Hundreds of thousands of traumatized migrants and refugees in Germany are in urgent need of help. A group of German scientists and psychiatrists has published a policy briefing saying many of the refugees are suffering severe stress and are incapable of forming relationships or learning a new language.
Of the refugees who came to Germany in 2015 and 2016, it’s estimated that around 250,000 were traumatized.
That means that in the past few years, at least a quarter of a million people have joined German society with serious mental health problems.
A policy briefing published this week by the German Academy of Sciences, “Leopoldina”, and the Berlin-Brandenburg Academy of Sciences, “Traumatized refugees – early treatment is needed now, ” says many of the migrants have experienced extreme poverty, violence, and torture. Many have also lost family members. As a result, there is a high incidence of psychological and physical illness.
From sleeplessness to suicide
The degree and range of symptoms are equally diverse. They can include insomnia and nightmares, a weakened immune system leading to the development of illnesses, drug addiction, self-harm and suicide.
As well as physical symptoms, social problems such as an inability to communicate, to form and maintain relationships and to learn a new language – crucial factors in integrating into society – are also common, mental health experts say. And yet, those who are suffering these symptoms of psychological stress and trauma are not getting the help they need.
One problem is that the migrants are receiving psychiatric treatment on a first-come first-served basis, explains Malek Bajbouj, who heads a neurosciences group at the Charite University Hospital in Berlin and was one of the authors of the policy briefing.
“[My colleagues described] somebody with very mild symptoms of stress who had been in very extensive trauma therapy. This patient said she suffered from sleep disorders and from time to time she would think about what happened in Syria. At the same time, another patient who has very severe nightmares and suicidal thoughts is having to wait for treatment,” Bajbouj says.
Restructuring the system
There are no Germany-wide figures available on refugees and psychiatric disorders – results from the first such study using a “refugee health screener” will be published within the next two months. But Professor Bajbouj and his colleagues say it is clear that the number of people who need help is more than health workers can cope with.
Bajbouj explains that the way the German health system is structured, people who need urgent professional psychiatric help are not being prioritized. This is because there isn’t enough mental health support offered at the other end of the scale – in what experts call low-threshold interventions.
A solution, they say, would be to offer all migrants immediate psychiatric screening to identify whether they need treatment. Severely traumatized people could then be directed to professional psychotherapy, and those with milder symptoms could get access to lower-level support such as peer-to-peer counseling from trained people with migration or refugee backgrounds.
The screening would not be compulsory, so some migrants who need help would fall through the gaps. Stigmatization of all kinds of mental illness still prevents many people from seeking help. Professor Bajbouj and his colleagues hope that offering migrants the option of counseling from lay people who share their language and have some insight into the refugee experience will help. He also says digital intervention, such as apps about stress and psychological disorders, may make it easier for people to seek treatment.
A cost-effective solution
The authors of the policy briefing say their proposal is efficient and cost-effective. It may be the best solution to the shortage of professional therapists in Germany. Bajbouj told InfoMigrants he believes there will be enough lay people willing and able to provide peer counseling. “Once you ask for people from this cultural background to help, to step in, with a psychology background or a biology background or students or whatever, you find those people.”
The policy briefing "Traumatisierte Flüchtlinge - schnelle Hilfe ist jetzt nötig" can be downloaded as a pdf (in German) here.