The Refuge Jesuit Refugee Service - Europe Vol. 1 / Issue 6, October 2011
Spotlight on Mental Health
Safeguarding refugee mental health JRS Portugal staff member (right) providing mental health support to a detainee in Porto
Cathal Foley
photo:Don Doll SJ
is not being adequately addressed. ration with other agencies, and giving advice to governMental health disorders can be “The bulk of refuAn estimatments. Dr van Ommerfound in people of all ages and from gees rarely have aced 450 milen urges governments all cultures, regardless of socioeco- cess to mental health lion people to add a mental health nomic status. The World Federation care (in emergencies)”, suffer from component to their genfor Mental Health ranks major de- says Dr Mark van Ommental health eral health services. “If pression as one of the top five lead- meren, the WHO fod i s o r d e r a person has pneumoing causes of disability worldwide. cal point for mental nia or bronchitis, they An estimated 450 million peo- health in emergencies. ple suffer from mental health disWHO projects that one in five get health care. This should also order, yet fewer than half get the refugees are likely to have a men- happen in mental health cases”. What he treatment they need. This is es- tal health disorder such as depresThe bulk pecially true for refugees. Their sion, anxiety or post-traumatic would like to of refumental health needs are often stress disorder. “The causes in are see most of all gees rarely unnoticed amidst the turmoil of multiple, such as exposure to hor- is more action have access flight and settlement in camps. rible things, previous events in in the field of mental In commemoration of World personal history, lack of social sup- mental health to Mental Health Day – October 10 port, traumatic events. All of these care. “Peo- health care ple often talk – JRS Europe spoke Words are things makes life more dif- about mental health, but there is to the World Health ficult for refugees and puts Organization (WHO) good for ad- them at risk to developing too little action,” he says. “If there but mental health problems”, is any message to give it’s that old about the state of refu- vocacy gee mental health care. we need to says Dr van Ommeren. expression of putting your monDespite the obvious move words Part of his work involves ey where your mouth is; words need for it, it’s one as- into action. developing guidelines and are good for advocacy but we pect of health care that policies, often in collabo- need to move words into action.” www.jrseurope.org
The Refuge
October 2011
Going the extra mile
for short term sessions where emoWell-travelled psychologist Sr. Maria José Rebelo provides tions such as guilt and sadness, and grief about recent loss are mental health counselling to refugees at JRS Portugal very common. Generally, the peoprogram. What began as a part- ple in this category only require a time service – ‘‘one or two days few sessions. One third of Sister a week’’ – quickly evolved Rebelo’s clients, however, require into a full-time program where between 10 to 20 sessions. A small Sr. Rebelo started ‘‘working in amount of other cases who suffer psychological support as a full from some predisposition to some time worker’’ by July of that year. mental health problems are referred Today, JRS Portugal’s mental to psychiatry or a general practihealth department consists of two tioner for long-term treatments. full-time workers who Very often, people Sr. Rebelo does not last year provided psyare struggling with usually have any chotherapy and coununemployment, problems getting her selling to 108 migrants. with social prob- clients to open up The culture shock of lems, being unable about their problems. being in a foreign counto meet their ba- She puts this down to try, prohibited from emsic human needs friendly and open atployment due to lack of mosphere ubiquitous Sr. Maria José Rebelo Photo: Don Doll SJ proper immigration stain JRS Portugal, but Cathal Foley tus can have a detrimental effect on also due to the proximity of each It was throughout her time spent migrants’ mental health. ‘‘Very of- of the different JRS departments. ‘‘We work in the same vicinity living in foreign countries such ten, people are struggling with unemployment, with social problems, as the other areas of support... if as Australia, Brazil, England and Spain that Sr. Maria José being unable to meet their basic a person goes to the social support Rebelo of the Portuguese Holy human needs such as food, shelter, office and Spirit Missionaries came to re- rent. Their illegal status is very is in a very There are a alise and empathise with the often a source of their anxiety”. bad condi- lot of feelCrisis intervention is one of the tion emoplight of migrants and refugees. ings of mismain ways JRS Portugal helps tionally, my After six and a half years in trust and low Australia where she completed migrants with psychological dif- c o l l e a g u e s e l f - e s t e e m . her studies in clinical psychol- ficulties. According to Sr. Rebelo, might call ogy - specialising in transcul- ‘‘People often feel a lot of guilt me to meet tural mental health - Sr. Rebelo when they cannot send money to the person which causes a relafelt the pull of her native Portu- their children or elderly parents. tionship to be built. If the person gal, where she returned to begin They suffer because they are una- also has a trusting relationship working as a volunteer for JRS. ble to visit them due to their irreg- with one of my colleagues, they The pressing need for Last year, JRS ular status. So, there will find it easier to trust me. If, the provision of mental Portugal's men- are a lot of feelings of for example, a colleague asked the health care for refu- tal health depart- mistrust and low self- client to go to the middle of Lisbon esteem. They stop begees became apparent ment provided lieving in themselves’’. for mental health support, I don’t think the person would go. They to JRS Portugal at this psychotherapy Most of the people trust us and feel cared for here’’. time, so from Febru- and counselling ary 2007, they started to 108 migrants. the JRS mental health continues on page 4 team deals with come their mental health PAGE 2
