Epicentre, Paris, France.
London School of Hygiene & Tropical Medicine, London, UK.
BMC Med. 2018 Mar 13;16(1):40. doi: 10.1186/s12916-018-1028-4.
Since 2015, Europe has been facing an unprecedented arrival of refugees and migrants: more than one million people entered via land and sea routes. During their travels, refugees and migrants often face harsh conditions, forced detention, and violence in transit countries. However, there is a lack of epidemiological quantitative evidence on their experiences and the mental health problems they face during their displacement. We aimed to document the types of violence experienced by migrants and refugees during their journey and while settled in Greece, and to measure the prevalence of anxiety disorders and access to legal information and procedures.
We conducted a cross-sectional population-based quantitative survey combined with an explanatory qualitative study in eight sites (representing the range of settlements) in Greece during winter 2016/17. The survey consisted of a structured questionnaire on experience of violence and an interviewer-administered anxiety disorder screening tool (Refugee Health Screener).
In total, 1293 refugees were included, of whom 728 were Syrians (41.3% females) of median age 18 years (interquartile range 7-30). Depending on the site, between 31% and 77.5% reported having experienced at least one violent event in Syria, 24.8-57.5% during the journey to Greece, and 5-8% in their Greek settlement. Over 75% (up to 92%) of respondents ≥15 years screened positive for anxiety disorder, which warranted referral for mental health evaluation, which was only accepted by 69-82% of participants. Access to legal information and assistance about asylum procedures were considered poor to non-existent for the majority, and the uncertainty of their status exacerbated their anxiety.
This survey, conducted during a mass refugee crisis in a European Community country, provides important data on experiences in different refugee settings and reports the high levels of violence experienced by Syrian refugees during their journeys, the high prevalence of anxiety disorders, and the shortcomings of the international protective response.
自 2015 年以来，欧洲一直面临着前所未有的难民和移民潮：超过 100 万人通过陆地和海上路线进入欧洲。在他们的旅程中，难民和移民经常面临恶劣的条件、被迫拘留和过境国的暴力。然而，对于他们在流离失所期间的经历和面临的心理健康问题，缺乏流行病学定量证据。我们旨在记录移民和难民在旅途中和在希腊定居时所经历的暴力类型，并衡量焦虑障碍的患病率以及获取法律信息和程序的情况。
我们在 2016-17 年冬季在希腊的八个地点（代表不同的定居点）进行了一项基于人群的横断面定量调查，并结合了一项解释性定性研究。调查包括一份关于暴力经历的结构化问卷和一份由访谈者管理的焦虑障碍筛查工具（难民健康筛查器）。
共有 1293 名难民被纳入研究，其中 728 名是叙利亚人（41.3%为女性），中位年龄为 18 岁（四分位距 7-30）。根据地点的不同，31%-77.5%的人报告在叙利亚至少经历过一次暴力事件，24.8%-57.5%的人在前往希腊的途中经历过暴力事件，5%-8%的人在希腊定居点经历过暴力事件。超过 75%（高达 92%）的≥15 岁受访者焦虑障碍筛查呈阳性，需要接受心理健康评估，但只有 69%-82%的参与者接受了评估。大多数人认为获取关于庇护程序的法律信息和援助很差或不存在，他们的身份不确定加剧了他们的焦虑。
这项在欧洲共同体国家的大规模难民危机期间进行的调查提供了有关不同难民环境中经历的重要数据，并报告了叙利亚难民在旅途中经历的高暴力水平、焦虑障碍的高患病率以及国际保护反应的不足。
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