Gabriele Al-Barghouthi is the director of the Mondial Bonn Psychosocial Center, the contact point in the western German city for refugees with psychological and social problems.* When people ask her about the main tasks of her small team, she says it is to stabilize people who have fled their home countries and often experienced violence.

That, she stresses, is far from easy.

"The long wait for the end of the asylum application procedure, the uncertainty, living in huge shelters without any privacy," Al-Barghouthi enumerates the difficult circumstances. "Many also experience the current political situation, racism in everyday life and exclusion. All things that would also affect healthy people."

One in three refugees suffers from mental illness

The Psychosocial Center in Bonn is one of a total of 51 facilities in Germany that provide therapeutic care for refugees across the country. According to their umbrella organization, they supported almost 26,000 people in 2022, that's 3.1% of those who need help. According to Federal Health Minister Karl Lauterbach (SPD), 30% of refugees suffer mental health problems.

These are figures that tend to get lost in the heated debate about the treatment of refugees. Following , the fatal knife attack in teh Bavarian city of Aschaffenburg, in which a 2-year-old child and a man were killed, immigration has become the number one topic in the campaign for the general election on February 23. The suspected perpetrator was reported to have been suffering from mental health problems and a refugee from Afghanistan.

The discourse on refugees and immigration has been exacerbated by the conservative CDU/CSU's motions in parliament: On Wednesday, January 29, they put forward a non-binding motion with a five-point plan to tighten asylum policy to parliament, which won a majority thanks to votes from the far-right anti-immigration Alternative for Germany (AfD) party.

Psychologist Milena Peitzmann told DW that she experiences first-hand every day what this does to refugees in this country.

"I notice that my clients after Aschaffenburg are extremely anxious, whether it's about stricter laws, tougher deportation regulations or a new government. Of course, everyone is aware of the debates, and that puts an additional strain on people," she tells DW. "There is the feeling of being collectively punished for something one person has done." 

Mental illnesses often go unregistered

Peitzmann and Al-Barghouthi list what they believe should actually be done to improve immigration policy: a systematic assessment of the need for support in the initial reception facilities and collective accommodation centers where people first arrive. Currently, the form refugees are asked to fill in upon arrival asks about their health condition but mental health issues are not listed. And finally, the psychologists call for better follow-up care through therapists in private practices. 

"Two years ago, we wrote to all 300 psychotherapists in the Bonn area seeking participants for a project for our clients. Only three responded. They were probably the idealists," says Gabriele Al-Barghouthi with a bitter smile. Treating refugees is too stressful for many, she suspects: "First of all, a translator has to be found, then a contract has to be drawn up and finally, the costs are often not covered."

Suicide is the main topic

There is an urgent need for more emergency care. Patients often end up in the hospital but are discharged after just one night and handed a box of pills without much explanation. Some then swallow too many of the pills. Suicide is generally the dominant topic in therapy, with more than half of the patients saying they have suicidal thoughts, say the Bonn psychologists.

"I've been working at the psychosocial center since 2020," social worker Majid Ibrahim tells DW, "and in all that time, we've seen exactly one case where a person made a massive threat of violence. Just one — and we called the police straight away. Usually, patients try to inflict violence on themselves."

Refugee aid criticizes general suspicion

Jenny Baron works as a psychologist at BAfF, the Federal Association of Psychosocial Centers for Refugees and Torture Victims. Shortly after the attack in Aschaffenburg, the center received many questions about how this attack could have happened and whether people with mental health problems in general pose a particular danger.

Baron told DW she was shocked by the debate, as it stoked fears and led to further social division. She says her organization has noticed a change in society.

"There is less recognition for people who work with refugees, for their great commitment under poor conditions to ensure a very high quality of care for refugees. We are noticing that financial resources are becoming scarcer because politicians no longer see the need," Baron says.

Baron explains that now, the psychosocial centers have to turn many people away for capacity reasons. Those seeking help sometimes have to wait longer than a year for treatment. Often, many mental illnesses go unrecognized and those affected simply withdraw, sometimes staying in their rooms for days or weeks at a time.

The psychologist appeals not to place those suffering from mental health disorders under general suspicion: "We know that a third of the German population develops a mental illness in the course of their lives. However, the absolute majority of these people, regardless of where they come from, do not become violent."

*Editor's note: If you are suffering from serious emotional strain or suicidal thoughts, do not hesitate to seek professional help. You can find information on where to find such help, no matter where you live in the world, at this website: https://www.befrienders.org/

This article was originally written in German.

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