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Refugees More than half reached Germany traumatized
One third of the children are psychologically stressed
According to a new study, refugee children suffer particularly as a result of an escape. A recent study of 100 Syrian children in the Bayernkaserne in Munich showed that around a third was psychologically stressed. Every fifth child suffered from a post-traumatic stress disorder.
Most refugees are traumatized and need mental support. Image: Lydia Geissler - fotolia Seventy percent of adult refugees living here and 41 percent of children and adolescents were witnesses of violence. About 50 percent of adults have experienced violence themselves. For the children it is about 15 percent. Many adults were tortured. Sexual abuse has also frequently occurred. "At least half of the refugees are mentally ill," says Chamber President Dietrich Munz.
Refugees suffering from post-traumatic stress disorder (PTSD) are often suicidal. Forty percent of them already had plans to kill themselves or even tried to kill themselves. Illnesses due to traumatic experiences are also particularly frequent among refugee children in Germany. Every fifth of them has contracted PTSD. This is 15 times more common than with children born in Germany. These are the central contents of the point of view "mental illness with refugees", which the Federal Psychotherapeutic Chamber (BPtK) presented today.
Psychotherapy is the recommended treatment for PTSD. The sole treatment with drugs is not sufficient and medically usually not responsible. However, only about four percent of mentally ill refugees receive psychotherapy. "Mental illness is one of the most common illnesses of refugees. As a rule, they are in urgent need of treatment, "says BPtK President Dr. Ing. Dietrich Munz. "The arriving refugees not only need shelter and food, but also medical care. But almost no mentally ill refugee receives adequate care. The BPtK therefore urgently requires legal changes and authorizations of psychotherapists and refugee centers in order to enable a guideline-oriented treatment of mentally ill refugees. "
Escape and trauma
Events that are considered life-threatening or catastrophic and cause profound distress can lead to severe mental illness. PTSD most often occurs after traumatic experiences triggered by other people ("man-made-disaster"). About half of the victims of rape, war, displacement and torture suffer from PTSD. The most common man-made disasters reported by refugees include small arms and grenade shelling, starvation and thirst (eg while in detention), death threats and bogus executions, physical torture, electrocution, sexual degradation and rape as well as the experience of executions or rape.
Anyone who suffers from PTSD, the traumatic situation experienced again and again, usually as nightmares or as lightning-like images or film-like scenes (flashbacks). These memories are experienced as intensively as if the event actually happened again. Yazidi women who escaped imprisonment in the Islamic State experienced flashbacks and panic attacks with racing heartbeat, shortness of breath, dizziness and fear of death during their flight to Germany. The tightness in the plane caused memories of captivity. PTSD patients therefore avoid situations that can evoke memories of the traumatic experiences. Other symptoms of PTSD include severe agitation, sleep and concentration disorders, emotional numbness, and indifference to other people. "PTSD sufferers are seriously mentally ill," says BPtK President Munz. "You urgently need psychotherapy. It is shameful that people with such severe and painful mental injuries almost never receive adequate help. "
Political demands
According to the current EU Acceptance Directive, Germany must take into account the special situation of vulnerable persons. These vulnerable people include those with mental illness and people who have suffered torture, rape or other serious forms of mental, physical or sexual violence. The directive should have been implemented by July this year. In fact, the care of mentally ill refugees in Germany continues to be shamefully bad. The amendments to the Asylum Seekers Benefits Act in March 2015 did not bring any improvement for mentally ill refugees. The BPtK therefore urgently demands to improve the care of mentally ill refugees. This requires, in particular, qualified assessors in social services, authorization of refugee centers and psychotherapeutic private practices for the treatment of refugees as well as the financing of interpreting services.
benefits under the Asylum Seekers Benefits Act
The decision as to whether psychotherapy is granted to a mentally ill asylum-seeker in the first 15 months of his stay in Germany often takes months in the social welfare offices. In most cases, clerks and doctors who are neither educated nor educated about mental illnesses, whether psychotherapy is necessary or not. This often leads to misjudgments. Mental illnesses are wrongly judged to be in need of urgent treatment or drug treatment that is inadequate. "The assessment and granting of psychotherapies under the Asylum Seekers Benefits Act is grossly deficient," explains BPtK President Munz. "In the future, an application for psychotherapy should only be examined by qualified assessors." From BPtK's point of view, it is also unacceptable for refugees to be deprived of medical care that is considered necessary in Germany to treat sick people. The restrictions on refugees in the Asylum Seekers Benefits Act should therefore be lifted.
Authorization of refugee centers and private practices
After the first 15 months, refugees can claim benefits from the statutory health insurance. This means that mentally ill refugees are in principle entitled to psychotherapy. Currently, their treatment is almost exclusively in psychosocial centers for refugees and torture victims. The psychotherapists working there are usually not allowed to settle with the statutory health insurance. As a result, refugees remain virtually without treatment even after the first 15 months. The BPtK therefore demands that psychotherapists in refugee centers and also psychotherapeutic private practices be authorized so that they can settle the treatment of refugees with the statutory health insurance. This would be possible due to the licensing regulation for doctors. "The treatment of mentally ill refugees would be so quick and unbureaucratic to significantly improve," said BPtK President Munz.
interpreter
For psychotherapies with refugees almost always interpreters are necessary. So far, interpreting services are rarely taken over by the social services and not at all by the statutory health insurance. The BPtK therefore proposes that the Asylum Seekers Benefits Act be amended in such a way that all refugees are in principle entitled to interpreting services if they are necessary for a medical treatment. (Sb)