Skip to main content
Top
Published in: Conflict and Health 1/2017

Open Access 01-12-2017 | Research

Mental health and trauma in asylum seekers landing in Sicily in 2015: a descriptive study of neglected invisible wounds

Authors: Anna Crepet, Francesco Rita, Anthony Reid, Wilma Van den Boogaard, Pina Deiana, Gaia Quaranta, Aurelia Barbieri, Francesco Bongiorno, Stefano Di Carlo

Published in: Conflict and Health | Issue 1/2017

Login to get access

Abstract

Background

In 2015, Italy was the second most common point of entry for asylum seekers into Europe after Greece. The vast majority embarked from war-torn Libya; 80,000 people claimed asylum that year. Their medical conditions were assessed on arrival but their mental health needs were not addressed in any way, despite the likelihood of serious trauma before and during migration. Médecins sans Frontières (MSF), in agreement with the Italian Ministry of Health, provided mental health (MH) assessment and care for recently-landed asylum seekers in Sicily. This study documents mental health conditions, potentially traumatic events and post-migratory living difficulties experienced by asylum seekers in the MSF programme in 2014–15.

Methods

All asylum seekers transiting the 15 MSF-supported centres were invited to a psycho-educational session. A team of psychologists and cultural mediators then provided assessment and care for those identified with MH conditions. Potentially traumatic events experienced before and during the journey, as well as post-migratory living difficulties, were recorded. All those diagnosed with MH conditions from October 2014 to December 2015 were included in the study.

Results

Among 385 individuals who presented themselves for a MH screening during the study period, 193 (50%) were identified and diagnosed with MH conditions. Most were young, West African males who had left their home-countries more than a year prior to arrival. The most common MH conditions were post traumatic stress disorder (31%) and depression (20%). Potentially traumatic events were experienced frequently in the home country (60%) and during migration (89%). Being in a combat situation or at risk of death, having witnessed violence or death and having been in detention were the main traumas. Lack of activities, worries about home, loneliness and fear of being sent home were the main difficulties at the AS centres.

