Mental health care barriers for refugees and asylum seekers

Dr. Gisela Penteker is a Family physician and expert on refugee health. As the example she gives in this video illustrates, there are many barriers to mental health care for refugees and asylum seekers.

One barrier is that many health care workers and public officials have not been trained in recognizing signs of trauma. They may not realize that incoherent information given by the asylum applicant or lack of ability to account for certain details often are hints of an underlying trauma, for example torture. As a result, asylum applications are sometimes rejected because the traumatized person is suspected of not telling the truth. For example, an African woman who arrived in Germany described the journey in the boat over the Mediterranean sea as a terrible storm. The official who interviewed her checked the weather during the days she had been on the sea and found them to have been calm days. He therefore concluded that she had not been telling the truth. However, she was just trying to find words for several incidents when she was raped during the journey.

In addition, refugees do not necessarily share information upfront about traumatizing events or mental health problems. Language difficulties and lack of access to an interpreter may also contribute. Another important barrier for access to mental health care for refugees is the fact that the diagnoses and the respective therapies in “western biomedicine” are sometimes not compatible with disease concepts among people from non-western cultural backgrounds. One-to-one psychotherapy with an interpreter is often difficult for patients from a background where the healing power of an entire community is important.