Greece: The impact of living in limbo on asylum seekers’ mental health

An Afghan couple living in a camp for a year discuss the mental toll of asylum processes, fear of deportation, and precarious living conditions.

A man sits on the shores of Greece and is tended to by two MSF workers.

Greece 2024 © Myrto Mouzaki/MSF

New migrants arriving in Greece are directly transferred to closed controlled access centers (CCACs), where ongoing securitization and restriction of freedom have harmed the mental health and physical well-being of the residents. 

These centers are in remote areas far from local communities and surrounded by barbed-wire fences. Doctors Without Borders/Médecins Sans Frontières (MSF) works in two such centers on the islands of Samos and Lesvos, where our teams provide medical and mental health care as well as emergency medical assistance.

Overcrowded conditions and poor sanitation

More than 1,500 people live in the Lesvos Mavrovouni CCAC as of early June. Many residents tell MSF they are completely exposed to the elements; they feel too cold in the winter and extremely hot in the summer. Sanitation is also a major issue in the camp because of the accumulation of garbage and food waste, leading to infestations of cockroaches, mice, and bed bugs.

Married Afghan couple Mahmud* and Zeinab* arrived on the island of Lesvos together by boat from Türkiye in April 2023. It was their first attempt to get to Europe. They did not experience any border violence incidents, like other people attempting to get to Europe for safety. The couple lives in a tent inside the camp, and Zeinab is five months pregnant. On April 28, they marked their first anniversary of living in the camp.

When we first arrived in the camp, there used to be warm water in the showers, [but] now there hasn’t been in a long time. The toilets are a mess. And as soon as you switch off the light, there are roaches everywhere.

Mahmud, resident of Lesvos camp

The CCAC in Lesvos was built on an area that used to be an army shooting range. One end of the camp faces the shore, the other side faces hills, and to enter or exit one must pass through a security checkpoint and wire mesh fences. 

“The camp was built hastily after the fire in Moria in September 2020, and not all existing structures are walled,” said Duccio Staderini, head of MSF projects in Lesvos. “Some areas of the camp also consist of big storage tents. People in the camp live in containers like the ones in Samos, and when occupancy reaches high levels, new arrivals might be given tents to set up in between the existing structures.”

The MSF team in Lesvos provides primary health care services with an integrated mental health and sexual and reproductive health care approach, as well as emergency medical assistance for new arrivals. Furthermore, to ensure people receive the necessary support, our multi-disciplinary approach also includes health promotion, intercultural mediation, and social and legal services.

Patients wait to be seen in a Lesvos displacement camp in Greece.
Between January and March 2024, MSF teams in Lesvos conducted a total of 1,867 primary health care consultations.
Greece 2023 © Evgenia Chorou/MSF

Opaque procedures and no clear guidance 

People seeking medical treatment from MSF tell us that they are given little to no information about the asylum process, often sign documents they do not understand, and give interviews without legal counseling or even proper interpretation. People seeking safety have no other choice but to adjust to a reception system that undermines their dignity, agency, and identity


After our first rejection, people told us not to lose hope, not to stress, because maybe with the next interview we could get asylum. With the second interview, we had hope, but then we got a rejection. We did the third one, hoping again. After the fourth rejection, we lost all hope.

Mahmud, resident of Lesvos camp

“When someone goes on this journey, they have some hope; they wish to find calm,” said Mahmud.  “After our first rejection, people told us not to lose hope, not to stress, because maybe with the next interview we could get asylum. With the second interview, we had hope, but then we got a rejection. We did the third one, hoping again. After the fourth rejection, we lost all hope. We’re desperate.”

Sonia Balleron, head of MSF projects in Samos

A "prison-like" center

“When you stand in front of Zervou, you feel like you are looking at a prison-like structure. At the main gate, you face a security checkpoint, and you look through several layers of mesh wire fences. Looking to your right and left, you cannot see the end of this fence. Behind you is a massive parking lot mostly used by staff working in the camp. One thing you witness very often when arriving at the camp is a long line of people waiting—they are being checked for proper paperwork to be allowed to leave ...

... Once you have entered the camp, you face container after container. They are grey and white, symmetrically arranged with no more than three feet of distance between them and there are no trees, no plants in sight. The containers have no additional roof that could provide protection which means that once you leave your container you have no chance to escape either the direct hot sun in summer or the rain and wind in winter."

A view of the Zervou Closed Control Access Center in Greece.

Access to health care, interpreters, and cultural mediators

For people living in the camps, access to health care services is hindered by shortages of resources and a lack of capacity in the national body responsible for health provision. The lack of interpreters and cultural mediators in public health care facilities adds to the challenges asylum seekers face in accessing health care.

This leads to preventable suffering and health deterioration for those with severe, life-threatening conditions.

An MSF worker checks a woman's glucose level in Lesvos, Greece.
An MSF nurse checks a patient’s glucose levels during triage at the MSF Sea House clinic, on Lesvos island.
Greece 2024 © Evgenia Chorou/MSF

The inhumane situations that people seeking safety experience on their journey weaken their coping skills and mental health, making it difficult to overcome other adversities when they arrive on Lesvos Island and during their stay at the camp.

“When I first arrived in Lesvos, I told them that I want to be in a country where I can be safe—a country where I could continue with my dentistry studies, find work, have security, and a future for my child,” said Mahmud. 

MSF urges the Greek government and European leaders to take all necessary measures to ensure that people seeking protection in Greece and other European Union member states are treated with humanity and dignity. This includes immediately and permanently ending all pushbacks and violent practices at borders; ensuring continued search and rescue

* Names have been changed for privacy. 

"We are all human beings": Refugee testimonies from Samos, Greece