Conclusion

MH conditions, potentially traumatic events and post-migratory living difficulties are commonly experienced by recently-arrived ASs, this study suggests that mental health and psychosocial support and improved living circumstances should be integrated into European medical and social services provided by authorities in order to fulfil their humanitarian responsibility and reduce the burden of assimilation on receiving countries.
Literature
2.
go back to reference Schweitzer R, Melville F, Steel Z, Lacherez P. Trauma, post-migration living difficulties, and social support as predictors of psychological adjustment in resettled Sudanese refugees. Aust N Z J Psychiatry. 2006;40(2):179–87.CrossRefPubMed Schweitzer R, Melville F, Steel Z, Lacherez P. Trauma, post-migration living difficulties, and social support as predictors of psychological adjustment in resettled Sudanese refugees. Aust N Z J Psychiatry. 2006;40(2):179–87.CrossRefPubMed
4.
go back to reference Laban CJ, Gernaat HBPE, Komproe IH, Van IDT, De Jong JTVM. Postmigration living problems and common psychiatric disorders in Iraqi asylum seekers in the Netherlands. J Nerv Ment Dis. 2005;193:825–32.CrossRefPubMed Laban CJ, Gernaat HBPE, Komproe IH, Van IDT, De Jong JTVM. Postmigration living problems and common psychiatric disorders in Iraqi asylum seekers in the Netherlands. J Nerv Ment Dis. 2005;193:825–32.CrossRefPubMed
7.
go back to reference Centro Studi e Ricerche IDOS. Dossier statistico immigrazione 2015. Roma: IDOS; 2015. p. 429–34. Centro Studi e Ricerche IDOS. Dossier statistico immigrazione 2015. Roma: IDOS; 2015. p. 429–34.
9.
go back to reference Trovato A, Reid A, Takarinda KC, Montaldo C, Decroo T, Owiti P, Bongiorno F, Di Carlo S. Dangerous crossing: demographic and clinical features of rescued sea migrants seen in 2014 at an outpatient clinic at Augusta Harbor, Italy. Confl Heal. 2016;10:14.CrossRef Trovato A, Reid A, Takarinda KC, Montaldo C, Decroo T, Owiti P, Bongiorno F, Di Carlo S. Dangerous crossing: demographic and clinical features of rescued sea migrants seen in 2014 at an outpatient clinic at Augusta Harbor, Italy. Confl Heal. 2016;10:14.CrossRef
10.
go back to reference Steel Z, Chey T, Silove D, Marnane C, Bryant RA, van Ommeren M. Association of torture and other potentially traumatic events with mental health outcomes among populations exposed to mass conflict and displacement: a systematic review and meta-analysis. JAMA. 2009;302:537–49.CrossRefPubMed Steel Z, Chey T, Silove D, Marnane C, Bryant RA, van Ommeren M. Association of torture and other potentially traumatic events with mental health outcomes among populations exposed to mass conflict and displacement: a systematic review and meta-analysis. JAMA. 2009;302:537–49.CrossRefPubMed
11.
go back to reference Fazel M, Wheeler J, Danesh J. Prevalence of serious mental disorder in 7000 refugees resettled in western countries: a systematic review. Lancet. 2005;365:1309–14.CrossRefPubMed Fazel M, Wheeler J, Danesh J. Prevalence of serious mental disorder in 7000 refugees resettled in western countries: a systematic review. Lancet. 2005;365:1309–14.CrossRefPubMed
12.
go back to reference Bogic M, Njoku, Priebe S. Long-term mental health of war-refugees: a systematic literature review. BMC Int Health Hum Rights. 2015;15:1.CrossRef Bogic M, Njoku, Priebe S. Long-term mental health of war-refugees: a systematic literature review. BMC Int Health Hum Rights. 2015;15:1.CrossRef
13.
go back to reference Heeren M, Mueller J, Ehlert U, Schnyder U, Copiery N, Maier T. Mental health of asylum seekers: a cross-sectional study of psychiatric disorders. BMC Psychiatry. 2012;12:114.CrossRefPubMedPubMedCentral Heeren M, Mueller J, Ehlert U, Schnyder U, Copiery N, Maier T. Mental health of asylum seekers: a cross-sectional study of psychiatric disorders. BMC Psychiatry. 2012;12:114.CrossRefPubMedPubMedCentral
14.
go back to reference Lindert J, Brahler E, Wittig U, Mielch A, Priebe S. Depression, anxiety and posttraumatic stress disorders in labor migrants, asylum seekers and refugees: a systematic overview. Psychother Psychosom Med Psychol. 2008;58:109–22.CrossRefPubMed Lindert J, Brahler E, Wittig U, Mielch A, Priebe S. Depression, anxiety and posttraumatic stress disorders in labor migrants, asylum seekers and refugees: a systematic overview. Psychother Psychosom Med Psychol. 2008;58:109–22.CrossRefPubMed