www.jrseurope.org
The Refuge
Torture a cause of refugee mental health problems Giancarlo Santone, Centro Safimo psychiatrist
Photo: Centro Safimo
A collaboration between Centro Astalli and the Italian health authority has led to the creation of a support service for torture victims
Cathal Foley
According to Bacigalupi, men- who have experienced rape and tal health problems exist amongst genital electrocution. This ‘‘esMental health disorder is a widespread phenomenon in Europe. refugees due to the traumatic ex- pecially has a really dramatic consequence Refugees are especially vulnerable. periences they have endured. ‘‘It psychological While their journey to Europe is is not that uncommon that we see amongst Muslim men because fraught with danger, not everything some psychological problems, even ... in the Islamic culture’’, such simply falls into place once entry sometimes some severe psychiat- subjects are particularly taboo. He points out, is gained. Of the many problems ric disorders. About 30 One third of the however, that the facing refugees, there is the press- per cent of refugees that people with menspecific types of come to Italy have psying need for mental health care due tal health probtorture which peoto the high percentage suffering chological problems’’ lems who we deal ple are subjected from post traumatic stress disor- he says. These disorders with have expeto are irrelevant, der. Awareness of this need, how- often lead to a myriad of rienced torture ‘‘it’s the humiliadifferent physical health ever, has risen over the past years tion that the torture and has led to constructive action. problems like insomnia, causes’’ the victim One example is the creation of gastritisand leg pains. Torture is often a chief cause of that causes most of the damage. Centro Samifo in 2006 in Italy. such disorders. ‘‘One third of the While Centro Samifo has been Centro Samifo came into being after the collaboration of Centro people with mental health prob- providing a service of utmost Astalli – the Italian office of JRS lems who we deal with have expe- importance for five years now, rienced torture’’, says Bacigalupi. problems lurk behind every cor– and the local health authority, to provide mental About 30 per One of the most com- ner. The worldwide financial health care for refugees. cent of refugees mon types of torture crisis has had an inevitable and Since 2007, the service that come to It- is of a sexual nature. adverse impact on the services has been operating five aly have psycho- ‘‘The sexual abuse they provide. ‘‘It is not possible to give psychotherapeutic treatdays a week, every week logical problem of women is really common’’ he states. ment to all the people that need of the year. ‘‘We have Shockingly, he claims it’’, Bacigalupi bemoans. But in two general practitioners an overall context, he is content that are in charge four days a week, never to have seen ‘‘a woman and optimistic with the ‘‘union’’ two psychiatrists and also there is who has been tortured that has not between the social services and a psychologist’’ says Centro Safimo been a victim of sexual abuse.’’ Centro Astalli because it ‘‘is a Sexual abuse, however, is not psychiatrist Maurizio Bacigalupi. good way to give a correct reperpetrated solely against females. Other types of specialists, such as sponse to the needs of migrants a gynecologist, are also provided. Bacigalupi has also counselled men with mental health problems.’’ www.jrseurope.org
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JRS News in Brief HOW TO HELP.....
To donate a Gift to JRS Europe Bank Address: BNP-Paribas-Fortis, Boulevard Anspach 3, 1000 Brussels Account number (in Belgium): 210-0906775-71 IBAN: BE 49 2100 9067 7571 Swift code: GE BA BE BB continued from page 2
Migrants intercepted by the Italian coastguard
New Frontex law adopted by EU Parliament Philip Amaral On 13 September the European Parliament adopted a new law for Frontex, the EU border agency. According to JRS, several provisions might enhance protection for forced migrants. There are numerous explicit references to human rights and refugee law. The principle of non-refoulement, protecting persons from being returned to countries where they life would be endangered, is included as well. Frontex staff will be required to receive training on refugee and human rights law. A ‘fundamental rights officer’ will be appointed to ensure the agency’s compliance with international legal protection norms. “The new law is a step forward. For years Frontex has operated without any obligations to respect PAGE 4
Photo: Frontex
fundamental human rights”, says Stefan Kessler, JRS Europe senior policy officer. But the law does have drawbacks. It does not contain a mechanism to allow external scrutiny of Frontex activities, such as by the European Parliament. The agency can implement return operations even if the merits of the return decision are in question. “In this scenario, Frontex officers could return a migrant even if they know that the action would endanger the migrant’s human rights”, says Kessler.
While the mental health departme ment has made huge strides since 20 2007, a lack of space and financi cial support has inhibited its furth ther expansion. Sr. Rebelo would al also like the department to be ab able to provide psychiatric suppo port but ‘‘we are dependent on vo volunteers”. If JRS could find a ps psychiatrist that would volunteer to help them, they could at least st start going into this direction. Such short term road blocks, ho however, cannot frustrate the good wo work JRS Portugal is doing. As Sr Sr. Rebelo puts it, ‘‘we have good ex experience on the ground’’ and a lo lot of data gathered for ‘‘conductin ing studies’’. This will eventually ‘‘ ‘‘give us more capacity for speakin ing on behalf of the migrants an and their mental health needs.’’
Jesuit Refugee Service Europe Rue du Progres 333/2 B-1030 Brussels Tel: +32 2 250 32 20 Fax: +32 2 250 32 29 Executive Editor: Philip Amaral Editor: Cathal Foley europe.media@jrs.net
With the financial support from the EU Fundamental Rights and Citizenship Programme
www.jrseurope.org