EVASP Transnational Research

›› Preface ‹‹
This report was produced by the ‘Centre for Trauma, Asylum and Refugees’ of the University of Essex and the IOM
Psychosocial and Cultural Integration Unit on behalf of the EVASP project.
The full list of members of the EVASP research team in the four participating countries is the following: Novita Amadei,
Vincenzo Ambrogio, Francesca Amerio , Ioanna Babassika, Catrina Salim, Rossella Celmi, Sabine De Jong, Nadine
El-hadi, Indhira Elsevyf Garcia, Martine Goeman, Maria Kalli, Susan Kinyany Schlachter, Natale Losi, Zuhura
Mahamed, Orso Muneghina, Renos Papadopoulos, Steven Petric, Dimocritos Sarantidis, Katia Scannavini, Guglielmo
Schininà, Georgia Stribakou, Caroline Tod, Kristina Touzenis and Carla Van Os.
We wish to express our gratitude to all our research colleagues for their collaboration, their competence and
enthusiasm; in particular, we thank Rossella Celmi and Guglielmo Schininà for technical supervision and overall
guidance. Working on this project all of us together was a most educational, rewarding and enjoyable experience,
despite its unavoidable difficult phases.
On behalf of the entire EVASP team, we wish to thank most sincerely all the Asylum Seekers and Service Providers who
took part in this project and shared generously with us their experiences and expertise. It is important to emphasise
that participation in this project took various forms and, in addition to the persons we interviewed during the research
phase, we also received significant contributions from many other colleagues and stakeholders from several European
countries during the project as well as at the final Rome Conference and subsequent to it. We are greatly indebted to
all of them! A special note of thanks goes to our co-funders, the European Refugee Fund of the European Commission
and the Italian Ministry of Interior.
Opinions expressed in this report are those of the authors and do not necessarily reflect the views of the European
Commission, the Italian Ministry of Interior or the Organizations participating in the project. Moreover, the designations
employed and the presentation of material hereby contained do not imply the expression of any opinion whatsoever
on the part of the Organizations involved in the project concerning the legal status of any country, territory, city or
area, or of its authorities, or concerning its frontiers or boundaries. The sole responsibility for this material and its
production, therefore, lies with us, the authors.
Orso Muneghina Renos K Papadopoulos

Project Manager Research and Training Lead
Publisher:
International Organization for Migration, MRF Rome
Psychosocial and Cultural Integration Unit
Via Palestro 1, 00185 - Rome, Italy
Tel.: +39 06 87420967
Email: psytraining@iom.int
Internet: http://www.iom.int
All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any
means, electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the publisher.
›› List of Acronyms ‹‹
AAD Adversity-Activated Development

AS Asylum Seeker
ASPI Asylum Seekers’ Protection Index
ASPIS Asylum Seekers’ Protection Indices
ASVAS Asylum Seekers’ Vulnerability Scale
ASVUP Asylum Seekers’ Vulnerability Profile
ASVUP-P Asylum Seekers’ Vulnerability Profile - Provision
CARA Asylum Seeker and Refugee Reception Centre (Italy)
CGAS Children’s Global Assessment Scale
GAF Global Assessment of Functioning Scale
DPR Distressful Psychological Reaction
ECHR European Court of Human Rights
ERF European Refugee Fund
EVASP Enhancing Vulnerable Asylum Seekers’ Protection
ICCPR International Covenant on Civil and Political Rights
ICESCR International Covenant on Economic, Social and Cultural Rights
IOM International Organisation for Migration
MS Member State (of the European Union)
NGO Non-Governmental Organisation
OHS Ordinary Human Suffering
PD Psychiatric Disorder
PTSD Post Traumatic Stress Disorder
SHAEF Supreme Headquarters Allied Expeditionary Force
UNESCO United Nations Educational Scientific and Cultural Organisation
UNHCR United Nations High Commissioner for Refugees
›› Contents ‹‹
EXECUTIVE SUMMARY 4
I. EVASP: ENHANCING VULNERABLE ASYLUM SEEKERS’ PROTECTION 8
Background, aims and objectives of the EVASP project 9
II. THE VULNERABILITY OF ASYLUM SEEKERS: THEORETICAL FRAMEWORK AND LEGAL CONSIDERATIONS 11
The Concept of Vulnerability 12

The Asylum Seeker Experience 13
Asylum Seekers’ Vulnerability 17
Additional considerations 20
Legal considerations 21
Summary and key issues 23
III. RESEARCH METHODOLOGY 24
IV. FINDINGS 27
Factors of Vulnerability 28
Service Provision 31
V. CONCLUSIONS 37
VI. DEVELOPING INSTRUMENTS TO ASCERTAIN VULNERABILITY IN ASYLUM SEEKERS 41
VII. SUMMARY OF KEY ISSUES AND RELEVANT RECOMMENDATIONS 44
KEY ISSUE 1: Current Conceptualizations and assessments of vulnerability 45

KEY ISSUE 2: Addressing social marginalization and exclusion 46
KEY ISSUE 3: Ensuring greater convergence between entitlement and access to services 47
KEY ISSUE 4: Building capacity and coordination 47
KEY ISSUE 5: Building up sound evidence on effectiveness and responsiveness 48
BIBLIOGRAPHY 49
APPENDICES:
all appendices can be accessed at : www.evasp.eu/aspis/
Appendix A: ASPI
Appendix B: ASPIS
Appendix C: Italian National Report
Appendix D: Dutch national Report
Appendix E: UK National Report
Appendix F: Greek National Report
Appendix G: Research Protocol
Appendix H : Individual and Focus Group Questionnaires
Appendix I : Local Round Table Minutes
Appendix L : Trainers’ Handbook
Appendix M : Final Conference presentations
EVASP | Enhancing Vulnerable Asylum Seekers Protection | Transnational Report 2009-2010 3

›› Executive Summary ‹‹
This report contains the background, aims, theoretical framework, methodology, research activities, findings and
overall outcome of the project “Enhancing Vulnerable Asylum Seekers’ Protection” (EVASP) that was carried out in
Italy, Greece, England and the Netherlands during the period between January 2009 and August 2010.
The project was co-financed by the European Commission under the auspices of the European Refugee Fund programme
(ERF) and the Italian Ministry of Interior, along with the four implementing partners: the International Organization for
Migration (IOM) that acted as the project leader, University of Essex in the UK (through its Centre for Trauma, Asylum
and Refugees – that provided the research lead), the Medical Rehabilitation Centre for Torture Victims in Athens,
Greece, and the Defence for Children/Ecpat International in the Netherlands.
The background of the project is based on the ‘Green Paper on the Future of the Common European Asylum System’
(2007) that, inter alia, asserted that ‘it is imperative to take account of the special needs of vulnerable people’ as
‘it appears that serious inadequacies exist with regard to the definitions and procedures applied by Member States
for the identification of more vulnerable asylum seekers and that Member States lack the necessary
resources, capacities and expertise to provide an appropriate response to such needs’ (emphasis retained).
Consequently, the aims of the EVASP project were to:

1. To contribute towards the clarification of the definition of vulnerable asylum seekers (AS)
2. To contribute towards a better identification of the needs of vulnerable asylum seekers
3. To contribute towards an improvement of the way of addressing the needs of vulnerable asylum seekers, and
4. To disseminate widely the project findings, especially to relevant actors.
In order to achieve these aims, the project collected data from the following sources:
a. asylum seekers themselves (individual interviews and focus groups)
b. those who work with asylum seekers in various capacities (individual interviews and focus groups)
c. direct, in vivo, observations of relevant settings
d. relevant documents (reports, descriptions, guidelines etc) of relevant services, and
e. relevant theoretical papers from the literature.
The sample included a total of 186 asylum seekers and 334 workers/professionals providing general and specialist
services to asylum seekers in various settings (including reception centres). The methodology the project employed was
essentially qualitative, analysing data from semi-structured interviews, focus groups and active observations.
The theoretical framework of the EVASP project is based on Professor Renos K Papadopoulos’ approach that is typified
in the ‘Trauma Grid’ according to which the focus is not restricted on the negative effects but it also acknowledges
the existing strengths of individuals, families and communities (resilience) as well as their newly acquired strengths
that were activated as a direct result of their exposure to adversity (Adversity-Activated Development). In addition,
Professor Papadopoulos (who was the research and training lead of this project) drew up the research protocol,
developed the specific instruments (see below) and was responsible for the overall theoretical and professional side
of the project. Finally, he was responsible for developing the training package that was devised on the basis of the
findings of the project and for writing the Trainers’ Handbook for this training.
The EVASP project consisted of the following phases:
I. Preliminary consultations: Preliminary meeting in Paris in February 2009

II. Initial planning: Project partners’ consultation at a meeting (in Rome, March 2009)
III. Carrying out the research activities and preliminary analysis of findings: Project partners’
consultation at a meeting (in Athens, September 2009)
IV. Four national round-table meetings: where the preliminary findings were discussed with relevant
individuals and services in each country (October – November 2009)
V. Further elaboration of the findings: based on the round-table meetings’ feedback :Project partners’
consultation at a meeting (in Leiden, February 2010)
VI. Further elaboration of the findings: based on the overall feedback
VII. Planning and delivery of four training programmes: (one in each country) to national relevant
bodies (March and April 2010)
VIII. Further elaboration of the research findings and trainings based on the overall feedback:
Project partners’ consultation at a meeting (in Rome, July 2010)
IX. Final Project Conference in Rome (July 2010).
4 EVASP | Enhancing Vulnerable Asylum Seekers Protection | Transnational Report 2009-2010

More specifically, the EVASP project included the following main activities:
A. Research (January - November 2009):
»» Identify best practices for the different categories of commonly identified vulnerable groups by means of desk
research and a direct analysis of the situation in the reception centres and the hosting territory in each of the 4
countries.
»» Develop a set of guidelines for the reception, referral and integration of vulnerable AS.
»» Develop 4 National Reports and Transnational Comparative Report.
B. Capacity building (November 2009 - March 2010):
»» Identify best practices for capacity building already implemented at the local and national level in the selected countries.
»» Organize and implement 4 local round tables to connect all different actors involved in the reception and
treatment of vulnerable AS and facilitate exchange of information and best practices.
»» Develop a 2 days multidisciplinary training programme for general and specific operators at different stages of
reception and integration phases.
»» Pilot test training programme in 4 countries and develop a Capacity Building Programme including a Training
for Trainers Handbook.
C. Dissemination (March - July 2010):
»» Develop a project website (www.evasp.org) that includes all the relevant information, activities and findings of
the projects.
»» Develop a report in order to disseminate the outcomes of the completed project including recommendations for
the EU Member States.
»» Develop an Online Resource Centre collecting best practices in the field of psychosocial assistance to vulnerable AS.
»» Organize a final conference in order to discuss and disseminate the EVASP findings and further activate the
debate at EU level.
The main findings of the EVASP project can be grouped into two categories:
a. factors of vulnerability
b. service provision.
More specifically, the research revealed the following themes in relation to the main two categories of findings:
factors of vulnerability service provision

1. Loss of supportive networks and contacts 1.Communication issues
2. Isolation and powerlessness 2. Issues of Trust
3. Lack of meaningful engagement 3. Information issues
4. Racism and discrimination 4. Difficulty in identification
5. Uncertainty and fear about the future 5. Language and Cultural Awareness
6.Lack of coordination for holistic assessments of needs
7. Excessive workload
In fact, one of the main arguments that this research advances is that these factors of vulnerability and service provision
are inexorably related and one cannot be understood without the other. Indeed, this project claims that vulnerability
cannot be understood as a single entity or characteristic that belongs to one dimension of human functioning ‘within’
one individual, but it essentially is a relational phenomenon and can only have meaning in the context of the interaction
between the individual (a family, a community) and the services available. In other words, the degree of vulnerability
is directly dependant on the extent of available services. Moreover, it is proposed that vulnerability is a complex
and composite phenomenon of various ‘external’ and ‘internal’ dimensions and it consists of various clusters (called
‘dimensions’) and each cluster (‘dimension’) includes a number of constituent ‘categories’.

