Identification and rehabilitation of victims of torture among migrants with disabilities
From report :
FRA / august 2016 / Full report available here
Identification and rehabilitation of victims of torture
The right to freedom from torture is enshrined in many international treaties and the return of an individual to a country where he or she could face torture, inhuman or degrading treatment or punishment is prohibited by Article 19 of the EU Charter, the European Convention on Human Rights and the UN Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment (CAT). It may also constitute persecution in the sense of the 1951 Convention on the Status of Refugees.
Article 14 of CAT sets out the right to rehabilitation for victims of torture who are asylum seekers and obliges States Parties to ‘ensure in its legal system that the victim of an act of torture obtains redress.’ Redress includes the means for full rehabilitation, which is ‘holistic and include medical and psychological care as well as legal and social services’.
Evidence has shown that victims of torture are more likely to suffer from post-traumatic stress disorder or other barriers to disclose their personal experience, as may be required in an asylum interview. Trauma can severely impact on the asylum applicant’s memory and his/her ability to present the claim in a credible way. Early identification is therefore crucial to ensure support of medical and legal experts.
The Asylum Procedures Directive introduces specific procedural guarantees for asylum applicants who are victims of torture. Article 4(3) requires Member States to ensure that people interviewing asylum applicants must also have acquired general knowledge of problems which could negatively impact the applicants’ ability to be interviewed, such as indications of past torture.
The Reception Conditions Directive introduced an obligation for EU Member States to identify vulnerable asylum applicants with special reception needs, including victims of torture (Article 21), to ensure that victims of torture receive the necessary treatment, in particular access to appropriate medical and psychological treatment or care (Article 25(1)) and to provide appropriate training to those working with victims of torture (Article 25(2)).
However, there is no formal legal or policy framework or specific procedure for the identification of victims of torture in any of the seven Member States. In practice, victims of torture may be identified during asylum interviews or health screenings, similar to the findings in relation to identification of persons with disabilities presented above.
In Greece, either the doctor or the psychosocial support group of the medical unit conducts the identification after the registration procedure. Medical practitioners in Sweden noted that persons who did not mention experiencing post-traumatic stress disorder during registration and who are yet to have their health screening must either themselves make an appointment with a doctor at a primary healthcare centre, or become ill enough to be taken to a psychiatric ward for emergency treatment. In Bulgaria, NGOs report that individuals who have been victims of violence and torture prior to their arrival nonetheless sign declarations that they do not want any medical help, for fear that this will result in them being transferred to a hospital, slowing down the asylum process and a possible exit from Bulgaria.
Since 2012, the Bulgarian State Agency for Refugees has applied a questionnaire developed by the Assistance Centre for Torture Survivors aiming at identification of victims of torture. A 2013-2014 project monitoring the application of the questionnaire with persons seeking protection in Bulgaria showed that this or similar instruments was used with just 7.1 % of the persons interviewed, and only 6 % were referred for health or psychological support. Based on this data, the project concluded that the application of the questionnaire is limited, and that proper referral is closely related to the existence of a formal identification procedure.
Promoting early identification and orientation for victims of torture.
The PROTECT-ABLE project
The PROTECT-ABLE project aims at promoting a process of early screening and orientation for asylum seekers suffering from consequences of traumatic experiences (torture, rape, serious forms of physical, psychological or sexual violence), to encourage EU Member States to comply with the European directives on asylum. The project started in September 2012 and involves the creation of specific screening tools and the delivery of trainings and dissemination activities in nine Member States. The project partners include 11 NGOs from nine countries involved in the rehabilitation and care of torture victims as well as IRCT (International Council for Torture Victims) and PHAROS (Netherlands). More information is available on the project’s website.
In Germany, once victims of torture are identified during asylum interviews, a special commissioner (Sonderbeauftragte Entscheider) for victims of torture and traumatised asylum seekers must be contacted immediately. Special commissioners must be available in all branch offices of the Federal Office of Migrations and Refugees. They have to provide expert advice and take over the most sensitive cases. However, identification mechanisms focusing on the consequences of torture are often not in place.
Findings also indicate the absence of formalised support for victims of torture in terms of access to rehabilitation programmes in reception and detention centres. In Germany, although the professional NGO-based treatment centres for refugees and victims of torture available in some German states offer specialised and interdisciplinary support and have long experience in interpreter-based, transcultural psychotherapy, they have very limited capacity.
Similarly, the Bulgarian State Agency for Refugees reported cases of both physical and psychological violence, but according to NGOs has insufficient resources and personnel to deal with them thoroughly. In Sweden, 13 municipalities have some kind of trauma centres focusing on PTSD treatment and rehabilitation of victims of torture. However, due to limited places in these centres, the majority of the patients with PTSD are treated as out-patients in the regular psychiatric healthcare of the different county councils and regions. Trauma centres rarely treat children.
In Italy, the Ministry of Public Health recently drafted guidelines (yet to be adopted) which set out that the staff operating in reception centres shall be properly trained to cope with the specific needs of victims of torture. The guidelines also set out the rehabilitation procedure for victims of torture according to three necessary steps : understanding the trauma that the subject has sufferedand its consequences on his/her mental and physical health ; identification of a therapy aimed at dealing with traumatic memories ; creation and strengthening of positive social relationships.