A mental health emergency on the Greek Islands

Four months has passed since a fire destroyed Moria camp, Europe’s largest refugee camp on the Greek Island of Lesbos. But despite repeated promises from the European Union (EU) that there will be “no more Morias,” more than 15,000 people remain trapped on the Greek Islands in unsafe and unsanitary conditions, ill-equipped to protect themselves from the harsh winter to come. Doctors Without Borders/Médecins Sans Frontières (MSF) mental health teams on Lesbos and Samos are witnessing concerning levels of mental health distress among our patients. MSF once again calls on the EU and Greek authorities to transfer all asylum seekers—especially the most vulnerable—immediately off the islands to safer, more humane, accommodations.

On Samos island, in Vathy refugee camp, 3,500 people are squeezed into a center designed to host 648 people. People are forced to live in miserable conditions—most living in the forest next to the official facility with limited access to showers, sanitation, and adequate shelters that will keep them warm in winter. MSF's mental health team in Vathy camp has seen a concerning rise in patients presenting with severe symptoms. In November, 60 percent of MSF’s new patients expressed suicidal thoughts, and 37 percent were considered by our team to be at risk of suicide. The situation is being closely monitored by our mental health team.  

“I have deteriorated in here," said Harin Halil, a mother of two from Syria who receives mental health care from MSF in Samos. "I was not like that before. Because of the fear I feel, every once in a while, I have a [panic attack]. For example, when there is a fight in the camp—and that is happening very often—or when there is a fire in the camp, these incidents affect me a lot. During the last fire in Samos camp I felt like I never left Syria. It was a very traumatic experience for me because the first time when Daesh [Islamic State] attacked us, there were bombings and fire, so it reminded me a lot of what I experienced there.”

“After each critical and harmful event—such as the fires, the recent earthquake, the lockdown—we have seen an increase of severe cases in our clinic with a deeply worrying rise in suicide and self-harm thoughts from people trapped in the camp,” said Lindsay Solera-Deuchar, MSF Psychiatrist on Samos. 

“The protracted containment in poor living conditions and ongoing uncertainty regarding asylum claims contribute to mental health difficulties among residents of the camp, many of whom have already experienced traumatic events in their country of origin or during their journey to Greece,” said Solera-Deuchar. “Without these issues being addressed, it is impossible to provide effective treatment to our patients. They need a safe and stable environment in order to recover.” 

On Lesbos, more than 7,000 asylum seekers—2,500 of them children—continue to live in flimsy tents that frequently flood during inclement weather. Recently, a three-year-old girl was raped in the camp. This shocking attack illustrates the absence of adequate protection measures in the camp, and the urgent need to transfer the most vulnerable people to safe and dignified accommodations.

Since the fire in Moria, and the subsequent evacuation to a new camp, MSF’s child psychologists have seen concerning symptoms in their patients, including sleepwalking, nightmares, regressive behavior, as well as self-harm and suicidal thoughts.

“We continue to see hopelessness, despair, depressive symptoms, and some extreme cases of reactive psychosis, self-harm, and suicidal ideation,” said Thanasis Chirvatidis, an MSF Child Psychologist. “The most severe cases we see are those [children] who want to be isolated or express the desire to end their lives. They want to be inside the tent all the time, they do not want to socialize, and they wish to die—to stop the pain, to stop feeling like that.”

In 2020, MSF’s child psychologists have treated 49 children with suicidal thoughts or suicide attempts.

“Despite EU promises, people will have to face another winter in inhumane conditions exposed to the elements, in absolute despair, this time amidst a global pandemic,” said Stephan Obberreit, MSF’s head of mission in Greece.

“To make it worse, a new ‘multi-purpose reception and identification center’ has been built five kilometers [about three miles] from Vathy camp in an isolated spot, and another one will be created on Lesbos. Barbed wire intends to contain people and even surrounds children’s playgrounds,” said Obberreit. “Let’s be very clear, these plans will only renew the unacceptable EU migration strategy, leading to more human suffering [and] making it even more invisible.”

MSF urges the EU and Greek authorities to move all asylum seekers, especially the most vulnerable, immediately to safe accommodation and to reconsider the unacceptable commitment to new, large, closed camps at the borders, which will only further trap people in miserable conditions and exacerbate mental health issues. The Greek authorities should also take measures to improve special guarantees for mental health patients on the islands and evacuate the most vulnerable to safe accommodation on the mainland or other EU states.