The ten dimensions that emerged as the most relevant, along with their categories are as follows:
DIMENSION categories
1.1. Physical safety
1.2. Financial security to enable, at least, survival (benefits/employment)
1.3. Education
1. External Circumstances:
1.4. Housing
1.5. Not being subjected to discrimination (gender, racial, ethnic, religious,
sexual orientation, etc)
2.1. Age
2.2. Gender
2.3. Family composition (e.g. divorced, reconstituted, active connection with
2. Family constellation:
extended family)
2.4. Family role (e.g. single mother, single head of household,
unaccompanied under age child, isolated elder, etc)
3. Physical Health
4. Psychological / psychiatric state
5.1. ethnic
5.2. racial
5.3. political
5. Community connections: 5.4. religious
5.5. ideological
5.6. cultural
5.7. regional (geographical), etc.
6. Wider society connections
7.1. language
7.2. education system
7. Degree of difference 7.3. cultural norms and practices
7.4. urban/rural living context
7.5. general lifestyle.
8. Type of journey
9. Legal position
10. Daily routine
On the basis of the EVASP research findings along with all the feedback received and responding to the needs of AS’s
workers to have a systematic way of ascertaining vulnerability in ASs, an attempt was made to develop appropriate
instruments for this purpose. To this end, four main instruments were developed at different stages:
1. The first one was the ‘Asylum Seekers’ Vulnerability Profile’ (ASVUP) which provided a graph enumerating the
identified dimensions of vulnerability and on the vertical axis the worker could mark the assessed degree of
vulnerability. ASVUP was formed in following two versions:
a. ASVUP: where the degree of vulnerability could be assessed according to five possible degrees on a scale
from 0 to 5,
b. ASVUP-P: where P stands for ‘Provision’; this version had the same scale of assessment (i.e. from 0 to 5) for
each dimension of vulnerability there were three sub-divisions: the first assessing the individual’s position, the
second assessing the degree of existing provision in relation to that dimension of vulnerability and the third
assessing the potential or planned future provision for that particular dimension of vulnerability. In this way, the
vulnerability was directly connected with the degree of actual and potential provision.
2. The second instrument was the ‘Asylum Seekers’ Vulnerability Assessment Scale’ (ASVAS). The intention here was to
make available a more rigorous way of marking the degree of vulnerability. For this purpose, ASVAS was identical
to ASVUP-P with the difference that instead of the marking of degree of vulnerability (on the vertical axis) being on
a 5 point scale, it was on a scale from one to 100, offering a more accurate way to assign a number. Indicative
criteria for each 10 points (i.e. ten such groups, from 0 to 100) of one dimension were developed to show
how such criteria could have been developed for all dimensions. However, later, it was felt, that such degree of
accuracy cannot possibly be feasible, given the nature of the phenomena addressed. Therefore, a new instrument
was developed, the ASPI.

3. The ‘Asylum Seekers’ Protection Index’ (ASPI) followed a different track and listed the ten final vulnerability
dimensions, along with some of their most important constituent categories in a way that allows the workers to
write in each box relevant notes and then mark their concern as a point on a continuous line from ‘No concern’ to
‘Maximum concern’ according to the evidence available to them and without using actual numbers or percentages.
This was felt more appropriate as such assessments cannot possibly be of that accuracy and they could create a
deceptive sense of definitiveness. It is for this reason that the word ‘index’ was introduced, to refer to a guiding
framework, to the fact that this instrument does not measure but it indicates and also provides a systematic listing
of the various dimensions and their constituent categories of vulnerability. A crucial innovation of ASPI was the
introduction of positive factors in relation to each dimension of vulnerability, thus avoiding to pathologise asylum
seekers that is intended to protect; and it also for this reason that the word ‘protection’ was introduced to its
name.
4. Finally, following the Rome Conference and all the feedback received, the ‘Asylum Seekers’ Protection Indices’ was
developed (ASPIS). ASPIS is an enhanced version of ASPI in that it includes a summary of all the lines of concern
of all the identified dimensions of vulnerability on one page for easy reference and, importantly, it also includes
a ‘Vulnerability Grid’ which enables the AS worker to identify the wide range of responses to vulnerabilities by
individual ASs, their families and their communities by identifying not only the negative effects but also (a) their
existing strengths that survived their vulnerability and (b) their newly acquired strengths that were activated as a
direct result of their exposure to vulnerability, i.e. Adversity-Activated Development. The Vulnerability Grid is a
modification of the Trauma Grid and it offers a more complete instrument for these purposes. The word ‘index’
was changed to its plural form ‘indices’ to refer to the fact that ASPIS includes more than one index, i.e. also the
Vulnerability Grid.
Fortuitously, ‘Aspis’ is also the ancient Greek work for ‘shield’, so it was considered appropriate for an instrument that
is intended to protect and, indeed, shield asylum seekers so that their rights are not ignored.
Ultimately, ASPIS aims to offer a systematic framework to indicate not the asylum seeker’s vulnerabilities
but the vulnerable positions within which he or she is located by a series of factors and circumstances
during a given period of his or her life.
What emerged clearly from the entire EVASP research was that it is not possible to measure vulnerability in asylum
seekers in an abstract way and in a vacuum. Hence the conclusion that although it is not possible to develop an
instrument to assess this type of vulnerability, indeed it is possible to develop an instrument that indicates, points out in
a systematic way the various vulnerable positions that AS periodically go through as a result of the various factors that
ASPIS attempts to indicate. It is recommended that ASPIS, as well as the other instruments developed by this project,
are used in a creative way and adapted to the requirements and remit of each service that uses them.
The feedback to the whole project has been positive and extremely encouraging. Already, in some countries major
services and organisations are not only using the specific instruments that the EVASP developed but they report the
benefits of having such a systematic framework available to them. Some of these advantages include the possibility
(for the very first time) to have uniformity across services in terms of grasping the elusive concept of vulnerability,
ascertaining the AS’s needs and addressing them more coherently, as well as benefiting from the resulting inter-agency
collaboration in terms of sharing practices and tasks.
Finally, the concluding Project Conference in Rome provided a most fruitful forum for the beginning of the articulation
of the EVASP findings in terms of policy development at national and European levels.

I. EVASP: ENHANCING VULNERABLE ASYLUM SEEKERS’ PROTECTION

›› Background, aims and objectives of the EVASP project ‹‹
The project Enhancing Vulnerable Asylum Seekers’ Protection” (EVASP) was carried out in Italy, Greece, England
and the Netherlands during the period between January 2009 and August 2010. It was co-funded by the European
Commission under the auspices of the European Refugee Fund programme (ERF) and the Italian Ministry of Interior,
along with the four implementing partners: the International Organization for Migration (IOM) that acted as the
project leader, University of Essex in the UK (through its Centre for Trauma, Asylum and Refugees – that provided the
research and training lead), the Medical Rehabilitation Centre for Torture Victims in Athens, Greece, and the Defence
for Children/Ecpat International in the Netherlands.
The European Commission intends to establish a ‘Common European Asylum System’ (CEAS) and as part of the
preparation for this, produced (in 2007) a ‘Green Paper on the Future of the Common European Asylum System’. One
of the important assertions (in point 2.4.1.) of the Green Paper was that ‘it is imperative to take account of the special
needs of vulnerable people’. It stated that ‘it appears that serious inadequacies exist with regard to the definitions and
procedures applied by Member States for the identification of more vulnerable asylum seekers and that Member States
lack the necessary resources, capacities and expertise to provide an appropriate response to such needs’.
Moreover, it specified that ‘It appears therefore necessary to prescribe in more depth and detail the ways in which the
special needs of the most vulnerable asylum seekers should be identified and addressed in all stages of the asylum
process. This kind of comprehensive approach would focus in particular on issues such as regulating more precisely
what constitutes adequate medical and psychological assistance and counselling for traumatised persons, victims of
torture and trafficking and a proper identification and response to the needs of minors, especially unaccompanied
minors; the development of appropriate interview techniques for these categories, based inter alia, on cultural, age
and gender awareness and inter-cultural skills’ and emphasised that ‘ways need to be found for enhancing national
capacities, by reaching out to all actors involved in devising and implementing measures designed to address the
special needs of more vulnerable categories of asylum seekers and refugees – such as professionals in the fields of
health and education, psychologists, interpreters, linguistic experts, cultural anthropologists, lawyers, social workers
and NGOs. This could involve specific EU-wide training programmes for such professionals, the establishment at EU
level of mechanisms (including databases and other information exchange tools) for the dissemination of best practices
at operational level or even the establishment of common standards regarding the qualifications and skills required
and, possibly, of a monitoring mechanism aimed at ensuring high standards of quality in services provided to more
vulnerable people’ 1.
The EVASP project was formulated as a direct response to this need expressed in the Green Paper.
PROJECT AIMS
Based on the above, the project aims were

1. To contribute towards the clarification of the definition of what constitutes vulnerability in asylum seekers
2. To contribute towards a better identification of the needs of vulnerable asylum seekers
3. To contribute towards an improvement of the way of addressing the needs of vulnerable asylum seekers, and
4. To disseminate widely the project findings, especially to relevant actors.
PROJECT OBJECTIVES
In order to achieve the above aims, the project developed the following objectives:
1. With reference to the definition of vulnerability in asylum seekers

a. To collect information and experiences from the four project-participating countries; more specifically,
I. to research relevant existing documentation, using methods of secondary (‘desk’) research
II. to elicit experiences, views and ideas from relevant service users, using methods of empirical research
III. to elicit experiences, views and ideas from relevant service providers, using empirical methods of research,
IV. to collect observations from relevant settings, using empirical methods of research
b. To analyse and discuss the findings (i.e. how the vulnerability of asylum seekers is understood and defined) in
the context of (a) relevant theoretical approaches and (b) other existing practices elsewhere
c. to propose an improved way of defining ‘vulnerable asylum seekers’.
1 Emphasis retained.

2. With reference to the identification of needs of vulnerable asylum seekers
a. To collect information and experiences from the four project-participating countries; more specifically, to collect
I. relevant existing documentation, using methods of secondary (‘desk’) research
II. experiences from relevant service users, using methods of empirical research
III. experiences from relevant service providers, using empirical methods of research, and
IV. observations from relevant settings, using empirical methods of research
b. To analyse and discuss the findings (i.e. how the needs of vulnerable asylum seekers are identified) in the context
of (a) relevant theoretical approaches and (b) other existing practices elsewhere, and to propose an improved
way of how to identify the needs of vulnerable asylum seekers.
3. With reference to the addressing of the needs of vulnerable asylum seekers

a. to collect information and experiences from the four project-participating countries; more specifically, to collect
I. relevant existing documentation, using methods of secondary (‘desk’) research
II. experiences from relevant service users, using methods of empirical research
III. experiences from relevant service providers, using methods of empirical research, and
IV. observations from relevant settings, using methods of empirical research
b.To analyse and discuss the findings (i.e. how the needs of vulnerable asylum seekers are addressed) in the
context of (a) relevant theoretical approaches and (b) other existing practices elsewhere
c. To identify gaps in the provision of an improved way to address the needs of vulnerable asylum seekers
d. To develop a training programme that addresses these identified gaps
e. To pilot this training programme, monitor the experience and collect feedback, , using methods of action
research (intervention / training research)
f. To develop a proposal (based on the overall findings of this project) that recommends improvements in the
a. theoretical conceptualisation of the problem,
b. provision of services,
c. staff training (capacity building).
4. With reference to the dissemination of findings, to maintain

a. ongoing communication with all project partners and stakeholders
b. a central project website that will include the main information and ongoing update of the project as well as
relevant links; in addition to produce three Newsletters outlining the progress of the project.
c. an Online Resource Centre that includes relevant information from existing practices in the four project-participating
countries.
d. To organise four local (one in each country) stakeholders’ roundtables (in September 2009) where the project
findings (up to that time) are presented and discussed. This is a forum for all relevant stakeholders to meet,
exchange information, views and experiences and develop a closer working network, and
e. To organise a final EU-wide conference (in Rome, July 2010) to present and discuss the findings, receive feedback
and plan specific action.
f. to prepare various presentations and publications based on this project.