15.
go back to reference World Health Organisation Regional Bureau for Europe. Policy brief on migration and health: mental health care for refugees. Copenhagen: WHO-EURO; 2015. World Health Organisation Regional Bureau for Europe. Policy brief on migration and health: mental health care for refugees. Copenhagen: WHO-EURO; 2015.
16.
go back to reference Horyniak D, Melo JS, Farrell RM, Ojeda VD, Strathdee SA. Epidemiology of substance use among forced migrants: a global systematic review. PLoS One. 2006;11:6. Horyniak D, Melo JS, Farrell RM, Ojeda VD, Strathdee SA. Epidemiology of substance use among forced migrants: a global systematic review. PLoS One. 2006;11:6.
17.
go back to reference Weaver H, Roberts B. Drinking and displacement: a systematic review of the influence of forced displacement on harmful alcohol use. Subst Use Misuse. 2010;45:2340–55.CrossRefPubMed Weaver H, Roberts B. Drinking and displacement: a systematic review of the influence of forced displacement on harmful alcohol use. Subst Use Misuse. 2010;45:2340–55.CrossRefPubMed
18.
go back to reference Schwarz-Nielsen KH, Elklitt A. An evaluation of the mental status of rejected asylum seekers in two Danish asylum centers. Torture. 2009;19:51–9.PubMed Schwarz-Nielsen KH, Elklitt A. An evaluation of the mental status of rejected asylum seekers in two Danish asylum centers. Torture. 2009;19:51–9.PubMed
19.
go back to reference Hassan H, Ventevogel P, Jefee-Bahloul H, Barkil-Oteo A, Kirmayer LJ. Mental health and psychosocial wellbeing of Syrians affected by armed conflict. Epidemiol Psychiatr Sci. 2016;25:129–41.CrossRefPubMed Hassan H, Ventevogel P, Jefee-Bahloul H, Barkil-Oteo A, Kirmayer LJ. Mental health and psychosocial wellbeing of Syrians affected by armed conflict. Epidemiol Psychiatr Sci. 2016;25:129–41.CrossRefPubMed
20.
go back to reference Gerritsen AAM, Bramsen J, Devillé W, van Willigen LHM, Hovens JE, van der Ploeg HM. Physical and mental health of Afghan, Iranian and Somali asylum seekers and refugees living in the Netherlands. Soc Psychiatry Psychiatr Epidemiol. 2006;41:18–26.CrossRefPubMed Gerritsen AAM, Bramsen J, Devillé W, van Willigen LHM, Hovens JE, van der Ploeg HM. Physical and mental health of Afghan, Iranian and Somali asylum seekers and refugees living in the Netherlands. Soc Psychiatry Psychiatr Epidemiol. 2006;41:18–26.CrossRefPubMed
21.
go back to reference Kortmann F, Ten Horn S. Comprehension and motivation in responses to a psychiatric screening instrument. Validity of the SRQ in Ethiopia. Br J Psychiatry. 1988;153:95–101.CrossRefPubMed Kortmann F, Ten Horn S. Comprehension and motivation in responses to a psychiatric screening instrument. Validity of the SRQ in Ethiopia. Br J Psychiatry. 1988;153:95–101.CrossRefPubMed
22.
go back to reference Rasmussen A, Verkuilen J, Ho E. Posttraumatic Stress Disorder Among Refugees: Measurement Invariance of Harvard Trauma Questionnaire Scores Across Global Regions and Response Patterns. Psychol Assess. 2015;27(4):1160-70. Rasmussen A, Verkuilen J, Ho E. Posttraumatic Stress Disorder Among Refugees: Measurement Invariance of Harvard Trauma Questionnaire Scores Across Global Regions and Response Patterns. Psychol Assess. 2015;27(4):1160-70.
26.
go back to reference Save the Children. Piccoli schiavi invisibili, I minori vittime di tratta e sfruttamento. 2016. Save the Children. Piccoli schiavi invisibili, I minori vittime di tratta e sfruttamento. 2016.
30.
go back to reference Inter Agency Standing Committee (IASC). IASC guidelines on mental health and psychosocial support in emergency settings. Geneva: IASC; 2007. Inter Agency Standing Committee (IASC). IASC guidelines on mental health and psychosocial support in emergency settings. Geneva: IASC; 2007.
32.
go back to reference Vostanis P. Meeting the mental health needs of refugees and asylum seekers. Br J Psychiatry. 2014;204:176–7.CrossRefPubMed Vostanis P. Meeting the mental health needs of refugees and asylum seekers. Br J Psychiatry. 2014;204:176–7.CrossRefPubMed
33.
