Abstract

BackgroundPushed by ongoing conflicts and pulled by the desire for a better life, over one million migrants/refugees transited Balkan countries and arrived in Europe during 2015 and early 2016. To curb this influx, European countries instituted restrictive migration policies often characterized by building of razor-wire border fences and border closures. Among migrants/refugees who received mental health care in Serbia while travelling through Balkan countries to Northern Europe, we assessed the prevalence and patterns of violent events experienced including physical trauma.MethodsA mixed methods study among migrants/refugees attending mobile mental health clinics run by Médecins sans Frontières (MSF) between July 2015 and June 2016, in Serbia – a main transit hub to European countries. Clinics were conducted according to MSF guidelines by experienced psychologists who were supported by cultural mediators. The main outcome measures were violent events and associated physical trauma.ResultsOf 992 migrants/refugees attending MSF mental health clinics, the majority (72%) were from Syria and Afghanistan and included vulnerable groups (14%) such as unaccompanied minors and pregnant women. The most frequent mental health symptoms/signs were anxiety (29%) and adjustment reactions (26%). Of the 992 migrants/refugees, 270 (27%) had experienced violent events during their journey. Signs of physical trauma due to acts of violence were seen in 223(22%) of the 992 individuals, 144 (65%) being perpetrated by State authorities and involving women (11%) and children (13%).Border closures along the Balkan route were associated with a dramatic decrease in registered migrants/refugee arrivals in Serbia. Conversely, among those that made it across the borders, an increasing linear trend in reported violent events was observed at MSF mental health clinics (X2 for linear trend, P <0 · 001). Qualitative evidence corroborated with quantitative findings.ConclusionsNearly one-in-three migrants/refugees seen in MSF clinics experienced violent events including physical trauma along their journey. State authorities, including those in European countries were the perpetrators in over half of such events which were associated with border closures. There is “a crisis of protection and safe passage” which needs to change towards one of respect for the principles of international human rights and refugee law.

Highlights

  • Pushed by ongoing conflicts and pulled by the desire for a better life, over one million migrants/refugees transited Balkan countries and arrived in Europe during 2015 and early 2016

  • The main branch of this corridor starts in Turkey, passes through Greece into the Former Yugoslav Republic of Macedonia (FYROM) and from there to Serbia, Hungary, Croatia and Slovenia - depending on border closures - and into Austria, Germany and beyond (Fig. 1)

  • Despite humanitarian and legal obligations of Europe to treat migrants/refugees with dignity and provide safe havens and asylum [4], what followed was the institution of restrictive migration policies which were often characterized by the building of razor wire border fences and border closures along the Balkan route [5] (Table 1)

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Summary

Introduction

Pushed by ongoing conflicts and pulled by the desire for a better life, over one million migrants/refugees transited Balkan countries and arrived in Europe during 2015 and early 2016. To curb this influx, European countries instituted restrictive migration policies often characterized by building of razor-wire border fences and border closures. Despite humanitarian and legal obligations of Europe to treat migrants/refugees with dignity and provide safe havens and asylum [4], what followed was the institution of restrictive migration policies which were often characterized by the building of razor wire border fences and border closures along the Balkan route [5] (Table 1)

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