Asylum seekers and migrants arriving in Greece have often experienced traumatic events. Almost one third of MSF patients spoke about attacks by armed groups, bombings, beatings or other forms of violence that they suffered directly or witnessed in their countries of origin. MSF psychologists observed symptoms of post-traumatic stress disorder (PTSD) in 9,5% of the patients. Furthermore 15% of the patients expressed their anxiety and worry about family members they had left behind. However being detained was the single most important reason of frustration for the majority of the irregular migrants and asylum seekers. For most, detention was a painful and inhumane experience. Of the 305 migrants seen in first consultations, 39% presented symptoms of anxiety such as constant worry, fear, panic, restlessness, while 31% presented symptoms of depression, such as sadness, loss of interest, hopelessness, and thoughts of death. Three percent (3%) of MSF patients attempted suicide or self-harm because they felt detention was unbearable or because they wanted to protest about the length of detention. Living conditions in detention facilities for migrants do not meet national and international standards. Inappropriate facilities are often used for the detention of migrants, such as in the case of Pagani or Venna detention centers. Overcrowding was a persistent problem in some detention facilities. Sanitary conditions are usually very poor. Overcrowding and poor hygienic conditions can contribute to the spreading of several medical conditions, for example dermatological infections, such as scabies, and viral infections, such as measles. Not being allowed out of the cells into the fresh air was also a significant concern for migrants. In the detention centers where MSF worked, families were separated and were given little opportunity for communication, which increased feelings of anxiety and insecurity. Patients also complained to MSF teams about degrading and abusive behaviour of police and other detention center staff. No provisions are in place to meet the needs of vulnerable groups, including unaccompanied minors, infants, pregnant women, and people with disabilities. Detention centers lack support staff and interpreters. Migrants and asylum seekers receive no or little information about their legal status and the detention system. Moreover due to the lack of appropriate information and the absence of legal counseling and interpretation services, many people in need of international protection are not identified and thus do not receive any support. Migrants systematically complained to MSF teams that they received inadequate medical care and had difficulties in communicating with the doctors. Reasons for inadequate health care in detention centers were the insufficient number of medical personnel, the absence of interpreter services, and the lack of a standard protocol for the medical screening and follow up of new arrivals. In addition detained migrants did not receive any psychosocial support, apart from that offered by MSF. MSF urges the Greek authorities to carefully measure the impact of detention on the well being of migrants and asylum seekers and to seek alternatives to the detention of new arrivals. Thus, the plans by the Greek government to establish reception/screening centers for new arrivals should be implemented without delay. Conditions and services provided in the reception/screening centers should be in accordance with international standards. In any case the Greek Government needs to immediately ensure that detained migrants and asylum seekers are treated in a humane and dignified manner and that those who wish to do so are given the possibility to seek asylum. 2