“Traumatized migrants, poor mental health assistance”



Doctors Without Borders

Scars on the psyche. Before the dramatic sea crossing, they have already crossed the desert and passed through Libyan detention centers. Where violence – including sexual violence – is almost inevitable. Same ordeal for those who attempt the “Balkan route”.

Torture and humiliation that cause forms of mental distress in migrants. But social and health services – despite specific ministerial guidelines – are mostly unaware of the problem. To shed light on the phenomenon, a report by Médecins Sans Frontières that the NGO will present today. It is an underestimated tragedy, which the Ministry of Health tackled almost five years ago by developing the “Guidelines on the Assistance and Rehabilitation of Victims of Torture”.

According to MSF, “however, they remain for the most part inapplicable over a large part of the territory: adequate public assistance services are often lacking”. MSF interviewed 50 health service operators, regional managers, staff in reception centers and in the private social sector. The guidelines to date are only formally implemented in Piedmont, Lazio and Tuscany. In others – Sicily, Veneto, Emilia-Romagna, Lombardy – there are virtuous experiences, often from the private social sector, in collaboration with local health organizations. The file lists the mental problems encountered most often. In descending order, these are: post-traumatic stress disorder, psychosomatic symptoms, anxiety or depressive disorders, psychotic images, cognitive or dissociative disorders, relationship difficulties, eating disorders, abuse of alcohol and drugs.

Traumatized migrants may exhibit alterations in time perception, dilated or contracted, with experiences blocked by backtrack in a circular time, then feelings of guilt or shame, disturbances of the sleep-wake cycle, memory, attention, concentration.

“An effective course of rehabilitation and treatment – he explains Silvia Mancini, MSF Humanitarian Affairs Manager – it is not only a right guaranteed to those who have experienced trauma, but also the necessary premise for integration”.

Adequate care – explains MSF – requires cultural mediation, forensic certification, different professional skills, integrated and coordinated approaches to meet complex needs that are not limited to the health sector. MSF launched several specific interventions, abroad and in Italy. In Palermo, he runs (in collaboration with the Provincial Health Authority, the Promis Department of the University of Palermo, the Astalli Center and Cledu) a clinic for the rehabilitation of migrants who have survived intentional violence: “We offer psychotherapy, medication, social and legal services. Intercultural mediators are an integral part of the process,” he explains. Edmond Tarek Keirallah, MSF coordinator of the Palermo project: “The biggest challenge is to bring out their experience. They often turn to us for other services, such as legal assistance, and we find that they have a terrible history of abuse behind them. »

The Palermo project affected more than 750 people and treated 78 patients, including 33 in the rehabilitation phase. In Rome, MSF ran a center for survivors of torture from 2015 to 2019. Today it has an ongoing project for the health of migrant women in collaboration with the ASL Roma 2.

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