II. THE VULNERABILITY OF ASYLUM SEEKERS: THEORETICAL
FRAMEWORK AND LEGAL CONSIDERATIONS

In this section, the concept of vulnerability is examined, first in general and then in the context of the asylum seekers’
experience. This examination is based on the literature review that was carried out in order to locate the EVASP project
actual empirical research of data collection on the relevant theoretical trends.
For this purpose, the asylum experience is investigated in order to identify its uniqueness and to discern the specific implications
these unique features have for the understanding of vulnerability in asylum seekers. The legal considerations pertaining to the
vulnerability of asylum seekers is then presented and discussed. It becomes evident that the legal perspective is deficient and
does not have the richness to match the complexities that the various theoretical approaches to this topic have.
At the end of this section, the main considerations that emerge in relation to vulnerability in asylum seekers are identified.
The importance of the question of vulnerability in asylum seekers in Europe is now well recognised. This is party due to
the recognition of the effect that past experiences of asylum seekers can have on their mental health, including conditions
such as the Post Traumatic Stress Disorder (PTSD); in addition, there is a growing awareness that the asylum process
itself may act as a stressor and can lead to deterioration in the mental as well as overall wellbeing of asylum seekers.
However, these are by no means the only conditions that lead to vulnerability. The European Union now distinguishes
between vulnerable and non-vulnerable asylum seekers, emphasising the need to engage sensitively with vulnerable
asylum seekers and, in line with the most recent EU directives, member states are introducing legislation and policies
designed to improve the reception of vulnerable asylum seekers, specifying the particular types of asylum seekers who
should be considered as vulnerable. To this effect, various categories have been introduced with a view to improving the
services and treatment of this type of asylum seeker.
›› The Concept of Vulnerability ‹‹
To begin with, what is the meaning of vulnerability? Vulnerability is a particularly slippery term and dependent on many
different factors. The Oxford English Dictionary defines ‘vulnerability’ as ‘The quality or state of being vulnerable, in various
senses’ and, in turn, ‘vulnerable’ as ‘susceptible of receiving wounds or physical injury’. This is the original meaning of
being vulnerable, i.e. vulnerability is understood in its primary sense of physical and bodily harm, based on the Latin word
‘vulnus’ meaning ‘wound’. Then, by extension and in general, vulnerability refers to the propensity to suffer damage or loss
along with a difficulty in recovering from it. Another way of understanding vulnerability is in terms of the tendency of an
individual to get hurt, harmed or attacked easily due to a lack of supportive and protective factors. Often, vulnerability is
understood in terms of risk and exposure. This means that the level of vulnerability is dependent on the degree of risk that a
person is exposed to as a result of being exposed to a certain set of conditions and circumstances.
Vulnerability has been examined by various researchers in relation to its location, i.e. the person/s or group/s that
is/are vulnerable, its contributing factors, i.e. the conditions that create vulnerability in people, its presentation
or manifestation, i.e. the way that vulnerability is experienced by a person and the way it is seen by others, and
its theoretical perspectives, i.e. the underlying theoretical and conceptual assumptions and models that inform an
approach to issues of vulnerability. This means that the subject matter is vast and, therefore, it is imperative to create
some feasible contours within which to examine this concept meaningfully.
Papadopoulos (2010) proposed that vulnerability should be understood as a product of a combination of at least four
groups of factors:
a. the state or condition of the subject of vulnerability (i.e. a person or a group),

b. the underlying causes that create a particular weakness in the subject,
c. the precipitating factors that trigger off the onset of vulnerability, and
d. the surrounding circumstances (conditions as well as people) that may affect positively or negatively the
damaging effect of the triggering factors.
Ultimately, the question needs to be asked, ‘vulnerability to what?’ because there are as many types of vulnerability as
there are spheres of human activity, e.g. social, financial, medical, psychological, educational, etc. This means that it
is possible that persons may be vulnerable in relation to one facet of their lives but not vulnerable in relation to other
facets, e.g. an asylum seeker may be vulnerable in terms of social exclusion by the receiving society but not vulnerable
in terms of his physical health, although this does not mean that vulnerability in one sphere of one’s life may not affect
other spheres. In all cases, vulnerability would involve a combination of factors and it is not based on just one set
of characteristics of only one actor. Consequently, in principle, vulnerability could be counteracted by awareness
of all the contributing factors, by taking action to minimise their potentially detrimental effects and by strengthening
everything that contributes to weakening these effect.
However, in order to examine further the specific meaning of vulnerability in the context of asylum seekers, it would
be important to first consider the very uniqueness and basic characteristics of this experience.

›› The Asylum Seeker Experience ‹‹
Phases of the asylum seekers’ experience
When persons are forced to flee from their homes and move to a new country seeking asylum, understandably, undergo a
considerably wide variety of experiences. The changes are stupendous and the persons are affected in almost every single
aspect of their lives. Hardly any facet of their lives is remains the same. Consequently, they tend to become overwhelmed
by all these new unpredicted experiences, by this bewildering turmoil finding it difficult not only to deal successfully with
everything but also to even understand what has befallen them and differentiate their experiences and their implications.
However, like with any other change, new opportunities and new gains may also result from such situations. It is important
to immediately emphasise that when others come into contact (directly or indirectly, e.g. informed by the media) with the
affected people, they equally find it difficult to comprehend and digest the enormity of losses and changes and they themselves
also tend to become overwhelmed. Workers with asylum seekers, however professional they may be and regardless of their
training, still as human beings are deeply affected when exposed to the plight of these persons. The impact on the workers
should never be underestimated because it manifests itself in many different ways, often unexpected.
One way of grasping the asylum seekers’ experience is to identify its various stages. As early as 1975, Keller proposed
that the refugee2 experience is understood as a phenomenon consisting of several discrete stages which he identified as
follows: “perception of a threat; decision to flee; the period of extreme danger and flight; reaching safety; camp behaviour;
repatriation, settlement, or resettlement; the early and late stages of resettlement; adjustment and acculturation; and, finally,
residual states and changes in behaviour caused by the experience” (cited in Stein 1981, p.321). In a comparable way,
Papadopoulos (2001a, 2001b, 2002) argued for the usefulness of considering four main phases of the asylum seekers’
experience (within which Keller’s specific moments are included) emphasising the importance of appreciating that each one
of them has its own unique set of external as well as internal (psychological) conditions and implications. Accordingly, he
distinguished the four following phases:
a. ‘Anticipation’ during which persons consider the impending catastrophe and attempt to develop plans to
minimise its destructive effects,
b. ‘Devastating Events’, when persons are experiencing the actual violence against them that forces them to leave
their homes,
c. ‘Survival’ when persons having fled their home are now safe from physical violence but live in temporary
accommodation often under most difficult conditions and in considerable confusion in relation to the past, as
well as uncertainty about the future; and
d. ‘Adjustment’ when, now re-located in a new country as asylum seekers, persons are going through the endless
efforts and procedures to secure their refugee status whilst at the same time attempt to start their new lives,
struggling to fit in their new environment (educational, professional, social, cultural, psychological, etc) whilst
also endeavouring to process all their past experiences and address all their losses.
Needless to say, these phases are not always so distinct and may overlap, the one running onto the other; also, depending
on the specificity of each given situation, additional phases may be equally or even more important. Nevertheless, it is most
useful to differentiate these four phases for at least the following reasons:
- it helps asylum seekers to acknowledge the totality of their experience assisting them to become aware and account
for of all facets and details that affect them, instead of distorting their experience by overemphasising one phase and
ignoring other phases and facets
– it helps those working with them become aware of the wide range of hardships asylum seekers had endured as well
as the skill and resilience involved in having survived them, so that they can understand them better and consequently
recognise more accurately their varied needs
- it helps the better planning of services as it can be based on a more informed understanding of the totality of the
phenomena involved.
2In this report, the term ‘refugee/s’ is used in its generic meaning to also include ‘asylum seeker/s’ unless it is in contexts that refers particularly
to those asylum seekers that were granted asylum in another country. More specifically, expressions such as ‘the refugee experience’, the ‘refugee
condition’, the ‘refugee predicament’ always refer to the generic situations that encompass all the phases one’s experiences from before fleeing
their homes to the struggle for adjusting in the new country before and even after being granted asylum. Similarly, when referring to a ‘refugee
worker’ those who work with asylum seekers are also included.

Hierarchy of human needs
Understandably, the entire spectrum of these phases encompasses a multiplicity of dimensions of human experience
that also impact and determine to a significant degree the asylum seekers’ needs. Inevitably, these needs are connected
with a wide variety of dimensions of human life, ranging from the more basic ones to the most advanced, on the top
of Maslow’s hierarchy of needs. To be reminded, the American psychologist Abraham Maslow, in 1943, identified
five groups of human needs that he ranked hierarchically. These are
1. Physiological needs that are connected with one’s survival, e.g. for urgent
medical attention, physical security and safety, shelter, food, water, etc.
2. Safety and Security Needs that are connected with one’s comfort, e.g.
Peak
basic freedom from pain, thread, terror, etc.
Experiences
3. Social, and emotional needs that are connected with one’s wellbeing
e.g. to have friends, have a family, to love and be loved, etc. Self-Actualization
4. Self actualisation and esteem needs that are connected with the sense
of self-respect, with one’s need to express one’s creativity, fulfil one’s Psychological Needs
potential, exercise one’s talents, develop a unique meaning for one’s
existence, etc, and Safety Needs (comfort)
5. Self actualisation needs, that are connected with peak experiences,
states of transcendence and experiences beyond one’s everyday Basic Needs (survival)
routines and obligations.
Although all these needs are important to every human being at every given time of one’s life, some of them are more
important than others during each one of the phases of the refugee experience. Consequently, those who are entrusted
with attending to the asylum seekers’ needs should be aware of these priorities especially given the limitations of resources.
Nevertheless, the pragmatic division of the asylum seekers’ needs into hierarchies and prioritisations does not mean that
each asylum seeker, like any other human being, does not have the whole range of needs at all stages. Therefore, it should
be remembered that their needs are multidimensional and multifaceted and, consequently, their vulnerability is equally
complex and directly dependent on the accurate recognition of their needs and appropriate means of meeting them.
‘Nostalgic disorientation’
The refugee experience has some shared characteristic features with other similar phenomena such as bereavement,
immigration, and other situations where it involves unexpected and radical upheavals, e.g. loss of or changes in
employment, natural disaster. However, in its entirety it is not similar to any other phenomena of human life and it is quite
unique. This means that in order to grasp it, people in general but also specialist researchers resort to borrowing views
and theories that belong to other similar phenomena. For example, the usual approach mental health professionals adopt
in relation to refugees is to consider them as suffering from some form of psychological trauma. This is understandable
because they compare the refugee experience to the closest other phenomena that they could consider comparable, e.g.
experiences in combat, accidental death, etc. Papadopoulos (2002) argued that theories of psychological trauma have
been used to understand the refugee experience because no other existing psychological understanding could fit in with
the uniqueness of these phenomena. Consequently, he endeavoured to identify the uniqueness of the refugee experience
and proposed that the ‘involuntary loss of home’ is the most characteristic feature of this phenomenon. Therefore, his
research followed the direction of examining the psychological meaning and consequences of having a home and of
losing involuntarily one’s home. This led him to formulate the proposal that what is unique about the refugee experience is
that, regardless whether refugees are traumatised or not, all of them experience what he termed ‘nostalgic disorientation’
which he argued is the direct result of losing involuntarily one’s home (Papadopoulos, 2002). Asylum seekers and
refugees do not constitute any one coherent diagnostic category of psychopathological characteristics, but the fact that
they all have lost their homes involuntarily makes them share a deep sense of nostalgic yearning for restoring that very
specific type of loss. The ‘nostalgic’ characterisation of this particular disorientation refers to the original meaning of the
word nostos that in classical Greek means ‘the yearning for home’ and nostalgia is the pain (algos) that accompanies
the feeling of pining to return home.
To understand this condition as a loss or disorientation or nostalgia in their ordinary psychological sense is to miss the
rich meaning and complexity that the involuntary loss of home entails under refugee conditions. Papadopoulos’ term
‘nostalgic disorientation’ encapsulates the totality of all the dimensions of home, i.e. physical, geographical, social,
cultural etc. More specifically, this totality captures three sets of binary elements that he identified as central to the image
of home,
a. home implies two diametrically opposite directions, i.e. home refers to both the locus of our origin as well as the
end goal, the points of both the beginning and the end i.e. the desired position of the achievement of our goals; the

