Trapped between Scylla and Charybdis: Asylum seekers and refugees and the Greek Asylum procedures; Impacts on mental health and psycho-social wellbeing .

Almost three years have passed since INTERSOS started working on the island of Lesbos, following the fire that destroyed the camp of Moria on September 9th, 2020. While relentlessly carrying out assistance projects for migrants, refugees, and asylum seekers stranded on the island, our operators have observed the failure of promises to offer dignified and non-emergency reception solutions, denouncing the inadequacy and inhumanity of the new camp of Kara Tepe.

Today, a new report by INTERSOS Hellas highlights the impact that living conditions on the island have on people’s mental health, often already compromised by the traumas and violence suffered during the journey. The research focuses on the testimonies of the 165 people who received ongoing psychological and psychiatric support and the 701 people who enjoyed the psychosocial support provided by INTERSOS. In some cases, people may spend several years on the island, waiting for an answer on their status or to be relocated elsewhere, without any certainty about the methods and timing of the process that awaits them.

The main categories of psychiatric symptoms identified through consultations are symptoms related to adjustment disorders (4.28%), symptoms related to depressive disorders (2.85%), symptoms related to post-traumatic reactions (2.14%), and symptoms related to multiple disorders (10.27%). Most of the people assisted by INTERSOS (76.18%) have psychological symptoms that are not related to any specific category. Their condition cannot be formally demarcated, and psychiatric support is aimed at relieving symptoms. Due to the associated increased risks, two symptoms that receive particular attention are suicidal and self-harming tendencies. The report shows that 10.8% (76 out of 701) of the population reported suicidal or self-harming behavior or a combination of both.


The psychological approach requires time and attention, and the re-emergence of the traumas suffered can be a long and difficult process: B. is a single woman from Central Africa whose asylum application had already been rejected four times. When she was first referred to our operators, she had severe symptoms of Post-Traumatic Stress Disorder (PTSD) and great difficulty in expressing herself and talking about her past. When she finally felt safe, she told us about extremely violent rape episodes she had survived. B. was so traumatized that she never disclosed these incidents to anyone, not even during the asylum interviews. Before starting treatment with INTERSOS, she spent two years almost isolated in her tent, never asking for support, without relating or socializing with anyone in the camp. Now B. has finally received adequate treatment, stabilized her emotions, and made great progress. She continues to have a serious medical-gynecological problem. Since last year she has received several appointments from the public health system for surgical interventions, which have been repeatedly postponed. This uncertainty is mentally destabilizing for a woman who has lived through her traumas and has spent the past three years between the Moria and Kara Tepe camps.”

Observing the data on assisted persons, the gender disparity should be highlighted immediately, with a large majority of women (between 80% and 90% of cases). The numerous episodes of gender-based violence affect 20% of the people assisted (women account for 91% of those who survived violence). Research shows that in many cases, the memory of gender-based violence focuses on the most traumatic episode but can hide other forms of violence and abuse suffered throughout life. The precarious living conditions on the island make these women particularly at risk. Single women in the Kara Tepe Registration and Identification Center face personal safety and security issues linked to the large preponderance of men in the camp and the inadequacy of prevention measures. A serious form of discrimination affects trans or non-binary people, whose gender identity is not considered a determining factor in applying for asylum, even when it puts these people’s lives at risk in their countries of origin.

 D. is from West Africa, and she is alone. She was forced to flee her country when her father found out she was a lesbian, consequently forcing her to marry a man. Her husband forced her to undergo female genital mutilation. During the ritual, she was in much pain, and still now, when she recalls the experience, she feels intense fear. To escape from her home country, D. had to rely on traffickers, who ‘sold’ her to an Iranian man. He used her as a sex slave and let her be raped by many men daily until she suffered a prolapsed uterus. At that point, she was abandoned in a remote place. During these rapes, she stood up to her attackers and fought back, breaking her finger and receiving many other scars on her body. Now when she talks about herself, she feels her body has changed, and she defines it as ‘broken’

Caregivers often reveal multiple and interdependent vulnerabilities. As in this case: E. comes from the Horn of Africa region and is a survivor of gender-based violence. More specifically, she is a survivor of female genital mutilation and domestic violence. In addition to these experiences, during the sea voyage from Turkey to Greece, she witnessed the drowning of the person sitting next to her on the dinghy. This episode, she says, had a profound impact on her, and she remembers it constantly, experiencing symptoms of PTSD, such as flashbacks, nightmares, and obsessive thoughts. In this situation, a few days before leaving the island to reach the mainland, she received a second rejection of her asylum application and was again stranded. The symptoms of post-traumatic stress disorder have been joined by suicidal ideation, disorientation, and an impaired level of functionality. Due to all these symptoms, she was referred to psychiatric treatment”.

In conclusion, apart from the lack of long-term mental health services to address the severe trauma experienced by refugees and asylum seekers, it is quite clear that a serious reassessment (and application) of vulnerability criteria in the asylum procedure is urgently needed. The therapies needed to address severe traumatic experiences are difficult enough without the healing process being further compromised by inhumane legal and bureaucratic processes.