"Psychological support plays a significant role in the adaptation process of refugees."

"At CEAR, we work with asylum seekers , that is, people who are in the process of applying for refugee status but are still awaiting a decision. We also work with stateless persons and people who already have recognized refugee status. The ultimate goal is for these individuals to be able to live independently and with maximum inclusion in our society, promoting their holistic development. To this end, we provide them with a range of services. Initially, we offer basic necessities such as housing and food through emergency or reception services. We also provide them with legal, psychological, language learning, and employment support."

"It's important to understand that some migration flows are more expected, but others are unexpected, and this leads to significant variability in the time it takes for people to progress towards integration or access available resources, not only from CEAR but also from state resources. This causes the pathways or phases to stagnate and last longer than expected."

There are several phases and different situations, starting with the most basic humanitarian assistance , which is usually provided to people arriving by boat. These are people who are typically in transit to other destinations, but some also go to initial reception or first-phase facilities. Each person's journey is very different; it's difficult to generalize.

In initial reception facilities, which is the first step, some people may stay for two weeks or a month because they arrived during a period of normal or lower migration flow, while others have stayed for more than a year, as happened in 2019. The fact that processes stall at a certain point does not mean that the overall journey will be prolonged. At CEAR and other organizations, asylum seekers typically stay between 18 and 24 months, depending on their level of vulnerability.

After this initial reception, the person goes through a first phase in which their destination is assigned. They live in centers or apartments and follow routines that include Spanish classes or training, legal advice, and, in cases of particular vulnerability, psychological support. Currently, those who move on to a second phase are those whose application for international protection is successful. This number is very small, as only about 5% of asylum applications are granted. This second phase involves greater autonomy for the individual, with CEAR providing some financial support for housing and living expenses.

"Psychological support plays a significant role in the work of the multidisciplinary team because, in order for a person to adapt to a new situation, they require this support. The same is true for people who have a pre-existing mental health condition before the migration process; they will need this psychological support to be able to adapt successfully. Ultimately, we don't work with a very specific set of symptoms, but rather people arrive in different emotional states. However, given the profile of our users, the symptoms of post-traumatic stress are much higher than in the general population."

Yolanda Osorio López

Psychiatrist. Coordinator of the Mental Health among the Homeless Team (ESMES) and Immigrant Population Mental Healthcare (SATMI) programmes

Parc Sanitari Sant Joan de Déu

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"Overall, we've had to make a very rapid and extensive adaptation because new facilities have been opened and more staff have been hired to accommodate the very large number of people who arrived practically overnight. An important factor is also the language, which is very different from what we were used to. Although we had worked with people from Ukraine before, it wasn't on this scale."

My personal impression is that when there is a migration crisis of this magnitude, the instructions change and, as happened to us with the crisis in Afghanistan, the aim is to prevent people from getting stuck in one phase, but rather to make everything more fluid in order to distribute this migratory flow as quickly as possible and not collapse the system."

"In the case of this migration crisis, the profile of the arriving population is somewhat different from previous crises. While in the previous humanitarian crisis with Morocco or Senegal it was practically all single men, now we are talking about mothers with children , although there are also people of all ages."

This is also a challenge because we have to adapt to the needs of families, both ourselves and the State, on which many essential services such as education, healthcare, and transportation depend. And all of this must be done quickly because this is a humanitarian crisis that has caught us by surprise and very close to home, so its scale is much greater and has unfolded in a very short time.

Armed conflicts have occurred and continue to occur in many parts of the world, but the flow of migration is always directed towards neighboring countries. In the case of Ukraine, the largest number of applications for international protection are received in countries bordering the conflict zone, but, being within Europe, efforts are being made to achieve a more equitable distribution. Despite seeking this balance, we are talking about a country with more than 44 million inhabitants from which more than 4.7 million people have already left. The challenge behind these figures is immense in terms of reception; we have a huge amount of work ahead of us.

"Although I'm not having direct contact with them during this crisis, they are usually people who are experiencing acute stress . Psychologically, the problem is that the person is still living through that situation. It's not enough for them to be safe; they can't start rebuilding because they probably still have a partner, parents, or friends there, a job, a home... It's a very difficult situation to work with in therapy."

People arriving in Spain seeking international protection are at greater risk of developing a mental health disorder because they also experience trauma. There are all kinds of mental health disorders, just as there are in the Spanish population, for example, but with the added risk of post-traumatic stress, which can arise from having lived through, for instance, a war.

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"I think the mental health needs of asylum seekers are somewhat different from those of the local population because they will always have that element of vulnerability due to being migrants and having to start over against their will. This vulnerability accompanies them for many years ; we're not talking about the short or medium term. It's very important to provide multidisciplinary, close, and as individualized a support as possible to achieve initial containment and even prevention."

“As a society, there are two aspects that I think are positive. On the one hand, there has been a very global movement of aid from different countries. In this sense, the response to the humanitarian crisis has been very positive. On the other hand, I want to believe that what we are experiencing can be an opportunity to better understand migration flows and not experience them, as has happened in recent years, as something we must defend ourselves against as a society, as has happened previously in crises like those in Morocco or Senegal. Migration flows and crises, whether expected or not, cannot be interpreted as invasions depending on where people come from. This experience with Ukraine, with whose inhabitants we may perhaps feel more identified, should be a learning experience in this regard. An important aspect as a society is to avoid this hierarchical ranking of people , as has been happening with the migrant population, as if we were talking about different statuses simply for being a migrant. It is essential that migrants have decent working conditions, that their vulnerability is not exploited, and that they are allowed to fully integrate.”