258.; DOI:10.1108/IJMHSC-08-2020-0082
Whitehouse K, Lambe E, Rodriguez S, Pellecchia U, Ponthieu A, et al.
Int J Migr Health Soc Care. 1 August 2021; Volume 17 (Issue 3); 241-258.; DOI:10.1108/IJMHSC-08-2020-0082
PURPOSE
Prolonged exposure to daily stressors can have long-term detrimental implications for overall mental health. For asylum seekers in European Union transit or destination countries, navigating life in reception centres can represent a significant burden. The purpose of this study was to explore post-migration stressors during residency in reception centres, and to formulate recommendations for adequate service provision in Belgium.
DESIGN/METHODOLOGY/APPROACH
Research was conducted in two reception centres in Belgium. A total of 41 in-depth interviews were carried out with asylum seeker residents (n = 29) and staff (n = 12). Purposive recruitment was used for asylum seekers (for variation in length of centre residency and family status) and staff (variation in job profiles). Interviews were conducted in English, French or with a translator in Arabic or Dari. Interviews were audio-recorded, transcribed verbatim and manually coded using thematic analysis.
FINDINGS
Asylum seekers face significant constraints with regard to their living conditions, including total absence of privacy, overcrowding and unhygienic conditions. These act as continuous and prolonged exposure to daily stressors. Several barriers to accessing activities or integration opportunities prevent meaningful occupation, contribute towards eroded autonomy and isolation of asylum seeker residents. Inadequate capacity and resources for the provision of psychosocial support in reception centres leads to a sense of abandonment and worthlessness.
ORIGINALITY/VALUE
Analysis indicates that structural and practical challenges to adequately support asylum seekers are rooted in policy failures necessary for appropriate resourcing and prioritization of preventative measures. Such deliberate decisions contribute towards state deterrence strategies, eroding both individual well-being and manufacturing a crisis in the systems of support for asylum seekers.
Prolonged exposure to daily stressors can have long-term detrimental implications for overall mental health. For asylum seekers in European Union transit or destination countries, navigating life in reception centres can represent a significant burden. The purpose of this study was to explore post-migration stressors during residency in reception centres, and to formulate recommendations for adequate service provision in Belgium.
DESIGN/METHODOLOGY/APPROACH
Research was conducted in two reception centres in Belgium. A total of 41 in-depth interviews were carried out with asylum seeker residents (n = 29) and staff (n = 12). Purposive recruitment was used for asylum seekers (for variation in length of centre residency and family status) and staff (variation in job profiles). Interviews were conducted in English, French or with a translator in Arabic or Dari. Interviews were audio-recorded, transcribed verbatim and manually coded using thematic analysis.
FINDINGS
Asylum seekers face significant constraints with regard to their living conditions, including total absence of privacy, overcrowding and unhygienic conditions. These act as continuous and prolonged exposure to daily stressors. Several barriers to accessing activities or integration opportunities prevent meaningful occupation, contribute towards eroded autonomy and isolation of asylum seeker residents. Inadequate capacity and resources for the provision of psychosocial support in reception centres leads to a sense of abandonment and worthlessness.
ORIGINALITY/VALUE
Analysis indicates that structural and practical challenges to adequately support asylum seekers are rooted in policy failures necessary for appropriate resourcing and prioritization of preventative measures. Such deliberate decisions contribute towards state deterrence strategies, eroding both individual well-being and manufacturing a crisis in the systems of support for asylum seekers.
Journal Article > CommentaryFull Text
BMJ Glob Health. 14 September 2017; Volume 2 (Issue 3); e000450.; DOI:10.1136/bmjgh-2017-000450
Zamatto F, Argenziano S, Arsenijević J, Ponthieu A, Bertotto M, et al.
BMJ Glob Health. 14 September 2017; Volume 2 (Issue 3); e000450.; DOI:10.1136/bmjgh-2017-000450
Journal Article > ResearchFull Text
Confl Health. 16 April 2017; Volume 11 (Issue 1); 6.; DOI:10.1186/s13031-017-0107-z
Arsenijević J, Schillberg EBL, Ponthieu A, Malvisi L, Ahmed AO, et al.
