Refugees are forced to endure lengthy, perilous journeys to exercise their right to seek asylum. For those who manage to arrive safely at the Eastern Mediterranean frontier, the reality of their experience is far from ideal. In supporting individuals to navigate the asylum process, Fenix has witnessed firsthand the stories of vulnerable people who are caught in a complex web of dehumanizing and harmful practices.

The relationship between mental health and the asylum experience has been widely documented by academics, civil society organizations, and professionals working on the ground. A fundamental precondition to rebuilding one’s life in a host country, the European asylum process has been criticized as deeply disempowering and inefficient in its aim of guaranteeing basic human rights. InGreece, multiple human rights entities have raised concerns surrounding the practical application of the reception and asylum procedure and the relentlessly stressful circumstances it creates for people seeking protection.

Research indicates that people on the move face an array of stressors and precarious conditions spanning all phases of the migration experience.War, conflict, and persecution in their homelands may be paired with unexpected and violent losses at the personal, familial and community levels, while journeys in pursuit of safety are often hazardous, presenting very real risks of physical harm, exploitation, and separation from loved ones. Although it is generally acknowledged that past adverse experiences may be strongly associated with negative mental health outcomes, there is ample evidence that post-migration factors place undue strain on refugees and may undermine their ability to cope over time. Broadly, these stressors include (a) legal uncertainties, including legal status, time spent in detention, length of asylum process, and complicated bureaucratic procedures; (b) socio-economic factors, such as financial hardships, unemployment, and inadequate housing; (c) social and interpersonal factors, such as family separation, lack of support networks, racism and discrimination, language barriers, and poor social integration.  

In the politically fraught and volatile context of Lesvos, asylum seekers are faced with a multitude of barriers stemming from the deficiencies and prejudices of systems, laws, and policies. Serious and recurring abuses have been documented in the media and by non-governmental organizations, including systematic pushbacks and collective expulsions at land and sea borders.Accelerated asylum procedures and poor legal outcomes exacerbate the suffering of thousands by creating a protracted legal limbo. Policies of containment and deterrence leave people feeling overwhelmed and despairing. Undignified living conditions and limited access to critical resources, including healthcare, employment, and livelihood opportunities, have an adverse impact on mental and physical wellbeing and drastically diminish social participation. These structural issues are linked to what has been widely cited as a ‘growing mental health crisis’, and all but preclude the possibility of recovery.

Grounded in the World Health Organization’s (WHO) conceptual framework for the social determinants of health, this report explores key issues impacting the mental health and psychosocial wellbeing of individuals navigating the asylum process on the island of Lesvos.It draws on statistical data and observational material collected as part of the Mental Health and Psychosocial Support (MHPSS) programming at Fenix overt he course of 22 months, from October 2020 to June 2022. To maintain confidentiality, all data in this publication has been fully anonymized and any names and identifiable information have been changed. The report is structured as follows:

●      ChapterI presents the rationale for integrating an MHPSS component within a legal aid organization. It offers a brief overview of Fenix’s psychosocial programming activities, alongside anonymous summary statistics collected by the MHPSS team over a 22-month period.

●      ChapterII provides enriched observations based on interactions with Fenix clients, as well as an in-depth exploration of the barriers faced by specific subpopulations. Commentary and testimonials by clients offer a unique window into the lived experiences of people seeking protection in Greece.

●      Chapter III examines serious institutional gaps and shortcomings identified through Fenix’s fieldwork, with Lesvos serving as a case in point. A contextual update capturing recent events and developments is provided. The report concludes with remarks and key recommendations informed by the voices of asylum seekers and their families.

Our findings add to growing evidence that the asylum process creates stressful andchallenging circumstances for refugees and asylum seekers. They also suggest that the structural failures and shortcomings in the reception and asylumprocedures adopted by Greece, and the European Union more broadly:

●      Have far-reaching consequences on people’s wellbeing;

●      Facilitate the systemic exclusion and dehumanization of people seeking protection;

●      Actively contribute to the deterioration of people’s mental health.