cradle and the grave (the ‘last home’), thus involving both a prospective and retrospective movement,
b. the double signification of home as both ideal and real; insofar as the image of home tends to be idealised
whereas our actual homes cannot be ideal but are real, i.e. they include positive and negative characteristics, our
understanding of home tends to be a combination of the real and ideal dimensions, the tangible and intangible,
the physical and imaginary with unpredictable consequences, and
c. the two successive phases of the homecoming process, i.e. first, arriving physically but then still needing to (re-)
connect and (re-)establish all relevant relationships within home, with persons, spaces and objects and with
everything that they signify; thus, the ‘return’ requires the additional phase of re-integration that also involves
reconnecting with the past in the present that also has a future.
Refugees sense the impact of the loss of home and experience a unique sense of disorientation that is very elusive yet
deep, pervasive and with acute effects. Matters become worse because it is difficult to pinpoint the clear source and
precise nature of this loss, due to its complexity and polymorphous multidimensionality. The inability to grasp it creates
further discomfort and deepens the disorientation and excites further the nostalgic yearning for a stable sense of ‘psycho-
ecological settledness’.
This ‘psycho-ecological settledness’ is a product of the unique combination and fit between the ‘tangible’ elements of our
identity and the ‘intangible’ elements of our identity which become disturbed when one loses their home involuntarily, as
refugees do. The ‘tangible’ elements include: Gender, age, physical and psychological characteristics, profession and
employment, family status, financial status, political and ideological affiliation, religious affiliation, activities and hobbies,
culture, nationality, family, body, etc. The ‘intangible’ elements we take for granted, we are not aware of them as they
form the basis on which the tangible elements fit. These include at least three groups of factors referring to (a) sense
input, (b) sense of belonging and (c) familiar ways of relating and communicating. The ‘sense input’ factors include all
the characteristics of the environment that we relate in an intimate way and got used to and consider them as part of our
own ‘home’ that contribute (often in a non-conscious way) to our sense of stability and ‘psycho-ecological settledness’.
Examples of these are Visual (nature, architecture, people, artefacts); Auditory (sounds from nature or human-made,
human voices, language, music); Olfactory (smells we get accustomed to from nature or human-made); Gustatory (the
used tastes of food, drink, air, etc); Tactile (our used sense of touch in various contexts, e.g. clothes and other familiar
objects); Temperature (the sense of cold or heat that we are accustomed to); Aesthetics (overall sense of what is aesthetic
and what is not). Sense of belonging: the sense that we belong to a home, to a family, community, culture, to our
body, to a country (that exists and we have access to it). The last group of factors that contribute to our sense of stability
are the specific ways we are accustomed to relate to different groups of people, the degree of intimacy and the ways we
convey it as well as the ways of we express various types of emotions, approval, disagreement, etc.
Papadopoulos (1997 and 2002) understood this set of ‘intangible’ elements of our identity as forming a ‘mosaic
substrate of identity’ because each element on its own may not be of relevance but in combination with the others, much
like a mosaic, form a coherent pattern, a design that accommodates all the elements which are part of our identity
but which we become aware of usually when they are absent, when we lose them or when their order and design is
disturbed and changed.
When refugees lose their homes they also tend to lose the sense of settled familiarity that enables them to ‘read life’,
i.e. to lead life with a fairly stable sense of predictability (e.g. what is dangerous and what is not). This disturbance of
the ‘psycho-ecological settledness’ creates a mixture of consequences that are difficult to identify clearly. They include
a feeling of an inexplicable gap, a sense of unreality, unsafety, unpredictability, lack of familiarity, lack of confidence,
pervasive anxiety, disorientation, frozenness.
It is important to appreciate that the ‘nostalgic disorientation’ that refugees experience is not a psychiatric disorder,
but a real ‘disorienting’ experience with a felt discomfort in varying degrees. Moreover, nostalgic disorientation has
a cyclical effect that tends to deepen this discomfort in so far as the nostalgic aspect of the disorientation worsens the
disorientation and, in turn, the disorientation activates further nostalgic yearning for a settled state of being. The greater
the disorientation, the more the nostalgic yearning for a return to an assumed past and a settled state is intensified, and
the more intensified the nostalgic yearning is, the greater discomfort is produced by the increased disorientation.
Thus, the main point here is that the involuntary loss of home refugees experience is not only about the conscious loss
of the family home with all its material, sentimental and psychological values, but this loss creates a more fundamental
psychological disturbance of their whole sense of one’s ‘psycho-ecological settledness’; this, in turn, activates a ‘nostalgic
disorientation’ which is a much more fundamental and primary disturbance than the sense of losing tangible possessions
or social positions – it is a loss that affects refugees deeply yet in a way that is difficult to grasp clearly its nature. It is for
these reasons that it is an important and unique condition that those who work with refugees should be aware of.

‘Refugee Trauma’
‘It is logical to assume that involuntarily losing one’s home is a difficult experience that may have adverse psychological
implications. However, the term ‘refugee trauma’ implies something more than that – it presupposes that all those who
experience this kind of adversity will become psychologically traumatized. This presupposition is not valid because we
know that each person perceives, digests and responds to external situations in a highly unique and individual way,
and not all refugees are traumatized in a psychological or, even less so, in a psychopathological sense’ (Papadopoulos,
2007, p. 303-304).
Trauma is a medical term that refers to an injury or wound, the condition that is created when the skin is broken. In
Greek, trauma means wound, injury, and it comes from the verb titrosko – to pierce. Thus, the original meaning of trauma
is the mark, the injury that is left as a result of the skin being pierced. Investigations into the etymology of the word
trauma (Papadopoulos 2000; 2001a; 2002, 2007) revealed that titrosko comes from the verb teiro which means ‘to
rub’ and, in ancient Greek, had two connotations: to rub in; and to rub off, to rub away. Therefore, trauma is the mark
left on persons as a result of something being rubbed onto them. Then, in so far as the rubbing is of two kinds, there
are also two different outcomes: from ‘rubbing in’, the result would be an injury or a wound; and from ‘rubbing off’ or
‘rubbing away’, the result would be the cleansing of a surface where there were previous marks, like when we use an
eraser, a rubber to erase writing on paper. With reference to refugees, the powerful impact of the four phases that can
produce traumatising experiences in them (i.e. anticipation, devastating events, survival and adjustment) would result in
psychological injury to varying degrees as well as (i.e. in addition to the distress) a re-viewing and re-evaluating their
lives. Invariably, people who survive adversity reflect (consciously or unconsciously) on the meaning and purpose of their
lives comparing somehow their ways of living before and after their exposure to that adversity. It is in this sense that the
trauma also has a ‘rubbing off’, or ‘rubbing away’ effect, i.e. in the erasing previously held positions (consciously or
unconsciously) about the meaning and values of life as well as their priorities in life. This effect has the potential result of
renewal and re-focusing on what is important in life that may lead to constructive revitalisation of the person’s activities
and overall stance in life. It should always be remembered that although these two outcomes are antithetical, in fact both
occur and each person is affected in both ways to varying degrees (consciously or unconsciously).
‘This means that, paradoxically, despite their negative nature, devastating experiences (regardless of the degree of
their harshness and destructive impact) may also help people reshuffle their lives and imbue them with new meaning
(Papadopoulos, 2007, p . 305).
The key argument here is that theories of psychological trauma have been used to understand the refugee experience
because no other existing psychological understanding could fit in with the uniqueness of these phenomena. Although
Papadopoulos suggested the specific psychological condition of ‘nostalgic disorientation’, the main psychological
discourse on refugeedom is dominated by the trauma theory and, more specifically, the PTSD approach. Consequently,
the emphasis of the understanding of the refugee experience has been on the pathological, negative side of the wide
spectrum of responses to trauma. However, as it has been indicated above, the traumatising experiences refugees
undergo also result in positive outcomes and this should not be forgotten.
What is of paramount importance here is to appreciate the serious difficulty in acknowledging any positive effects from
clearly brutal, reprehensible and condemnable actions such as the ones that lead persons to abandon their homes and
become refugees. There is an understandable reluctance to attribute anything positive to a clearly negative situation.
However, at the same time, it should not be forgotten that additional violence is inflicted on refugees if professional see
them exclusively in a pathological light and without acknowledging that they retain some of their positive characteristics and
they also gain from their exposure to adversity. Indeed, this is a most delicate situation that requires the utmost sensitivity
on the part of those who work with asylum seekers and refugees. Therefore, it is essential that an appropriately balanced
perspective is held that whilst we unequivocally condemn all the perpetrators and all the conditions that force citizens
become refugees at the same time we do not pathologise those we want to help and deprive them of their human dignity.
Political vs psychological approaches
There is a tendency among workers of international organisations to view the refugee phenomenon in purely political terms.
For example Hein a sociologist, observed that “Research on refugees accumulated with minimal conceptual elaboration:
Immigrants constituted an economic form of migration, refugees a political form” (1993, pp.43-44),. Lawyers, for example,
tend to interpret refugees in terms of the Geneva Convention or other legal frameworks. Mental health professionals on
the other hand have tended to approach refugees through a psychological (in fact, usually, a psychopathological) prism.
Brik et al note that “It is a generally accepted conclusion...that refugees constitute a high-risk group as far as mental health
is concerned, due to the mere fact that they have been forced to emigrate”(1988, p.179) . The perception that refugees
suffer from mental health problems has been linked to, and strongly reinforced by the introduction of post-traumatic stress
disorder (PTSD) as a diagnostic category in the Diagnostic and Statistical Manual of Mental Disorders (DSM) issued by

the American Psychiatric Association. PTSD was first introduced in 1980 in the third version of the DSM to account for the
psychological distress experienced mainly by US soldiers fighting in Vietnam. Then, it was considered useful in grasping the
specific types of distressful reactions experienced by survivors of other political violence and natural disasters (as well as of
child sexual abuse). Then, since the end of the 1980’s decade it became particularly popular and was used extensively in
the humanitarian field ever since, at times and in places, dominating over any other approaches and considerations. With
specific reference to asylum seekers, Ryan et al argued characteristically that this over-domination of the PTSD discourse in
this field has led to increased levels of perceived trauma among them refugees and the formation of the general perception
that ‘refugees were very ‘sick’ people, with prevalent rates of PTSD and depression as high as 86 per cent and 80 per cent
respectively among one community sample of Cambodian refugees’ (Carlson and Rosser-Hogan 1991 cited in Ryan et al
2008, p.2).
It is important to consider the impact of the PTSD discourse on asylum seekers as this inevitably skews the perception of them
by the various services and organisations that work with them and affects directly they way their vulnerability is construed.
This is not to say that some refugees are not psychologically vulnerable. But it is important that the totality of the experience
of asylum seekers is taken into consideration and not just their ‘trauma’. Papadopoulos (2001) argues that it is impossible
that a purely medical, psychological or political approach to grasp the totality of their experience; instead it should be held
in mind that the refugee experience involves several overlapping dimensions: political, ethical, ethnic, religious, financial,
sociological, ecological, to name but a few. Consequently, their needs are equally multiple and diverse and more attention
should be paid to develop approaches that encompass this totality. Ryan et al suggest that the strong emphasis on trauma
has meant, for example, that mental health professionals have ignored ‘the actual migrant adaptation process or the impact
of the host social environment on the psychological well-being of refugees’. (2008, p.2)
›› The Asylum Seeker Vulnerability ‹‹

