Conclusions and recommendations This report has documented the inhumane and degrading conditions in detention centers for new arrivals in Greece and the negative impact of detention on the well being of migrants and asylum seekers. Fleeing violence, conflict, and poverty, asylum seekers and migrants come from countries such as Afghanistan, Iraq, and Somalia to seek safety and a better future in Europe. For many, Greece is the first European country they reach after a long and dangerous journey. Upon arrival they are systematically arrested and detained in detention centers for migrants, border police stations or other detention facilities. Living conditions in detention centers do not meet national and international legal standards. Problems in the detention centers where MSF worked included overcrowding, unacceptable hygiene conditions, irregular distribution of personal hygiene items and clothing, lack of provisions for the accommodation of vulnerable groups, family separation and inadequate time outdoors. Medical care in detention centers was inadequate. The number of medical staff was often insufficient and new arrivals were not systematically screened. Psychological support was lacking. The absence of interpreters was a serious constraint for communication between detained migrants and the staff working in the detention centers. Moreover, new arrivals did not receive information about their legal status, the detention system and the right to apply for asylum. MSF offered psychosocial support to detained migrants and asylum seekers in Pagani, Filakio and Venna detention centers between August 2009 and May 2010. MSF’s intervention aimed at addressing the psychosocial needs of new arrivals and advocating with the authorities to improve living conditions and introduce mental health services in the detention centers for migrants. Through its daily work in the detention centers MSF witnessed the negative impact of detention on the wellbeing and mental health of migrants and asylum seekers. Symptoms of anxiety and depression were observed in the majority of our patients. Unacceptable detention conditions, fear of deportation, not knowing how long they would be detained and being treated like criminals made detention a painful and inhuman experience for the majority of the asylum seekers and migrants. Furthermore, detention added to their suffering, as many had already been through or witnessed traumatic events in their countries of origin and during their journey. The increasing use of detention in many EU member states, including in Greece, has been criticised by a number of international organizations, who have stressed that, in accordance with international standards, detention of migrants must be a measure of last resort, proportionate and for the shortest period possible, and where possible alternatives to detention should be sought. MSF urges the Greek authorities to carefully measure the impact of detention on the well being of migrants and asylum seekers and to consider alternatives to the detention of new arrivals. In that regard, the intention of the Greek government to establish reception/screening centers for new arrivals is a positive first step. MSF calls on the Greek government to implement these plans and to guarantee that conditions and services provided in these centers are in accordance with international standards. Particular attention should be paid to ensure the provision of appropriate medical and mental health care, including medical screening and adequate follow-up of new arrivals. 27