NATIONAL REPORT 2016 The situation for victims of torture and ill-treatment According to a number of surveys, approximately 20 to 45 percent of asylum seekers in Germany are likely to suffer from mental illness4. Due to the overstrained reception conditions in Germany, many more traumatised refugees requested help compared to previous years. In 2015, 502 victims of torture, ill-treatment and violent conflict benefitted from general rehabilitation services at bzfo. These services aimed to improve clients’ mental health and social wellbeing, including by offering assessment of needs, MLRs and complex rehabilitation treatment and support in individual and group settings. Clients also benefitted from medical diagnostics, psychiatric and psychotherapeutic treatment as well as social support. Psychological and medical problems also often overlap with social problems for victims of torture, which is exacerbated by the anxiety of spending long periods in uncertainty over the type of protection status granted the entitlements resulting thereof. Many bzfo clients were particularly worried about the situation of their loved ones remaining in warzones. As a result of this, victims of torture needed more social support as well as more urgent psychotherapeutic and psychiatric crisis interventions. This has meant that capacity has shifted from the normal long-term rehabilitation programme – with an average duration of one and a half years – in order to meet the acute needs of newly arrived victims of torture in an ongoing situation of distress. As a part of the Early Access treatment programme, 199 clients were initially seen for intake interviews. After a diagnostic interview, they either received counselling or in cases of urgent indication were admitted to the Early Access treatment programme. Upon completion, participants in the short-term treatment programme reported a significant improvement in their mental health. About 80 percent of the clients received stabilising treatment and were released. Only 20 percent of the clients were referred to intensive or prolonged therapy at the bzfo day-clinic or to long-term treatment and rehabilitation programmes. These clients were mainly torture victims with complex posttraumatic and psychiatric syndromes or persons with a pre-traumatic unstable personalities, which had resulted in reduced capacity to cope with trauma and flight. It is likely that some of the participants of the Early Access programme with persistent posttraumatic symptoms will return at a later point to receive more trauma-focusing therapy. For the time being, the majority do not wish to look back but want to start their new lives in exile by learning German and looking to enter the workforce. To address the acute and immediate needs of victims of torture, partners5 from Bulgaria and Germany launched an EU-funded project titled “Early Access to Adequate Therapy” (hereinafter, “Early Access”) to give support to a greater number of victims with effective support for a period of up to six months. The project was designed as an early-intervention support mechanism for traumatised refugees and was tailored to meet the acute needs of recently arrived victims of torture. This was done in order to offer stabilising, therapeutic interventions so that the victim of torture could faster access holistic support measures. page 6