Having examined the various characteristics of the asylum seekers’ experience, it is now possible to consider vulnerability
issues in relation to asylum seekers. In the light of the above discussion, vulnerability can be understood in the context of (a)
the four stages of the refugee experience, (b) the hierarchy of human needs, (c) Nostalgic Disorientation, (d) refugee trauma,
and (e) the continuum between political and psychological discourses. Moreover, it is now possible to take this discussion
further and investigate some of the relevant consequences of this examination.
Construction and Co-construction of vulnerability
When considering the vulnerability of asylum seekers, a key aspect is the specific type of relationship they have with the
professionals that work with them. It is for this reason that this report has dedicated a specific section (in Chapter 4) to the
modalities of interaction observed across the four countries participating in the EVASP project between asylum seekers and
their workers. What is relevant here is highlighting the fact that this focus on interaction can help to bring into relief systemic
problems that may be involved over an extensive period of time. Papadopoulos (2008) draws on his work in the Dadaab
refugee camp in Eastern Kenya to show how reflecting on the type of psychological processes that occur in the interaction
between staff and asylum seekers can deepen our understanding of the refugees’ vulnerability and thus improve the care
provided to them. He offers an example of his observation according to which the refugees and their workers got caught
up in a circular way of perceiving in a negative way each other. On the one side, refugees perceived their workers as being
too detached and not interested in them. On the other side, the workers perceived construed the refugees as ‘greedy’ and
as having endless demands that they always felt that they were never satisfied. In accordance with the systemic principle
of circular causality, the refugees became more demanding in response to their perception that the workers were detached
and, in turn, the workers became more ‘detached’ in response to their view that the refugees were ‘greedy’ (Papadopoulos,
2008, p. 13). This example demonstrates that workers and asylum seekers can collude in the co-construction of particular
identities, fixing each other into positions that they may not correspond correctly with the reality thus exacerbating the
asylum seekers’ vulnerability.
Another example from the same field work in Dadaab, was Papadopoulos’ observation that staff expressed frustration at the
fact that the refugees in the camp were obsessed with maintaining a ‘victim’ identity and were not available to interact with
them in any way other than as victims. However, he also noted that within the context of that camp, where refugees were
powerless and helpless in many respects, this ’victim’ identity seemed to be the most readily available one to them especially
if they felt that such an identity would secure more benefits to them (Papadopoulos, 2008, p.13). In a comparable way,
asylum seekers in general, are easily tempted to adopt the ‘vulnerability’ identity due to their powerlessness throughout the
asylum process hoping that this will improve their chances of obtaining the assistance and support they require.
Moreover, views held in society in general regarding asylum seekers affect directly the way workers and other professionals
tend to view refugees. Currently the dominant notion is one of vulnerability, victimhood or poverty; however this has not

always been the case. Indeed, in the last years of World War II and the immediate post-war years, displaced people
in Europe were viewed purely in military terms and their workers were not therapists but army personnel working for the
Displaced Persons Branch of the Supreme Headquarters Allied Expeditionary Force (SHAEF). The army viewed refugees
purely through a military perspective even recognising their benefits “for useful service behind the combat lines” (Proudfoot,
1956, p.107). Arendt (1973) in her study of totalitarianism examined the displacement of people through the prism of
ideological forces such as xenophobic national states, examining the political rhetoric that had the effect of demonising or
criminalising refugees. Modern day examples of this type of construction is the ‘Tampa Crisis’ which shows how Australian
military action against asylum seekers was justified through a discourse based on nationalism (O’Doherty & Augoustinos,
2008). Inevitably, these social and ideological influences will have an effect on professionals who work with asylum
seekers. Will they see themselves as protecting ‘vulnerable’ asylum seekers or protecting the ‘vulnerable’ nation? If a host
society is generally hostile to asylum seekers and their needs, the worker can see him/herself as a special spirited person
within his/hr society, as a type of hero. Or alternatively s/he could aim to protect the state and its resources. The attitudes
of mental health professionals can be related to social factors in which accounts of asylum seekers are created in every day
discourse. It is important for professionals to examine wider political and social forces that pattern our constructed attitudes
to asylum seekers
The Victim triangle and Victim Identity
Papadopoulos et al (2007) draw on Karpman’s (1968) triangular framework of Persecutor, Rescuer and Victim to
show how a typical relationship between the professional and asylum seeker may develop. First, the professional
views the asylum seeker as a Victim and provides care. In turn, the refugee sees the professional as the Rescuer. A
symbiotic relationship results in which the Victim feels cared for while the Rescuer enjoys the feelings that come from
helping others. However in time, the requests of the Victim tend to be considered burdensome by the Rescuer which
leads the Rescuer to feel like a Victim, constructing the refugee as the Persecutor. The role of Persecutor is integral to
the relationship between Victim and Rescuer; their relationship is dependent on the existence of a Persecutor and,
therefore, they keep locating other players in that role. This, of course, does not mean that the assignment to any one
of these roles is not based at all on actual real events and reasons but what is important here is that these roles often
lose their direct connection to the actual reality and they may be switched around almost at random.
The dynamics of this triangle are very important in the understanding

of the vulnerability in asylum seekers as it can provide an additional
way of grasping the systemic inter-relationships within which
positions are assigned.
This triangular relationship also illustrates how important it is to

investigate the epistemological considerations that lead one to form
a view of the characteristics of an asylum seeker. The tendency to
see asylum seekers only as victims develops an one-sided view of
them, focusing on their deficits whilst ignoring their totality that also
includes their strengths. Whilst asylum seekers have undeniably
suffered a great deal and have real needs, it should not be forgotten
that they also have a great deal of vitality and potential and these
are ignored and one were to focus exclusively on their deficits, such
an approach would be not only incorrect but also pathologising.
As Stein points out however “most refugees are not poor people. They have not failed within their homeland; they are
successful, prominent, well-integrated, educated individuals who fell because of fear of persecution” (1981, p.322).
The idea that all asylum seekers come from the same socio-economic backgrounds or herald only from poor countries
will obviously affect the ways in which workers treat asylum seekers. For those from higher social status in particular,
this view projected onto them by asylum workers will compound their loss of identity.
This triangle is also instructive in identifying some of the mechanisms that lead to the formation of lasting identities. It is
of paramount importance to appreciate the difference between vulnerabilities in asylum seekers and them developing
a vulnerability identity. As it has been shown above, being vulnerable is a relative term, time and context dependent
and based on so many different factors. However, once an asylum seeker develops an actual identity as being
vulnerable or as victim or anything else similar (i.e. of negative connotation) then their position in that role acquires a
more permanent character thus making any possible improvements more difficult and leading to further deterioration.
This means that workers should endeavour not only to actively attempt to reduce the possibilities of asylum seekers
developing vulnerability identities but, most certainly, they should be vigilant not to contribute (wittingly or unwittingly)
to the very development of such identities either by forcing asylum seekers assume such identities or by co-constructing
with them such vulnerability identities.

The Trauma Grid
The ‘Trauma Grid’ was developed by Papadopoulos in order to provide a framework tabulating the wide range of
responses to adversity and has been specifically applied to the refugee context (2004, 2006, 2007). It is particularly
useful in the context of considering vulnerabilities in asylum seekers because it offers a specific way of avoiding
over-emphasising one aspect of their response to adversity over an other, thus limiting the possibilities of workers
contributing to the development of vulnerability identities in asylum seekers.
Levels Negative effects ‘Neutral’ effects Positive effects

INJURY, WOUND ADVERSITY
Psychiatric Distressful Ordinary ACTIVATED
Disorders Psychological Human RESILIENCE DEVELOPMENT
(PD), PTSD Reactions Suffering (AAD)
(DPR) (OHS)
Individual
Family
Community
Society / culture
The Grid consists of three columns (that refer to the three possible responses, i.e. negative, neutral and positive) and
four rows (that refer to the levels where the response is observed, i.e. individual, family, community and society/
culture).
Negative
The most common way of understanding refugees’ response to traumatising experiences is in a negative way, in terms
of them being wounded or injured by the experience. This corresponds to the ‘rubbing in’ effect of trauma. However,
it is important to appreciate that not all negative responses are of the same severity and it is essential to differentiate
between at least three degrees of severity.
»» Psychiatric disorder (PD): some refugees develop diagnosable psychiatric disorders and the most common
one is PTSD (Post Traumatic Stress Disorder) which definitely requires professional intervention.
»» Distressful psychological reactions (DPR): this refers to the wide variety of negative psychological
reactions that do not amount to an actual psychiatric diagnosis but, at the same time have a detrimental
effect on the individual refugee. These may include many different symptoms, e.g. flashbacks, insomnia, lack
of concentration etc. Not all refugees who exhibit these symptoms require specialist professional attention.
Ordinary support systems may be able to assist the refugee to overcome these responses.
»» Ordinary human suffering (OHS): this is the most common and human response to tragedies in life.
Suffering is not always a pathological condition; suffering is part of life and it is not useful always to medicalise
or pathologise it. No professional help is needed to address this type of response to adversity.
Positive
The second category of possible responses of refugees to adversity refers to phenomena that tend to be neglected by the
mainstream professional theories and practices. Undoubtedly, there are people who not only survive, with a significant
degree of intactness, the inhuman and cruel conditions they had endured but, moreover, become strengthened by
their particular exposure to adversity. It is for this reason that this response has been termed ‘Adversity-Activated
Development’ (AAD) (Papadopoulos, 2004); it refers to the positive developments that are a direct result of being
exposed to adversity. There are endless accounts of individuals and groups who found meaning in their suffering and
were able to transform their experiences in a positive way, finding new strength and experiencing transformative
renewal. People in these situations often say how, as a result of the harrowing experiences, they are now more
compassionate to human suffering, and are determined to make better use of their own lives.
‘Neutral’
The third possible response to adversity is that of resilience. There are various definitions and approaches to
resilience but here it is used according to its original meaning (in physics), specifically to refer to the positive
characteristics and functions that survived the exposure to adversity without being affected either negatively or
positively. It is for this reason that ‘neutral’ is placed between inverted commas; the actual responses are themselves
positive but the impact of adversity had a ‘neutral’, i.e. no effect on them. Instead of trying to decide whether a

person is ‘resilient’ or ‘traumatised’ in a global and undifferentiated way, it is better that we discern the specific
positive functions and characteristics that were in the person resilient to the trauma impact. These include a wide
variety of everyday functions that often we take for granted, e.g. continuing to be able to look after oneself and
maintain one’s personal hygiene, continuing to be able to look after one’s own children, etc; every person has many
positive abilities and characteristics, e.g. a sense of humour, zest for learning, generosity, etc that they may not be
affected by their exposure to adversity either positively or negatively. It is important that we acknowledge the fact
that these have not been altered despite the trauma impact; not all traumatised persons may be able to continue
having these functions intact, and this fact should not be overlooked and these functions should not be taken for
granted. Indeed, the ability to continue performing these functions is an indication of the person’s resilience in that
respect. Consequently, it is essential that we should also help asylum seekers to appreciate their achievement in
being able to retain intact such functions.
It is important to emphasise that the existing literature does not distinguish between AAD and resilience. Anything that
does not fall within the negative spectrum of effects usually is termed ‘resilience’, yet it is important to differentiate
between AAD and resilience.
The key characteristic of resilience is that it refers to positive qualities, characteristics and functions that existed
before the exposure to adversity and continue to exist unchanged, whereas AAD refers to new characteristics
that did not exist before the traumatising experiences but were acquired as a result of the exposure to adversity.
This distinction is vital for assisting refugees appreciate the wide range of their own responses to adversity and
acknowledge that some positive characteristics were retained and some additional gains were also made; such an
acknowledgement will help them substantially in their moving forward in life.
The Trauma Grid enables all those who work with asylum seekers and refugees to differentiate the wide range of
responses that each refugee exhibits in relation to being exposed to adversity. It is a useful framework and reminder
not to fall into the trap of making simplistic generalisations about each human being but endeavour to identify his
or her uniqueness. The Grid reminds workers that individual pathology occupies only a small space in the context
of the wider spectrum of other consequences that also co-exist along with the pathology. The Grid also emphasises
the importance of not leaving out of our understanding the wider contexts within which individuals are located,
i.e. family, community, society /culture. These are not abstract and passive factors but are most active contexts that
provide meaning to the individual’s way of experiencing, digesting and responding to their exposure to adversity.
By being mindful of this totality in a differentiated and not over-simplified way, refugee workers have better chances
to address the effects of trauma more appropriately.
›› Additional considerations ‹‹
More specifically, in the context of asylum seekers, it has been suggested that the underlying causes of vulnerability often
include factors such as poverty, discrimination, inequality, lack of resources, lack of familiarity with the surrounding
environment, society and culture, and the way to counteract them could be the development of preparedness and
increasing capacity. According to Red Cross (2010), physical, economic, social and political factors influence levels
of vulnerability and resilience. Poverty is identified as the one of the most significant factors influencing vulnerability.
Not infrequently, vulnerability in asylum seekers has also been associated with the psychological condition of the
individuals themselves, thus, emphasising the internal (i.e. psychological) predisposition. This tendency has been
particularly influential in the wider field of humanitarian work where, in the recent years, the psychological dimension
has been gaining ground over other more pragmatic considerations. This tendency has both positive and negative effects.
On the one hand, it is important to become aware of the significance of the different and unique ways each person
experiences the external events and circumstances that they are exposed to but, on the other hand, over-emphasising the
psychological dimension, poses the danger of underestimating the various political, economic and other social realities
that, most certainly, cannot be ignored when one attempts to grasp the totality of an asylum seeker’s experience.
Many researchers have explored the concept of vulnerability. Watts and Bohle understood vulnerability as a ‘multilayered
and multidimensional social space defined by the determinate political, economic and institutional capacities of
people in specific places at specific times’ (1993, p.46). Cannon (1994) observed that a person’s location in one
vulnerable position is likely to lead to the same person becoming vulnerable in other aspects, too. This means that
vulnerability is connected with a position (indeed, a disadvantaged position) that becomes itself the pre-condition for
the development of additional vulnerabilities in other spheres of one’s life, i.e. one vulnerability is likely to trigger off
another vulnerability in another area. Watts and Bohle (1993) emphasised the role of social structures and political
forces in the development of vulnerability, arguing against the privileging of internal, psychological approaches to

vulnerability. More specifically, they postulated three theoretical frameworks for understanding vulnerability that are
fairly self-evident:
I. Vulnerability as entitlement (or lack of entitlement)

