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PART 1: The Aegean Island refugee camps – An unprecedented mental health emergency

Trigger warning: readers might find the following content distressing as it discusses mental illnesses, suicide and self-inflicted harm.

A drawing by a child living in Moria refugee camp on Lesvos, Greece (one of 18 minors who attempted to take their own life there between February and June 2018) – Image by The Guardian.

The UK’s Mental Health Awareness week 2020 is from 18-24 May. The Mental Health Foundation claims that its purpose is to ‘raise awareness of mental health and mental health problems and inspire action to promote the message of good mental health for all’. Thus, it seemed apt for this to be a focus of one of the week’s blogs.

Image by The Guardian

The (limited) mainstream media attention on the humanitarian crisis unfolding on the Aegean Islands tends to focus on the deplorable material conditions that asylum seekers and refugees are experiencing: severe overcrowding with people living in small tents, under tarpaulins or in cramped containers; lack of adequate sanitation; little access to healthcare and education. However, the state of people’s mental health, which is undoubtedly related to these living conditions, receives relatively less coverage. It is important that this is acknowledged.

Most of the people who cross to the Aegean islands to seek refuge in Europe have left countries that are at war and have been exposed to high levels of violence. Some are survivors of torture or have lost family members or friends. Many have experienced violence on their journey to Turkey’s coast and all have made the perilous and distressing crossing to the islands on small rubber dinghies. The people arriving on the islands are therefore extremely vulnerable and high numbers experience some form of post-traumatic stress disorder.

People who have experienced trauma require time and a safe space to recover. The Aegean island camps do not allow for this. In these camps where fighting is common (this in itself is partly a result of people’s own frustrations and poor well-being) and living conditions are abysmal, people experience further stress, fear and violence. Women, children and men are also at a high risk of sexual exploitation and violence. People’s mental health therefore further deteriorates in these camps.

Medical organizations on the islands report high numbers of people suffering from PTSD, depression and anxiety - experiencing panic attacks, constant nightmares or psychosis. Young children who are unable to express their feelings or thoughts verbally have been observed engaging in self-destructive behaviour including biting or scratching themselves, pulling their hair out or banging their head against walls until they bleed. Severe mental health conditions among children on the islands have also manifested in selective mutism (a severe anxiety disorder that prevents people from speaking) or withdrawing from social life. In October 2019, a young girl from Afghanistan in Moria camp on Lesvos was diagnosed with ‘resignation syndrome’. This refers to children who, previously acting normally and showing no signs of brain damage, enter a coma-like state and become ‘totally passive, immobile…unable to eat and drink, incontinent and not reacting to physical stimuli or pain’. Swedish doctors have described this as ‘willed dying’ suggesting that it is a psychological response to severe trauma, hopelessness and despair.

The process of applying for asylum on the islands is stressful and receiving a decision on asylum claims takes months or even years. Asylum seekers live in a constant state of uncertainty during this period as they wait to hear about whether they will be granted asylum or be deported back to Turkey. The asylum process is a huge source of anxiety for people. Conditions in the camps, therefore, compound people’s existing trauma.

Médecins Sans Frontières has described the situation in the island camps as an ‘unprecedented health and mental health emergency’ with the number of suicide attempts and incidents of self-harm rising among their populations. In their health centre on Lesvos they see multiple cases each week of people requiring ‘immediate and urgent care’ due to self-harm incidents or attempts to take their own life. Following high numbers of arrivals on the islands in summer 2019 child mental health referrals to MSF’s paediatric centre doubled in July compared with previous months.

Image by Médecins Sans Frontières

Read more about the disturbing findings of Médecins Sans Frontières in PART 2 of this article and how COVID-19 has impacted mental health on the Greek islands.


About the author: Isla is from Scotland and recently finished her MA in International Relations at the University of Edinburgh. She volunteered with asylum seekers for organization Action for Education on the island of Chios in 2017 and hopes to return to this project later this year. Isla feels strongly about social justice and universal human rights and wants to see more countries resettling more refugees across Europe as soon as possible. She is also a focal point for Europe Must Act – Aberdeen.

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