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Room for change: The Impact of accommodation on refugees’ mental health in Germany

By Hannah Zoe Schütt | Issue 23

Vacant building in the middle of a forest in Brandenburg (Germany) where authorities are planning a new accommodation centre (courtesy of the author).

In 2020, Aluel flees the civil war in South Sudan. The young woman decides to leave her hometown in the southeast of the country, after suffering sexual violence. She applies for asylum in Germany where – after getting registered in a reception facility – she is being transferred to a collective accommodation centre. Here, she shares a room with three other women. The washing room that all eighteen women on the floor share is at the very end of the corridor and Aluel must often pass by the men living on the same floor to get there. Substance abuse is common among the men in this particular accommodation, and they are often erratic and shout at her or the other women. Suffering from post-traumatic stress disorder, Aluel often gets flashbacks in her everyday life in the accommodation centre, which causes her severe mental distress.

Refugees have often witnessed the effects of war, persecution, and torture first-hand. As a result, rates of post-traumatic stress disorders (PTSD), anxiety disorders and depression are (worryingly) high. Even when being out of immediate danger, the arrival and settlement in a new country hold a range of stressors that negatively impact refugees’ mental health. Adequate and sufficient psychosocial care rarely exists and refugees often have to navigate the mental stress of the asylum procedure and settlement process with very scarce support.

The effects of PTSD can have major negative impacts on the asylum application. It is important to note that not all people who have witnessed a traumatic event necessarily develop PTSD. Some factors that heighten the risk of developing PTSD include being in situations and contexts of feeling helpless, lack of social support, and added stress after the traumatic event – factors that are particularly prevalent among refugees. PTSD can include symptoms such as flashbacks, nightmares, avoidance of potentially triggering situations and hyperarousal, which can manifest in constant irritability and high startle responses. It can also include dissociative amnesia, which describes a distorted understanding of both content and structure of one’s memories. This poses a significant difficulty as the asylum process fundamentally revolves around the concept of credibility. Here, case officers decide whether an individual’s fear of persecution is believable. The internal consistency of a narration and the ability to recount the events become pivotal factors in the assessment. The symptoms of PTSD, however, work against the applicant.

The lack of attention paid to this also shows in the UN guide on credibility assessments in the EU asylum systems. Here, PTSD is only hinted at through an emphasis on a person’s ‘individual circumstances’. Disability advocates and critical scholars emphasise how the asylum procedure reproduces an ableist framework that puts refugees with disabilities at increased risk of being deemed non-credible and their asylum application being rejected. Moreover, being viewed as non-credible heightens the risk of an application being deemed ‘obviously unfounded’, which can result in an immediate deportation.

Life in accommodation centres

In Germany, people seeking asylum are obliged to stay in collective accommodation for the duration of their asylum process, but no longer than 18 months. However, in practice, some people, particularly families with many children, end up residing in these facilities many more years, even after obtaining refugee status. As some of the reasons for this, practitioners point to landlords being unwilling to let apartments out to refugees due to an uncertainty and a lack of knowledge around legal statuses.

The covid-19 pandemic has been a wake-up call to an awareness of the relationship between housing and health. Studies also demonstrate that the conditions of crammed collective accommodation hold a negative impact on the mental health of refugees. Accommodation for refugees tends to be designed as temporary solutions, which fosters an unsustainable approach to health and well-being. Life in these temporary accommodation facilities is often described as a ‘life on hold’ or ‘living a frozen life’, conditions that are also enforced by the lack of possibilities to partake in social life. In Germany, refugees’ choice of residence is highly restricted through the obligation to stay in the centres as well as the residential obligation, which binds them to live in a particular geographical location. This degree of control exercised over refugees’ lives and living situations can increase feelings of helplessness and loss of control, which are critical in the context of traumatic experiences and PTSD.

The case of Aluel highlights how living in close contact with others can heavily impact the mental well-being and cause traumatic events to resurface. The lack of private spaces can further exacerbate the anxieties and stress that people live with. Furthermore, practitioners note how basic security measures such as well-lit rooms, lockable private rooms or shower cabins are often missing. This starkly increases the probability of violent acts and a feeling of insecurity among vulnerable people. Collective accommodation centres are oftentimes refurbished office or school buildings, and their architecture is not made for a healthy living environment, which makes the enforcement of protection standards even more difficult. These factors can have severe consequences for everyone living in them but especially those who carry additional mental stress and need a more adequate and better supported living environment.

Legal pathways, structural battles

Existing possibilities for refugees to access more suitable and trauma-sensitive housing are being impeded by structural barriers. The legal pathways that exist for refugees to access special services (which can include specialised living arrangements) are blocked by bureaucratic hurdles. Especially those people whose asylum application is still pending must often engage in legal battles for their right to health. The realisation of the universal right to health is progressively constrained by an individual’s legal status.

Notably, lawyer Volker Gerloff emphasises that the EU Reception Directive grants individuals with disabilities the right to receive specialised services aimed at mitigating the effects of their disabilities and enabling them to participate in society more fully. Regrettably, this legal instrument is rarely, if ever, utilised.

While there are legal avenues for refugees and individuals in the asylum process to access specialised support and transition to alternative forms of accommodation, administrative practices and the lack of appropriate services act as barriers preventing refugees from exercising their rights.

Hannah Zoe Schütt holds a master’s degree in Global Migration from University College London and a bachelor’s degree in Cultural Studies and Political Science from Kiel University. Currently, she works as a social scientist in a research project on accommodation and mental health of refugees in Brandenburg, Germany. She also pursues her doctorate on the role of migrant-migrant relations in the integration process in urban areas and is a voluntary researcher for a project on psychosocial support for unaccompanied minors in London. Hannah’s research focuses on theories of integration and diversity, mental health and refugee reception, and postcolonial spatial imaginations.



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