II. Vulnerability as exploitation
III. Vulnerability as powerlessness.
Undeniably, asylum seekers are exposed to all these three facets of vulnerability. The identification of these three
frameworks indicates that vulnerability encompasses a wide range of areas and it is a complex concept with many
and varied implications.
›› LEGAL CONSIDERATIONS ‹‹
At the international level both basic and specific human rights instruments specify the obligations member states are under
to protect non-nationals. The International Covenant on Civil and Political Rights (ICCPR)3 applies to both nationals and
non-nationals. It adopts an all-embracing language such as “everyone”, “all persons”, and “no one” and also contains
non-discrimination clauses requiring each State party to respect and ensure the rights recognised therein to all individuals
within its territory without distinction of any kind such as race, colour, sex, language, religion, political or other opinion,
national or social origin, property, birth or other status. Although nationality is not explicitly stated as a prohibited ground
for discrimination in either instrument, these provisions are clearly open-ended. The position of non-citizens under the
International Covenant on Economic, Social and Cultural Rights appears somewhat more limited than the rights enjoyed
under the ICCPR and ECHR.4 The very existence of Art. 2(3) of the ICESCR, however, arguably confirms that the ICESCR
does apply to non-citizens. There are also further specific instruments such as the Convention on the Elimination of All Forms
of Racial Discrimination which calls for an end to all forms of discrimination, including prejudice against aliens seeking
asylum or citizenship, and the (not much ratified) International Convention on the Protection of All Migrant Workers and
Their Families which clarifies the wide-ranging freedoms due to those migrant workers who are legally employed in a
country other than their own. 5 The Convention against all forms of Discrimination against Women offers specific protection
to women as the Convention on the Rights of the Child does to children. Importantly these specific instruments do not
invent anything new compared to the two Covenants, but focus attention on specific groups or rights reflecting a need
for added (not different) awareness and protection. The Convention on the Status of Refugees specifically focuses on the
situation of people who are outside their country of origin and are unable or unwilling to avail themselves of that country’s
protection due to a well-founded fear of persecution on specific grounds – importantly the Refugee Convention also grants
economic and social rights. A criminal law instrument which offers a certain degree of protection 6 is the Protocol to the
UN Convention Against Trans-national Organised Crime to Prevent, Suppress and Punish Trafficking in Persons, especially
women and Children. Also of relevance here is Resolution WHA61.17 by the World Health Assembly in 2008, on
the ‘Health of Migrants’ that calls upon Member States, inter alia, ‘to devise mechanisms for improving the health of all
populations, including migrants, in particular through identifying and filling gaps in health service delivery’ and ‘to raise
health service providers’ and professionals’ cultural and gender sensitivity to migrants’ health issues’ 7
Most States have national laws reflecting their international commitments and obligations. In this respect it should be
stressed that human rights are not principles or abstract ideas, but binding legal obligations – which can be seen from the
vast jurisprudence and a slow but consistent tendency of States to conform to International Court Rulings. It is nonetheless
true that many Human Rights violations still take place daily and thus a focus on and effort to implement existing standards
remains crucial.
3 Some rights in the ICCPR are expressly limited to citizens, such as political rights in Art. 25 ICCPR. See also Art. 16 ECHR, which reads: “Nothing
in Articles 10, 11 and 14 shall be regarded as preventing the High Contracting Parties from imposing restrictions on the political activity of aliens”.
The clauses enumerated are respectively concerned with the rights to freedom of expression, peaceful assembly and association, and the right
to non-discrimination. However, Art. 16 ECHR has been interpreted restrictively by the European Court of Human Rights. See Piermont v. France
(1995) 20 EHRR 301. Moreover, Article 16 ECHR remains controversial vis-à-vis the expansive and universal protection afforded by more general
human rights instruments.
4 Although the ICESCR is also phrased in all-embracing language, there are differences of opinion whether the non-discrimination provision in
Article 2(2) ICESCR can be of assistance to non-nationals. These differences centre upon the lack of clear open-ended language as to the prohibited
grounds of discrimination enumerated in Art. 2(2) ICESCR. The Limburg Principles on the Implementation of the ICESCR assert unequivocally that
“the grounds of discrimination mentioned in article 2(2) are not exhaustive” (Principle 36). Art. 2(2) ICESCR should also be read in the context of
an explicit restriction on the economic rights of non-citizens in the clause that follows, Art. 2(3) ICESCR: “Developing countries, with due regard
to human rights and their national economy, may determine to what extent they would guarantee the economic rights recognised in the present
Covenant to non-nationals”.
5 including: freedom of expression (article 12), protection from discrimination (article 7), and the right to procedurally fair process (article 16.7).
The treaty allows for states to limit the employment options of migrant workers (articles 51, 52) and to take action against migrant workers
considered ‘irregular’—those whose presence is not sanctioned by the state in question.
6 See Touzenis 2010.
7 Resolution WHA61.17 by the World Health Assembly, on ‘Health of Migrants’. Can be accessed at
http://mighealth.net/eu/images/c/c4/Whores1.pdf

It is also true that emphasising the legal force and nature of Human Rights can be paramount in such a context.
However, an extreme over-reliance on legal and political narratives risks presenting a fixed rather than fluid
understanding of vulnerability. An asylum seeker is either in a vulnerable category or not. This top-down definition
of vulnerability does not appear to accurately capture the true nature of the asylum seeker experience. Moreover,
at its root this process represents something of a departure from individual assessment as the proper means
through which to grasp the needs of asylum seekers. It is for this reason that the legal considerations should be
not separated from other perspectives when it comes to ascertaining who is vulnerable and who is not.
The ultimate criteria for granting asylum is based on the central definition of refugees that stresses the ‘well-founded
fear of being persecuted for reasons of race, religion, nationality, membership of a particular social group or
political opinion’. Granting asylum is a legal process and therefore it requires to be grounded on evidence that
can have legal weight. Understandably, such evidence would be stronger if it is based on objective, external
and tangible criteria. For example, a person’s age, gender, the fact that she is the head of a household, etc, all
of which constitute uncontroversial evidence. In the case of persons who were tortured, the objective evidence is
often sought on the body of the claimant. Such a tendency has been critiqued for attempting to produce objective
evidence by minimising the person’s own experience and testimony. As it is known, evidence of torture is not
always visible on the body: ‘Psychological scars … sometimes replace the missing corporeal inscription of the
trauma’ and in those cases it is has been argued that ‘by trying to help the refugees, physicians and psychologists
deprive them of their truth’ (Fassin and D’Halluin, 2005, p.602). Such arguments point out that there is a price to
be paid for a legal emphasis on the tangible evidence at the expense of the person’s own truth. Ideally, of course,
one would wish to produce as much evidence as possible in order to strengthen one’s case for seeking asylum,
but these authors make a plea for not undervaluing or abandoning the importance of the asylum seekers’ own
truth, of their own psychological reality. It is equally important not to neglect these other dimensions of evidence
and to assist both the asylum seekers in valuing more their own experiences as well as to impress on the relevant
authorities to validate more the persons’ own experiential and psychological truth. Ultimately, as it has already
been discussed, there is an inherent paradox in that in their attempt to assist, mental health professionals and
physicians inadvertently may alienate further asylum seekers from their own reality, thus, contributing to their
increasing dehumanisation. One of the most important considerations in this respect is the full awareness of the
multiple implications of the fact that the legal and psychological discourses are completely different, emphasising
different facets of the human nature. Consequently, there is an almost tragic paradox that in order to assist
somebody one has to first pathologise him or her, risking to fix on them a vulnerability identity that may last
longer than the asylum process thus impairing for a long time the very person one wants to assist.
This project values the vital importance of both the legal and psychological dimensions but equally acknowledges
the difficulties in bridging their different discourses and, therefore, encouraged closer collaboration between
professionals from both perspectives and attempted to solicit their views and experiences.
A related phenomenon is worth noting: the existing system is based on asylum seekers’ demonstrated helplessness
and vulnerability, thus creating the danger that the process of asylum seeking itself may foster further victimisation
and have the ‘effect of repeating the refugee’s experiences that had led to the original flight’ (Losi, 2006, p.
25). Key ingredients of those original painful experiences are not only the victimisation and brutality but also the
lived reality of vulnerability and helplessness. It is often pointed out that the very process of asylum seeking may
trigger off secondary traumatisation. Moreover, in their eagerness to help, if certain conditions are not met, even
therapeutic work with refugees may result in secondary traumatisation (Kira, 2004).
Asylum seekers as well as those who wish to assist them are required to provide tangible evidence of ‘vulnerability’;
this sows the seeds of potential perpetuation of helplessness and it may lead to the well-identified phenomenon
of ‘learned helplessness’ (Petersen, Maie, and Seligman, 1995). Moreover, all parties involved (asylum seekers,
their helpers and the asylum granting authorities) may, inadvertently (and, of course, unwittingly), get entangled
in the entrenchment of helplessness in the asylum seekers. In effect, this set of three parties forms a closed system
where each is involved in a mutual process of co-construction leading to the strengthening of helplessness in
asylum seekers.
This is expressed clearly in a UNHCR report referring to the words of a Sudanese refugee ‘“To realize that you
are indefinitely going to have to rely on the assistance of other people can be disempowering, discouraging,”
she added, referring to a process of “learned helplessness” or unlearning how to help yourself.’

›› Summary and key issues ‹‹
»» Government legislation and guidance is often foregrounding some aspects of vulnerability at the potential expense of
others.
»» Another concern is that current legislation defines and categorises vulnerability in terms of its identification. There should
be a clearer distinction between the act that makes a person vulnerable and its identification. It is the fact that a person
has been tortured that is important, not that it has been identified.
»» Vulnerability can often be co-constructed by workers and asylum seekers in response to structural and political forces
in society.
»» Vulnerability and strengths in asylum seekers can either be ignored or exaggerated by focusing selectively on only one
aspect of an asylum seeker’s life, instead of taking a holistic approach.
»» Service providers need to be aware of the meaning of home, of the involuntary loss of home and nostalgic disorientation
in asylum seekers.
»» Service providers need to be aware that the exposure to psychological distress triggers off a wide range of responses
both negative as well as positive. In addition, certain existing strengths always are retained and this should not be
forgotten. Workers need to be aware of this as well as of the differences between ordinary human suffering (OHS),
distressful psychological reactions (DPR) and psychiatric disorder (PD) such as PTSD, and be able to identify them.
»» Service providers need to be aware that the experience of adverse events does not automatically lead to psychological
trauma and allowance should be made for asylum seekers and refugees to explore their capacity for resilience and for
accessing their own coping resources.
»» Even though PTSD is the most researched outcome of asylum seekers’ psychological distress by far, most individuals
who experience adversity require no professional intervention to recover.
»» Conversely, service providers need also to be aware that certain psychological trauma can be a real debilitating
condition warranting medical and/or psychiatric attention.
»» Of paramount importance is the differentiation between asylum seekers (a) experiencing vulnerability in relation to
certain facets of their lives at certain times of their lives and (b) developing a vulnerability identity that is a more
permanent state with many detrimental effects.

