IRCT REGIONAL REPORT 2016 In the opinion of the Red Cross Treatment Centre, material reception conditions initially did not provide an adequate standard of living to guarantee physical and mental health. Many of the additional problems relate to the fact that there are no mechanisms for early identification of torture victims, and the integration process can be hampered if the victim is unable to seek appropriate treatment at an early stage. Furthermore, there are no special accommodation provisions for torture victims and other traumatised asylum seekers. One of the big challenges is the coordination between different services, including healthcare. The experience is different across Sweden, but in principle all asylum seekers are supposed to receive a medical examination as soon as possible. There are added complications as torture victims are often examined by GPs who do not necessarily have the right training to work with them. As a result, the Red Cross Treatment Centre believes that the state is struggling to ensure torture victims get specialised medical and psychological treatment. Many victims receive treatment from their local GPs, which is not adequate for their specific needs. The GP system is currently under great strain and many GPs do not feel comfortable providing rehabilitation services to torture victims without the necessary training. On some occasions there is confusion about the legal implications of any GP involvement. The Red Cross Treatment Centre reports that some GPs can be reluctant to inquire about torture as they fear they are overstepping a legal boundary, will make the victim uncomfortable, or simply feel they do not know what to do with the information at hand. The Red Cross Treatment Centre does provide training through workshops and lectures. However, many of those working with torture victims do not receive adequate training; For example those working in sectors other than health care, such as social services. This is further complicated by the increase in new staff and the overwhelming number of asylum applications the Swedish Migration Agency is dealing with. “Referrals to our services can happen in an arbitrary manner, depending on the knowledge of the asylum caseworker or the health worker. But we have found that when torture victims are identified, they are generally accorded special procedural guarantees.” — Anette Carnemelm Asylum application Sweden, 2010 - 2015 Asylum applications in Sweden, 2010 – in 2015 180,000 156,110 160,000 140,000 120,000 100,000 81,325 80,000 60,000 54,365 40,000 20,000 29,710 31,940 43,945 0 2010 2011 2012 2013 page 36 2014 2015