Is Germany facing a mental health crisis among refugees and migrants?
Whenever a migrant or refugee is the perpetrator of a violent crime, questions asked seem to revolve around their background and whether being a migrant has somehow predisposed them to commit the crime.
What can mental health professionals add to the debate?
In the German city of Freiburg, a student was gang-raped by several men, many of them of Syrian origin, spurring once again a debate in German society over a possible predisposition of migrants to committing violent acts.
For health professionals, such acts require a different approach - one that is focused on the psychological risks of migrant journeys.
Professor Dr. Thomas Elbert, a research professor in neuropsychology at the University of Konstanz, says that a mental health crisis among migrants is looming. As one of the authors of a new study for the Leopoldina (The German National Academy of Science), he calls for immediate action. “This [kind of violent incident] is something we have predicted.“
Elbert warns that violent acts will occur more frequently if nothing is done to create conditions where, “young men in particular, but in general people who are seeking protection here in Germany, have the opportunity to acquire social status.”
For Elbert, social status is key. Social status is the thing which stops many more people from committing crimes like rape or murder, he says. The loss of social status, which happens when you are sent to prison and excluded from society, is more of a barrier to crime than the actual punishment. But if you have nothing to lose then it is much easier to graduate to crime.
That is not to say that refugees or migrants are naturally predisposed to commit such crimes because of their background or ethnicity, he adds.
Risk factors, stress
However, a greater proportion of migrants are exposed to risk factors which increase the likelihood of committing crimes, Elbert explains. This is due to the reasons which led them to flee or what they experienced on the road to Europe. People who have made it to Europe are often laboring under huge amounts of stress. “They feel under permanent threat,” he says.
“We have asked refugees who have crossed the Sahara desert, how did you get here? And they told us: ’We had to commit crimes; we were attacked, people robbed us, so we also had to start attacking.’” From his research, Elbert found that out of 10 boys who leave West Africa, only two make it to the Mediterranean coast and only one actually crosses to Europe. He thinks that these people, in spite of their traumas, can be integrated successfully. They have, after all, already learnt to survive, but their traumas need to be treated, a key point of his study “Traumatized refugees –immediate response required.”
Research conducted for the study has found that as many as half of migrants and refugees could have psychiatric problems or post-traumatic stress. The effects of these traumas can be worse for society in men than in women. And the majority of the migrants who arrived in 2015 were young men.
Migrants abandoned in the Sahara desert Photo Sylla Ibrahima Sory
Elbert found that one-third of men who experience a violent upbringing will turn to crime, whereas only one in 20 or 50 women will do so. However, women who have undergone trauma might be more prone to suicide or self-harm. All these things will cost society huge amounts of money – hence the call for therapy and more intensive screening.Treating #trauma
Virginia Edwards-Menz is a registered nurse with 30 years experience working in mental health and more than 13 years counseling refugees and migrants on a volunteer basis near Freiburg.
She agrees with a recent study by the University of Erlangen-Nürnberg which found that at least one in three people coming from Syria are laboring under some kind of mental health issue. However, the German system is not equipped to invest the amount of time needed to really assess each individual’s psychiatric needs, she says.
She points out that most new arrivals are on welfare which means that only the most acute cases are even dealt with. Most social workers have more than 100 people to attend to. There is no way they can even begin to tackle the effects that violence may have had on the refugees. In addition, many refugees are not even aware that they might need that kind of help, says Edwards-Menz.Can trauma lead to gang-rape?
Elbert does not see a correlation between trauma and rape. Rape he thinks is usually caused by problems of socialization and can also be the result of a continual witnessing of violence. “Once you have lost your moral barriers, what is allowed, what is not allowed, then rape is one of your options. We see that in war-like regions where there is no state or monopoly of power. Young men begin to rape. They do so in gangs, to show and test who is the most terrible cruel and dominant guy in the group.”
Gender, attitude towards women
Can crimes like the gang-rape in Freiburg be attested to having grown up in a different culture where the role of women is defined much differently than in Western cultures?
Elbert and Edwards-Menz agree that there is no simple explanation. “It’s not a justification to say we have not learnt that the situation in Germany is maybe different [to the country of origin.]," Elbert says. But he also says that limits of what is OK and not OK “are learnt within a cultural context.” If the moral barriers you grew up with (for instance certain dress codes and behavior) are no longer present, then it can be easy to think that you do not have to respect the person who appears to be flouting the codes you learnt.
As a volunteer, Edwards-Menz has often come across men from countries like Afghanistan who do adhere to Islamic codes of behavior and believe that European society should change to their way of thinking. She advocates talking to gradually shift mentalities and continually repeating the message of what is acceptable, and what is not in Germany. She notes that quite a lot of them arrive illiterate. This creates a barrier to integration and can also go some way to explaining sometimes entrenched attitudes. With no access to other ways of thinking or being, their opinions can take a long time to shift.The government and agencies who work with refugees and migrants are already doing this, she says. The main problem is time and resources, as in enough translators to work with people and enough time to devote to each individual and understand each separate biography. Only then, can these traumas really be overcome and people integrated successfully.
Full assessment necessary
Both experts agree that German society as a whole is facing a problem and that the solution cannot be to deport people and thereby push the problem onto another society.
What both experts want is a proper assessment of the extent of the problem so that the trauma that many people are carrying can be digested. The problem is that this involves a long process and no simple answers, but it is only that which will aid better integration in the future.
▻http://www.infomigrants.net/en/post/13164/is-germany-facing-a-mental-health-crisis-among-refugees-and-migrants
#Allemagne #santé_mentale #réfugiés #asile #migrations #crime #criminalité #stress #traumatisme #viol #statut_social