III. RESEARCH METHODOLOGY

On the basis of the theoretical considerations discussed in the previous section, the following methodology was
considered appropriate for the EVASP project:
To begin with, it is important to clarify that EVASP was designed to be an action research project that, on one hand,
aims to broaden specific theoretical knowledge on current practices of reception workers in assisting and supporting
vulnerable asylum seekers and on the other hand observes the experience of social actors in the field to introduce
improvements to those practices.
Starting from a systemic and multidisciplinary analysis of European, national and local-level experience in reception, support and
treatment of psychosocial vulnerabilities, the research took place in 10 reception centres and 2 detention centres, 18 specialised
service providers’ offices, 3 schools, 2 immigration board offices, and 1 airport terminal during the course of 2009.
The research methodology was developed by the University of Essex team (from the ‘Centre for Trauma, Asylum and
Refugees’) led by Professor Renos K Papadopoulos, who was also the overall project research and training lead.
The methodology consisted of a qualitative analysis of data from semi-structured interviews, focus groups and active
observations of relevant settings since the aim was not to establish general trends across large samples but to develop
an in-depth understanding of the complexities involved. Moreover, secondary (desk) research was carried out by
studying relevant documents (reports, descriptions, guidelines, etc) of related services, as well as literature review.
Selected number of resources identified as best practices, and they are accessible online through the EVASP Online
Resource Centre [www.evasp.eu]
Examples of people interviewed included lawyers, cultural mediators, interpreters, psychologists, employees at detention
centres and immigration services, social workers, managers and staff of reception facilities and other professionals working
with specialised treatment services.
The research was discussed in working group meetings between representatives of service providers in each of the 4
countries involved. The working groups offered a valuable opportunity to interface and network amongst colleagues from
different geographical and diverse professional profiles whose goal was to find a common set of challenges and possibilities
for the improvement of service provision targeted at addressing the needs of vulnerable asylum seekers.
An important starting point for researchers was that the experiences of asylum seekers are multi-dimensional and
take place at several different levels or in several different spheres, such as political, legal, psychological, cultural, or
economic. In order to achieve insight into the multiplicity and multidimensionality of vulnerability in asylum seekers
and the ways in which vulnerable asylum seekers can be supported, three key areas were extensively explored by
means of both empirical and secondary research:
1. The characteristics of the current working definition of vulnerability in the eyes of asylum seekers and service providers
themselves.
2. The ways in which vulnerability is identified and assessed by refugee/asylum seeker service providers.
3. The ways and extent to which the needs of vulnerable asylum seekers are (and could be) met by service providers.
The rationale for this approach arose from a consideration of the interconnectedness of the above three processes,
and the following considerations:
»» Vulnerability cannot be adequately identified if it is not adequately or appropriately defined.

»» The needs of vulnerable asylum seekers cannot be addressed if they are not properly identified.
All country partners’ projects utilized the same methodological instruments and a shared research protocol developed
by the University of Essex, consisting of:
»» In-depth Interviews
Semi structured individual interviews lasting approximately 2 hours each were conducted at various service provider
locations in the participating countries. Informed consent was obtained from all interviewees prior to commencement of
interviews. Interviewees were informed of their right to withdraw from the research at any time without any adverse affect
on service provision. Interviews were conducted in English, Dutch, Greek and Italian. Interviews in other languages were
conducted or facilitated by bilingual (or multilingual) researchers or interpreters. A standardized topic guide was developed
for the use of all researchers. Asylum seekers were usually referred to the research teams by local service providers as being
vulnerable individuals. Others were put forward by their peers or spontaneously asked to be interviewed after finding out
about the researchers’ presence in the locations where they were hosted. Service providers interviewed included a variety
of different professionals in order to allow researchers to explore vulnerability form a multidisciplinary point of view.

»» Focus groups
Focus groups were utilised alongside one−to−one interviews due to the fact that it was felt that the group dynamic
available in the focus groups would help to discover more about the topic investigated. Each focus group involved two
facilitators and a sample of 5 to 10 asylum seekers and service providers. Service users were put into focus groups
separately from service providers. There are several reasons for this. Firstly, studies have shown that the optimal benefit
from focus groups is with participants that are closer in terms of their identities (Krueger & Casey, 2000). Moreover,
it was important to foster an environment in which views could be expressed openly and frankly. It was believed that
service users may have felt that their service provision could be affected by their responses if expressed in front of
refugee workers. Also service providers may have felt uncomfortable sharing some of their views and difficulties with
asylum seekers they are supposed to work for. Throughout the four countries 24 focus groups were held with a total
of 199 individuals involved.
»» Direct Observation
The locations for the interviews, observations and working group meetings were chosen for their connection and
relevance to vulnerable asylum seekers. Examples of these locations are reception asylum centres, Immigration Service
offices, trauma treatment centres, schools and juvenile justice centres where unaccompanied minor asylum seekers
are detained. This aspect of the research involved the systematic investigation of organizational settings and practices
while an actual intervention by service providers (with or without the presence of service users) was taking place. The
type of activities observed and investigated included clinical referral meetings, drop-in sessions, organization-wide
team meetings. In general, researchers spent 1 or 2 days in each location where the research took place and all in all
36 different locations were visited. The researchers kept detailed notes of their observations and then analysed them
further in relation to the overall findings.
»» Working group meetings

Different stakeholders in the refugee and asylum seeker service provision field (none of whom had previously been
involved directly in the interviews or focus groups) were brought together for reflective discussion on their work
in relation to vulnerability. This part of the research process did not explicitly involve member-checking in which
participants are asked the extent to which they agree with the interpretations of data made by the researchers.
However the preliminary findings of the research were presented to them and the participants were invited to share
their opinions on these findings as well as to discuss good practice in vulnerability across the different spheres of the
asylum seeker experience, such as legal, psychological, health, etc. An e-mail discussion group was also established
in each country, which took the form of a network of professionals for the purposes of shared practice and information.
Each working meeting involved between 35 to 40 professionals, with a total of 137 people participating across the
four countries in this study.
The research participants were varied in both age and gender and were recruited from different geographical regions
within each country. The following table provides an overview of the individuals involved at different stages throughout
the research.
TABLE 1: OVERVIEW OF RESEARCH PARTICIPANTS ACROSS THE FOUR COUNTRIES

Working
Interviews Focus Focus
Country Interviews SP Group
SU Groups SU Groups SP
Meetings
United Kingdom 26 26 3 3 1
Greece 19 14 2 3 1
Italy 32 28 5 5 1
Netherlands 16 23 2 2 1 Grand total
total individuals 93 91 95 104 137 520
SP >Service Providers (Staff) SU > Service Users (Asylum Seekers)
On the whole, the overwhelming majority of asylum seekers that participated on the project became involved in a
vigorous way and offered generously their contributions discussing with honesty their experiences and views, their
fears, difficulties and hopes; they spoke about moments they felt most vulnerable, and about moments where they
felt strong. Their contributions included many suggestions for improvement. Not unexpectedly, some of them were
suspicious about the researchers’ presence and the purpose of the research despite the unambiguous information and
additional clarifications the researchers provided. However, these were a small minority. The majority felt that it was
an opportunity for them to be actively involved in their own situation and they were only too pleased to had been
offered the opportunity to tell their story. One of them, characteristically, said: “I find it of importance to cooperate
with your research. I want to prevent others from suffering the way I did”.

IV. Findings

In this section the findings of the study are presented and discussed. First, the main factors of vulnerability are
gleaned from the experiences and reports by both asylum seekers and service providers across the four countries
involved in the project. An attempt is made to identify the key themes to grasp the way they conceptualise and
understand this concept in the context of their actual everyday life. At the same time, an analysis and comparison
across the four countries is attempted in order to find out which themes are shared across the board and which
are unique for each country. Then, in the second part, a similar exercise is undertaken with reference service
provision. What emerged clearly form the interviews was that often the service provision is built largely around
single issue interest and pressure groups. So, aside from the large ‘generalist’ asylum seeker service providers, the
other service providers offering support and care to vulnerable asylum seekers are built around specific themes
and targets and, inevitably, view vulnerability through the prism of their own particular work. While the work of
these organisations work is commendable, and they have taken many welcome steps to reach out beyond their
traditional client base and provide support to other asylum seekers, it is also the case that they will need more
support in order to be able to view their asylum seeker clients more holistically as individuals facing an asylum
process that places pressure on them at several different levels: psychological, social, legal, and so forth.
›› Factors of Vulnerability ‹‹
In interviews with service users and service providers it was often expressed that all asylum seekers were vulnerable. The
following are some examples of these views: ‘All asylum seekers are vulnerable because we are all liable to detention;’ ‘I
think it is hard for you-especially if you have family- to come to a new country which you don’t know and you don’t know
anyone;’ “Here, everyone is vulnerable. Leaving your country, the smells, your language, this is already vulnerability. I’ve
been through it too;” “Just look and you’ll see it yourself. It’s the one over there in the corner who doesn’t talk to anyone,
or the one who torments you constantly with the same story. So you try to talk to them and alert the social worker or
psychologist. Just look and you’ll see it. With experience, you can tell immediately;” “Minors, the elderly... basically those
provided for by law. Those are vulnerable people, right?” “Vulnerable is someone who can’t do everything for him or
herself, like a pregnant woman or the infirmed;” “We are all vulnerable because everyone has a story in his or her past
that creates vulnerability;” “Here, everyone is vulnerable. Leaving your country, the smells, your language, this is already
vulnerability. I’ve been through it too”.
Many service providers on the other hand, often tried to unpick the specific details of the asylum seekers lives and look for
aspects of vulnerability making comparison within the broadest asylum seekers group. For example more recently arrived
asylum seekers were often seen as vulnerable compared to asylum seekers who had been in the country for some time,
because of their newness. ‘We will be seeing people who are vulnerable but then someone new would come and we
would have to leave our work with those ones for the new ones.’ (service provider in the UK).
Although these definitions of vulnerability were common there were also accounts from both asylum seekers and service
providers that voiced the opposite sentiment, i.e. that all asylum seekers were resourceful and strong. “How can anyone be
considered vulnerable, man or woman, elderly, minor or disabled who has succeeded in escaping from war and finding
the strength to leave his home and people to cross the desert and sea?” (service user in Italy).
So, what is vulnerability and who is a vulnerable asylum seeker?
During the interviews with beneficiaries, the term vulnerability was not easy to translate or explain as it does not necessarily
have a linguistic and cultural equivalent in their countries of origin. Asylum seeker interviewees who talked about vulnerable
people – often unfamiliar for instance with the UNHCR or EU categorizations – more frequently made reference to factors in
the reception context or country of asylum that make them (feel) vulnerable, indicating only as a second thought individual
characteristics of a person or his or her biographical data. In this respect, asylum seekers more frequently connected
vulnerability with issues such as isolation, detention, language barriers, racism and lack of work These issues all related to
present conditions more than past experiences and were frequently talked of in terms of emotions and feelings rather than
concrete needs.
Despite the increase in the official recognition of the legal and policy dimensions related to vulnerability, it is possible to
discern an overall deterioration in the rights of the general asylum seeking population in terms of employment, housing and
financial rights. It is quite possible that these two processes are linked. That is to say, the process of categorising particular
groups of asylum seekers as vulnerable and foregrounding their needs risks masking or overshadowing, and at times
increasing, the overall vulnerability of the asylum seeker population. The assumption frequently made by service providers
seemed indeed to be that because certain asylum seekers fall into pre-identified categories of vulnerability, those lacking this
label are not vulnerable. This perspective was using an asylum seeker-non-asylum seeker comparison model. However, the
asylum experience is crucial to the idea of vulnerability and it was clear that the asylum seekers did not view themselves as
vulnerable because of their past experiences but rather because of their current circumstances.
What emerged clearly from the interviews is that what creates distress in asylum seekers is no so much the past from which

they have escaped or their journey to Europe, as much as a lack of prospects. This is compounded by the undefined length
of stay in the reception centres asylum seekers are hosted in, as well as long waiting times for documents, a lack of work,
housing, economic resources, the uncertainty of family reunification and fragmented contact with both their country of origin
and the country of asylum.
From this point of view, it can be stated that in the opinion of both the asylum seekers and the professionals working
with them, it is often not the asylum seekers who are vulnerable but the system that makes them so. In this respect many
of the service providers interviewed seemed to consider the actual asylum seeking procedure, with its body of laws and
regulations, to provoke vulnerability not only in asylum seekers but also in the professionals working with them as a result
of their incapacity to provide real care and reception through the many inconsistencies of the system. “Initially, many
guests thought that the entire asylum process would take around 30 days, in fact the pamphlet they are given by the police
mentions that the maximum time allowed for review of the asylum request is 21 days. This figure is quite far from the reality,
as the guests of the centres experience first hand. It actually takes between 3 to 4 months and the times are always getting
longer; in fact the personal kit given to guests on their arrival is not sufficient for the duration of their stay as foreseen in the
CARA regulations.” (service provider in Italy)
Uncertainty of how the system functions, lack of access to complete information, an excess of legislation, the vagueness
of procedures and their timing, a lack of future prospects, disconnection from the outside world and discrimination fed by
false cultural and professional stereotypes are only a few of the factors that provoke vulnerability in asylum seekers and
put the service providers in a difficult position when attempting to carry out their work. Based on the testimonies collected
during the research, five discrete sub/themes as main factors of vulnerability according to both asylum seekers and service
providers were identified:
1. Loss of supportive networks and contacts

