For sick refugees living in state facilities, Bremen is creating two new offerings that, according to the social authorities, are nationwide likely to be unique.
To begin with, in the second half of this year a facility is to open for refugees with an increased need for care and support due to physical illnesses.
Secondly, since December there are ten to twelve places for mentally ill refugees in a physically separated section of a home where unaccompanied minor refugees otherwise live. It is located in the former Zollhaus of the Hafengebiet, in which the new district Überseestadt has emerged.
What matters for the latter is not the diagnosis, said a spokesperson for Bremen’s Social Authority to , but the degree of disturbance. “They are people for whom it has become evident that they cannot live well with others in a communal accommodation and may even have been issued house bans.” This means that, for example, people with a severe depression who only endanger themselves are not part of the target group.
Only a fraction receives psychotherapeutic help
Estimates show that 30 percent of all refugees suffer from a trauma-related disorder, nationwide about 990,000 people. Less than ten percent of them would receive psychotherapeutic help or something comparable, says the Bundesweite Arbeitsgemeinschaft der Psychosozialen Zentren für Flüchtlinge und Folteropfer (BAFF). Public attention has recently mostly focused on individual cases in which mentally ill refugees seriously injured or killed people.
Housing mentally ill refugees in a communal accommodation with families, children and other vulnerable groups is often not tenable, according to the Social Department.
Women could theoretically be housed in the new Bremen facility, the spokesperson said. “In practice, however, it turns out that it is mainly unaccompanied young men whose mental state is so notable that they would be considered for a move to Zollhaus.” A lack of family ties is regarded as one of the causes of a mental illness.
Their residence in a communal facility with families, children and other vulnerable groups is often not tenable, and relocation to their own housing is likewise not possible, according to a letter from the Social Authority to a parliamentary committee in April. Homelessness, in turn, leads to a deterioration of condition and can lead to increased drug use—a vicious circle.
In the Zollhaus, the refugees are to experience stabilizing daily structures, at least during the week. Social-psychiatric staff should assist residents in dealing with their respective illness and the resulting everyday impairments, according to the government letter. This also includes psychiatric care, for example in day clinics.
Relatives should provide care
In the other facility with capacity for 155 people, housed in a former nursing home in the Neustadt, people with increased care and support needs should live. Besides refugees, this can also include homeless people. The care should be taken over by relatives, as it explicitly is not a care home. “This principle takes into account both cultural and practical realities and can help relieve existing care systems,” says the government letter.
If relatives cannot take over the care, home care services would be commissioned. The staff of the facility would have a “coordinating, advisory and supportive role.” The aim is to “bring the residents as early as possible into regular support services and strengthen their participation in social life.”
“Medical care should also be ensured. How this will look is not yet decided, according to the spokesperson. Under the legal framework, the municipality cannot simply hire a doctor to treat patients there. It is conceivable, the spokesperson said, that a general practitioner would come to the facility for a few hours per week and bill treatments through statutory health insurance.”