Confl Health. 16 April 2017; Volume 11 (Issue 1); 6.; DOI:10.1186/s13031-017-0107-z
BACKGROUND
Pushed by ongoing conflicts and pulled by the desire for a better life, over one million migrants/refugees transited Balkan countries and arrived in Europe during 2015 and early 2016. To curb this influx, European countries instituted restrictive migration policies often characterized by building of razor-wire border fences and border closures. Among migrants/refugees who received mental health care in Serbia while travelling through Balkan countries to Northern Europe, we assessed the prevalence and patterns of violent events experienced including physical trauma.
METHODS
A mixed methods study among migrants/refugees attending mobile mental health clinics run by Médecins sans Frontières (MSF) between July 2015 and June 2016, in Serbia – a main transit hub to European countries. Clinics were conducted according to MSF guidelines by experienced psychologists who were supported by cultural mediators. The main outcome measures were violent events and associated physical trauma.
RESULTS
Of 992 migrants/refugees attending MSF mental health clinics, the majority (72%) were from Syria and Afghanistan and included vulnerable groups (14%) such as unaccompanied minors and pregnant women. The most frequent mental health symptoms/signs were anxiety (29%) and adjustment reactions (26%). Of the 992 migrants/refugees, 270 (27%) had experienced violent events during their journey. Signs of physical trauma due to acts of violence were seen in 223(22%) of the 992 individuals, 144 (65%) being perpetrated by State authorities and involving women (11%) and children (13%).
Border closures along the Balkan route were associated with a dramatic decrease in registered migrants/refugee arrivals in Serbia. Conversely, among those that made it across the borders, an increasing linear trend in reported violent events was observed at MSF mental health clinics (X[squared] for linear trend, P <0 · 001). Qualitative evidence corroborated with quantitative findings.
CONCLUSIONS
Nearly one-in-three migrants/refugees seen in MSF clinics experienced violent events including physical trauma along their journey. State authorities, including those in European countries were the perpetrators in over half of such events which were associated with border closures. There is “a crisis of protection and safe passage” which needs to change towards one of respect for the principles of international human rights and refugee law.
Pushed by ongoing conflicts and pulled by the desire for a better life, over one million migrants/refugees transited Balkan countries and arrived in Europe during 2015 and early 2016. To curb this influx, European countries instituted restrictive migration policies often characterized by building of razor-wire border fences and border closures. Among migrants/refugees who received mental health care in Serbia while travelling through Balkan countries to Northern Europe, we assessed the prevalence and patterns of violent events experienced including physical trauma.
METHODS
A mixed methods study among migrants/refugees attending mobile mental health clinics run by Médecins sans Frontières (MSF) between July 2015 and June 2016, in Serbia – a main transit hub to European countries. Clinics were conducted according to MSF guidelines by experienced psychologists who were supported by cultural mediators. The main outcome measures were violent events and associated physical trauma.
RESULTS
Of 992 migrants/refugees attending MSF mental health clinics, the majority (72%) were from Syria and Afghanistan and included vulnerable groups (14%) such as unaccompanied minors and pregnant women. The most frequent mental health symptoms/signs were anxiety (29%) and adjustment reactions (26%). Of the 992 migrants/refugees, 270 (27%) had experienced violent events during their journey. Signs of physical trauma due to acts of violence were seen in 223(22%) of the 992 individuals, 144 (65%) being perpetrated by State authorities and involving women (11%) and children (13%).
Border closures along the Balkan route were associated with a dramatic decrease in registered migrants/refugee arrivals in Serbia. Conversely, among those that made it across the borders, an increasing linear trend in reported violent events was observed at MSF mental health clinics (X[squared] for linear trend, P <0 · 001). Qualitative evidence corroborated with quantitative findings.
