Katerina Nomidou Secretary General of GAMIAN-Europe Refugee inflow and effect on Mental Health The Greek perspective Vienna, 15 September 2016

Over 1,000,000 people in search of sanctuary have traveled through Greece since 2015. More than 60,000 refugees stranded in Greece both by border closures along the Balkan route and by the EU-Turkey agreement dated 20th of March, 2016 wait to restart their lives

International aid organisation Doctors Without Borders (MSF) said yesterday (23 March) it had suspended activities at a refugee centre on the Greek island of Lesbos to avoid being complicit in an “unfair and inhumane” EU deal to send newcomers back to Turkey. Oxfam did the same hours later. The move came a day after the UN refugee agency UNHCR said it had suspended some activities in Greece, saying reception centres had become “detention facilities”. UNHCR refuses to play ball with EU, as 'hotspots' become prisons The United Nations refugee agency has refused to be involved in the refugee returns organised by the EU under its recent deal with Turkey, claiming that the so-called “hotspots” on the Greek islands, where refugees and migrants were received, assisted, and registered, have become prisons.

Many of these refugees have been given no indication as to when they can move on with their lives. Sixty percent are women and children. Many are the mothers, wives and daughters of refugees already in northern Europe. 

To be eligible for relocation in other countries in Europe, refugees must have arrived in Greece before the EU-Turkey agreement was put into effect on March 20. Afghans and Iraqis are not eligible for relocation. Their only option is to apply for asylum.  That said, Syrians are given priority so Iraqis and Afghans must wait interminable amounts of time even to get that critical first appointment to pre-register for asylum.

Although the Greek government has created temporary housing for the tens of thousands stranded by the EU-Turkey agreement, many of these camps do not meet accepted humanitarian standards Asylum and relocation services are overburdened and under-resourced, so the process is slow

Healthcare entitlements of migrants in an irregular situation

Highlights July 2016 Reception conditions: the Hellenic Centre for Disease Control and Prevention recommends the closure of accommodation centres in Greece due to public health concerns Child protection: More than 1,400 unaccompanied children are waiting for placement in specialised facilities; among them, 350 are held in hotspots or police detention. Hate speech: many 100s of refugees and migrants refuse to stay in the hotspots due to safety concerns regarding conflicts in the hotspots and with the local civilian vigilante groups.

Mental health and Psychosocial Support assessment by International Medical Corps, July 2016

No MH care is available in some camps MH care in some camps is fragmented with only specific aspects aspects being provided (basic psychosocial support BUT NO ACCESS to clinical care) Access to psychiatrists is often limited Lack of follow up after MH care is provided MH care workers limited training and capacity for working with refugee populations Community level MH promotion & activities are planned only for a few camps Lack of entry and cross-referral points

Greece Community-based interventions July-August 2016 Activities UNHCR prioritized throughout mainland Greece, targeting around 5,000 beneficiaries, through over 30 small scale projects in 15 different sites. School material and supplies Leisure activities - kindergarden Sewing classes for women – clothes making Dance lessons – music projects English classes – communal gym – football club Hairdressing – beauty salon - community barber Opening of a tea shop

Reception conditions for persons with disabilities The Reception Conditions Directive highlights the “primary concern” to be given to mental health of vulnerable persons in detention, and requires that Member States ‘provide necessary medical or other assistance to applicants with special reception needs, including appropriate mental health care where needed’ In Greece the Reception Conditions Directive has not been transposed into national law.

Local population reacts differently to the asylum crisis Very positive reactions, particularly shown through a very high level of volunteering, go hand in hand with very negative reactions including protests and attacks against refugees connected with Fear of Muslim-ization & NGO-ization 7yrs of extreme unprecedented econom.crisis Long-term unemployment of Greeks: 72,2% Under 25s unemployment: 50.5% Seasonally adjusted unemployment: 23,5% Homeless: at least 660,000 /11,000,000 (ELSTAT - EUROSTAT)