go back to reference Carta MG, Bernal M, Hardoy MC, Haro-Abad JM. Migration and mental health in Europe (the state of the mental health in Europe working group: appendix 1). Clin Pract Epidemiol Ment Health. 2005;1:13.CrossRefPubMedPubMedCentral Carta MG, Bernal M, Hardoy MC, Haro-Abad JM. Migration and mental health in Europe (the state of the mental health in Europe working group: appendix 1). Clin Pract Epidemiol Ment Health. 2005;1:13.CrossRefPubMedPubMedCentral
34.
go back to reference Bhugra D, Gupta S, Bhui, Craig KT, Dogra N, Ingleby JD, Kirkbride J, Moussaoui D, et al. WPA guidance on mental health and mental health care in migrants. World Psychiatry. 2011;10:2–10.CrossRefPubMedPubMedCentral Bhugra D, Gupta S, Bhui, Craig KT, Dogra N, Ingleby JD, Kirkbride J, Moussaoui D, et al. WPA guidance on mental health and mental health care in migrants. World Psychiatry. 2011;10:2–10.CrossRefPubMedPubMedCentral
35.
go back to reference Aragona M, Pucci D, Mazzetti M, Maisano B, Geraci S. Traumatic events, post-migration living difficulties and post-traumatic symptoms in first generation immigrants: a primary care study. Ann Ist Super Sanita. 2013;49:169–75.PubMed Aragona M, Pucci D, Mazzetti M, Maisano B, Geraci S. Traumatic events, post-migration living difficulties and post-traumatic symptoms in first generation immigrants: a primary care study. Ann Ist Super Sanita. 2013;49:169–75.PubMed
36.
go back to reference Silove D, Sinnerbrink I, Field A, Manicavasagar V, Steel Z. Anxiety, depression and PTSD in asylum-seekers: associations with pre-migration trauma and post-migration stressors. Br J Psychiatry. 1997;170:351–7.CrossRefPubMed Silove D, Sinnerbrink I, Field A, Manicavasagar V, Steel Z. Anxiety, depression and PTSD in asylum-seekers: associations with pre-migration trauma and post-migration stressors. Br J Psychiatry. 1997;170:351–7.CrossRefPubMed
37.
go back to reference Momartin S, Steel Z, Coello M, Aroche J, Silove DM, Brooks R. A comparison of the mental health of refugees with temporary versus permanent protection visas. Med J Aust. 2006;185(7):357–61.PubMed Momartin S, Steel Z, Coello M, Aroche J, Silove DM, Brooks R. A comparison of the mental health of refugees with temporary versus permanent protection visas. Med J Aust. 2006;185(7):357–61.PubMed
38.
go back to reference Laban CJ, Gernaat HBPE, Komproe IH, Schreuders BA, De Jong JT. Impact of a long asylum procedure on the prevalence of psychiatric disorders in Iraqi asylum seekers in The Netherlands. J Nerv Ment Dis. 2004;192:843–51.CrossRefPubMed Laban CJ, Gernaat HBPE, Komproe IH, Schreuders BA, De Jong JT. Impact of a long asylum procedure on the prevalence of psychiatric disorders in Iraqi asylum seekers in The Netherlands. J Nerv Ment Dis. 2004;192:843–51.CrossRefPubMed
39.
go back to reference Von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche C, Vandenbroucke JP. Policy and practice the strengthening the reporting of observational studies in epidemiology (STROBE) statement : guidelines for reporting observational studies. Bull World Health Organ. 2007;45120:867–72.CrossRef Von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche C, Vandenbroucke JP. Policy and practice the strengthening the reporting of observational studies in epidemiology (STROBE) statement : guidelines for reporting observational studies. Bull World Health Organ. 2007;45120:867–72.CrossRef
40.
go back to reference World Health Organization and United Nations High Commissioner for Refugees. mhGAP Humanitarian Intervention Guide (mhGAP-HIG): Clinical management of mental, neurological and substance use conditions in humanitarian emergencies. Geneva: WHO; 2015. World Health Organization and United Nations High Commissioner for Refugees. mhGAP Humanitarian Intervention Guide (mhGAP-HIG): Clinical management of mental, neurological and substance use conditions in humanitarian emergencies. Geneva: WHO; 2015.
Metadata
Title
Mental health and trauma in asylum seekers landing in Sicily in 2015: a descriptive study of neglected invisible wounds
Authors
Anna Crepet
Francesco Rita
Anthony Reid
Wilma Van den Boogaard
Pina Deiana
Gaia Quaranta
Aurelia Barbieri
Francesco Bongiorno
Stefano Di Carlo
Publication date
01-12-2017
Publisher
BioMed Central
Published in
Conflict and Health / Issue 1/2017
Electronic ISSN: 1752-1505
DOI
https://doi.org/10.1186/s13031-017-0103-3

Other articles of this Issue 1/2017

Conflict and Health 1/2017 Go to the issue