CONCLUSIONS
Nearly one-in-three migrants/refugees seen in MSF clinics experienced violent events including physical trauma along their journey. State authorities, including those in European countries were the perpetrators in over half of such events which were associated with border closures. There is “a crisis of protection and safe passage” which needs to change towards one of respect for the principles of international human rights and refugee law.
Journal Article > CommentaryAbstract
Ponthieu A, Incerti A
27 April 2016; Volume 35 (Issue 2); DOI:10.1093/rsq/hdw006
Providing assistance to mobile populations has long been a challenge for healthcare providers and humanitarian organisations. The challenge is even greater when these populations need long-term chronic care for diseases such as tuberculosis or HIV, which require adherence to treatment and regular follow-up. This article examines the implications of medical care in contexts of displacement, when human movement is a major obstacle to ensuring compliance with treatment regimes. It argues that patients’ mobility can be integrated into health service provision through cross-border and regional referral systems, and examines how aid agencies can successfully work with other stakeholders, considering the impact of immigration policies, discrimination in health facilities, and xenophobia on the health of migrants in need of chronic care. It asks what the correct balance is to take in dealing with a medical crisis in a highly politicised environment. The experiences of Médecins Sans Frontières in Southern Africa are explained as an illustration of this dilemma.
Journal Article > CommentaryFull Text
Lancet. 1 February 2020; Volume 395 (Issue 10225); 668-670.; DOI:10.1016/S0140-6736(19)33175-7
Orcutt M, Mussa R, Hiam L, Veizis A, McCann S, et al.
Lancet. 1 February 2020; Volume 395 (Issue 10225); 668-670.; DOI:10.1016/S0140-6736(19)33175-7
Restrictive migration policies that deny migrants and asylum seekers their right to health—a fundamental right enshrined in universal human rights declarations and treaties since 1948—are increasingly prevalent globally. They are the result of the so-called migration crisis that is a politically made humanitarian crisis. States are criminalising people who are in some of the most vulnerable situations, often also denying their right to seek asylum and right to health. Such policies are particularly apparent in situations of indefinite containment, such as on the Greek Islands (Chios, Kos, Leros, Lesvos, and Samos), where people are contained in EU-supported hotspot facilities in overcrowded, unhealthy, and undignified conditions.
Journal Article > ResearchFull Text
Soc. Sci. Med. 1 July 2018; Volume 209; 86-94.; DOI:10.1016/j.socscimed.2018.05.038
Arsenijević J, Burtscher D, Ponthieu A, Severy N, Contenta A, et al.
Soc. Sci. Med. 1 July 2018; Volume 209; 86-94.; DOI:10.1016/j.socscimed.2018.05.038
During 2015 and 2016, an unprecedented flow of approximately 800,000 migrants coming from Turkey towards Western Europe crossed the Balkans. Male migrants are perceived as being less vulnerable compared to other migrants and they are not given priority in service and support provision. This qualitative study examines the self-perceived vulnerabilities of male migrants travelling alone along the Balkan route to Europe. Twenty-four individual in-depth interviews, two group interviews and participant observation were conducted with male migrants in Belgrade, Serbia in 2017. Data was coded manually, and analysed thematically. Male migrants traveling alone face the cumulative vulnerability of various traumatic events and migration-related contextual circumstances. Three main themes emerged: the ongoing desperate journey, the better treatment of 'traditionally' well recognised vulnerable sub-groups and the impact of the continuous stress on mental health. Deterrence measures imposed for border control purposes in the form of push-backs, expulsions, detention and degrading, inhumane treatment amplify the psychological distress of male migrants. Feelings of hopelessness, desperation, lack of self-value and self-esteem were reported. 'Traditionally vulnerable' populations were said to have had better treatment throughout the journey from smugglers, border state authorities, governmental officials, civil society and international organizations. The devastating experiences of male migrants, as well as the better treatment offered to other groups of migrants like women and children, results in a perceived neglect of the needs of men in humanitarian response, rendering them vulnerable and exposing them to further health and protection risks. In a context where needs are unmet and people's dignity and health are at risk, specific strategies should be developed to include men in the assistance and protection offered, particularly in relation to exposure to violence.