Impact of detention on the mental health and well being of irregular migrants and asylum seekers arriving in Greece Between August 2009 and April 2010, MSF psychologists in Filakio, Venna, and Pagani detention centers saw 305 patients in 381 first and follow-up individual consultations.48 Eighty nine percent (89%) of MSF patients were male and 11% female. 46% were younger than 26 years old and 12% were minors. The majority of the patients came from Asia. Smaller numbers came from Northern Africa, sub-Saharan countries, Bangladesh and Georgia. 30% 25% 20% Main nationalities of MSF patients 15% 10% 5% 0% Afghanistan Iraq Pakistan Palestine Iran At the moment of the first consultation with the MSF psychologist, 25% of the patients had already been in detention for a period of up to one week, 45% for a period from one to four weeks, and 30% for a period over four weeks. Patients have often experienced traumatic events. They left their countries because of violence, insecurity, conflict, or extreme poverty. For many the journey was fraught with risks including being exploited by smugglers or traffickers. On arrival in Europe, their expectations for security and a better life were shattered as they were faced with detention and disillusionment. Detention contributed to the deterioration of their mental health. Emotional responses to this multitude of events are complex and vary from person to person. Our findings indicate that patients seen by MSF psychologists suffer from symptoms of anxiety, depression, and post-traumatic stress disorder. Traumatic events Having experienced a traumatic event was the presenting problem for 17.3% of our patients during first consultation. Patients mentioned attacks by armed groups, bombings, beatings or other forms of violence which they themselves suffered or witnessed in their countries of origin or during their journey. Those acts of violence often resulted in their personal injury or the death of significant others. According to the MSF Mental Health Guidelines, A traumatic event involves a confrontation with helplessness and death, and a complete loss of control. Definitions of what constitutes a trauma are often subjective and culture-bound but generally include a direct encounter with or witnessing of lifethreatening events and violent personal assaults. By nature a traumatic event is sudden, unexpected, and overwhelming. The very essence of an acute traumatic stress reaction is that it hampers the critical processes of survival and adaptation.49 Traumatic events do not affect everyone in the same way. What may be traumatic for one person may not be experienced as such by another individual. In some cases, a traumatic experience may cause post-traumatic stress disorder (PTSD), which occurs when people are not able to integrate the traumatic experience in their present life. MSF psychologists observed symptoms of PTSD in 9,5 % of the patients. Drawing by migrant 19