Asylum seekers often expressed accounts of extreme loneliness, linked to the loss of their home, family, friends and separation
from the rest of the host population. For unaccompanied minors in particular, the absence of parents is a factor that makes
them feel extremely vulnerable. According to many children interviewed, parents are in most cases the people who correct
you when you make mistakes or behave inappropriately, who look after you and take care of you, and who can teach you
and serve as a good example for proper behaviour, values and norms. “If you have parents, you live on a different way;
your parents help you by telling you what is good and what not. I don’t have any parents anymore, I have to find out myself
what is good and what not.” (minor service user in the Netherlands)
Because the asylum centres are often located in isolated areas, the social networks of asylum seekers are thus often limited
to interaction with reception staff from the asylum centre and other asylum seekers. The relationship with staff, in particular,
is often perceived as being far from equal (strict rules, no room for discussion, etc.) and the personal involvement of certain
reception workers was considered to be minimal.
A further concern found among asylum seekers was the extent to which they related vulnerability to lack of information.
In Italy, for example, there seemed to be a greater concern with regards to information about the home country which
may point to further aspects of isolation and other systemic issues. “Knowing that my family is still alive gives me security.
Knowing that the situation in my country is peaceful gives me security. I’m not safe if my family and country are not safe,
if I can’t bring my family and children here, or if I can’t support them. Security does not depend on others;” “We want
information on our countries because we are cut off from everything, we have no contact with our country or Italy.” (service
users in Italy) In the United Kingdom, on the other hand, their concern was relating more to lack of information about the
host country.
2. Isolation and powerlessness

The feeling of isolation in its abstract form is connected to uncertainty – of being lost in the system and not knowing where
to get information or assistance from. However spatial or physical isolation is also suffered by many service users owing to
the locations of accommodation in which they are housed. Vulnerability is a situational state and the remoteness of shelters
or centres for asylum seekers creates vulnerability, and can impact on the mental health and general well being of service
users housed in far-flung areas. It also has implications for service users’ ability to integrate and adapt to their host society,
and impedes access to health services and education and their ability to find work. Health, education and employment are
fundamental needs of service users, which are made harder to be addressed through isolation.
Often former military facilities have been converted into asylum centres, meaning that they may be surrounded by boundary
walls and have armed guards verifying the coming and going of residents, thus reinforcing a feeling of ‘otherness’ and
separation from society at large. It is also very common that asylum seekers are housed on the outskirts of cities, or in
remote areas without good transport into main centres. This not only makes it difficult for them to make visits into the cities to
pass their time, something that they have a lot of owing to the long waits in the system and lack of activities in the centres, but
it is also difficult for them to make it to appointments related to their cases or medical needs. In the Dutch system, travelling

time was an issue of concern for minors who, owing to short-staffing, are often required to make their way to their interviews
unaccompanied and some have to wake up at 5am to make it on time to a morning interview with Immigration Services.
These interviews are of great importance to the children’s cases, and the stress and exhaustion of the trip can influence the
child’s ability to concentrate and so also the outcome of the interview.
Employment opportunities are also diminished if service users are living far from main centres. Most are unable to find
steady employment and, if anything, work illegally, do odd jobs or resort to begging. The lack of information and support
when it comes to finding employment is also an issue of concern. The feeling of despair, of the inability to find work or to
integrate, is summed up by one Italian service user: “In the beginning, my wife and I used to go out. We’d walk around
the city; we’d visit the centre, the sea. Not anymore. We stay here. Everything is too expensive and we can’t buy anything.
Since we’ve been here, I haven’t worked and it keeps me awake at night. I have to take care of my wife; I’m all she has
here. I talk about it often with other Somalis, but we know that our brothers in town sleep on the streets. They have no home,
no work. It’s tough. This worries me. What will we do?” (service user in Italy)
This situation of isolation and marginalization is often compounded by a lack of involvement in meaningful activates. “Here
they give us to eat and sleep, but the spirit needs more than that;” “There are no activities and waiting time is dead time.”
Comments such as these were found in numerous accounts, which describe the time in the reception centre as an empty
period where one first awaits the commission’s decision and then insertion into society. Beneficiaries struggle with a lack of
influence and information on decisions taken about their own destinies as well as the impossibility to make their own choices
day to day. Consequently, they feel stuck in a situation of passivity. The energy that individuals had summoned up to this
point to mobilize an escape, a transcontinental journey and the capacity for continuous adaptation seems to become stalled
in the centre. Profound disappointment in their current situation causes applicants to obsess over the asylum application
decision, trapping them in a condition of passivity and dependence.
Dispersal polices also cause isolation and uncertainty and was found to be distressing for service users. “When they dispersed
me they took me to a place where I had to climb stairs. I told them that I couldn’t climb stairs and I wanted to go back to
London. The man told me no. Even if you go back to London you will have to climb stairs;” “I feel lonely. In London there were
plenty people and I didn’t feel lonely” (service user in the UK). It causes instability and the feeling that ones destiny is not in your
own hands. It can also be damaging to child development and education, as a child benefits from a stable environment and
moving from school to school or from centre to centre can be very disruptive and unsettling. It was documented that children
who are moved around a lot have trouble making or maintaining attachments to people, and give up trying to make friends.
It is also of course difficult to care for those in need of long term treatment if they are not settled in one place. “I sometimes
wonder what is worse: the consequences of the events a child has been trough or the consequences of the constant moving. I
think it is almost the same;” “If children have been moved from an asylum centre for two or three times, they give up investing
in making new friends. They don’t see the use of trying it again.” (service providers in the Netherlands)
3. Lack of meaningful engagement

A lack of activities to help reduce the tension and the stress of waiting leads many asylum seekers to “sleep all day,” as was
noted with disapproval by reception personnel and confirmed by many guests as well. “If only we had a ball to play with at
least we’d have a little distraction. Because all we do is think about what will happen to us, and when we talk, we talk about
nothing but this: the decision of the commission, work, housing, how to support our families…” (service users in Italy)
To render their stay (which varies from country to country considerably), more useful and less of a “waste of time,” many
asylum seekers request the possibility to perform work activities - “even cutting the neighbours’ lawns would be fine” (service
user in Italy) - or to receive frequent and meaningful training courses or professional qualification and re-qualification
courses. (Some interviewees specifically request English language courses, computers, or professional training for successful
labour insertion). Aware that employment – which would allow the beneficiary to provide for family needs – is one of the
main goals of a successful migratory process, some of the organizations providing reception services to asylum seekers
are promoting the creation of social cooperatives that perform gardening and ecological maintenance activities. However,
the reason a particular initiative was activated in certain reception centres and not in others, was often less to do with top
down planning than with individual initiative. An inherent weakness of such ad hoc strategies is that these initiatives heavily
rely on the personal skills and resources of committed individuals, which often causes problems in terms of continuity and
integration into the organizational mandate and into mainstream health and social care provision.
A lack of ‘child-friendliness’ in centres for asylum seekers was commonly noted, and it was felt that growing up in such an
environment was not beneficial to the child’s development. For instance, the enrolment in education is not only a right, but
it is also a way to break the isolation of the system and in this sense it can be easier for children to integrate and learn their
host country’s language. “I like going to school. I have a lot of friends here, I don’t have any friends at the asylum centre;”
“I really want to go to school. If I want to make something of my life, I need to have a diploma. Right now, I’m just sitting
at home and waiting, I can’t do anything with my life.” (minor service users in the Netherlands). It can break the cycle of
frustration and feelings of uselessness and make service users feel that they ‘exist’.

4. Racism and discrimination
As well as spatial isolation in terms of the remote location of accommodation is the problem of social isolation and
segregation from the host society, which can be attributed to a lack of mechanisms to encourage integration (for example,
language instruction and education about the host country, or support finding employment) as well as indifference or racism
of local communities that some asylum seeker centres encounter.
When outside contact with the host population does occur, discrimination and exclusion is often the outcome due to
negative attitudes of the local community. This seems to be due also to misconceptions regarding the “political nature” of the
problems faced by asylum seekers, which are frequently equalled with illegal migrants and the perception local populations
have of reception centres, seeing them as occupying the territory rather than being fully integrated with it. When relating
to the local population, asylum seekers indeed reported facing suspicion or indifference. “There is no integration with the
natives. No one comes to visit us;” “The only Dutch people I have seen so far are the people I meet when I go to my lawyer
in the city. But when I see them, they are listening to their iPods and minding their own business. I don’t make any contact
with them.” (service users in Italy and the Netherlands)
Several asylum seekers complained about the racism of local host populations. “When we walk by they plug their noses
and clutch their purses” (service user in Italy). As an example, the Syracuse CARA in Italy, is located near the city in a
residential area that did not accept the centre’s opening easily. “There were local resident demonstrations, petitions and
anonymous flyers against the opening of this centre. With the scouts from the church parish, we organized collective
meetings to explain what the centre was and how it functioned and since then things have improved; people even come by
to take a look.” (service user in Italy)
Exposure to racism or indifference caused considerable distress and made asylum seekers feel vulnerable and isolated.
5. Uncertainty and fear about the future

The uncertainty of asylum seeking procedures and commission response times are factors of vulnerability both for asylum
seekers – whose futures depend on the result of the application – and for professionals who are unable to explain the
discrepancy between what is stated in the law and the actual situation. The case of refugee status denials provides an
example of how policies and laws do not effectively or coherently regulate the phenomena of immigration and asylum
causing counter-productive fallout for the immigrants and the staff working with this population. Operators from several
organizations pointed out that the asylum laws change frequently and that there is often very little correspondence between
what is stated in the legislation and what actually occurs in practice. Many refugee workers have highlighted for instance
the great disparity that exists between the judgments of one asylum seeking commission and another, not only across
different countries but also within the same national territory.
This ambiguity often causes feelings of frustration and impotence which have important effects on the interactions between
beneficiaries and refugee workers, clouding perceptions and influencing the way each entity plays out his or her respective
role. “They’ve learned the procedures well, but how can I explain to them that the reality is different? How can I explain that
what they see written in the handbook8 isn’t true? Here they discover that the reality is different, that the timeline is longer,
and that we can’t find them a house. And they get angry with us, but what can we do?” ( service provider in Italy)
As a result of the uncertainty inherent in the asylum process, asylum seekers interviewed reported a strong sense of anxiety.
Concrete plans as well as vague ideas about their future and dreams about how life could develop, all are thwarted. As a
result, life in the interim period takes the form of dead space; life becomes a period of waiting and waiting, holding back
any form of excitement and planning. Some asylum seekers reported that the uncertainty is much worse than even bad news
or deportation. Although in many cases new asylum policies have been promoted to reduce the application time-frames, in
practice asylum applications still take too long to process.
›› Service Provision ‹‹
In order to ensure that the needs of vulnerable asylum seekers are met effectively, they must, obviously, first be identified
and so an effective system capable of understanding and recognising the needs of asylum seekers is of crucial importance.
Although the systems in the four countries studied are different in numerous ways, there are common themes that can be
drawn out of the research carried out in each, through the eyes of both service providers and users. Seven key issues have
been identified and are presented as follows:
8 On March 12, 2009 the Italian Ministry of Interior published an informational pamphlet to its website (www.interno.it) for international protection
seekers. The document was drafted by the national commission for the right to asylum, the central service of the Protection System for Refugees and
Asylum Seekers, the UNHCR and the Association for Juridical Studies on Immigration with the supervision of the Ministry of Interior Department for
Civil Liberties and Immigration. The text was drafted in Italian but translations were made available in 9 other languages: English, French, Spanish,
Arabic, Tigrinya, Amharic, Somali, Farsi and Kurdish.

1. Communication issues
The most common issue that emerged when it came to identifying needs was the difficulty many asylum seekers have in
expressing their needs. The main problem was language, centring mainly on translation and interpretation short-comings,
and a language barrier is certainly a significant obstacle to successfully identifying needs.
Indeed, language is a fragile terrain in the relationship between refugee workers and beneficiaries, a point of encounter
and exchange but also a source of incomprehension and conflict. Service users often complained about imprecise
translations or misunderstandings that made it difficult for them to take advantage of services, or which created problems
during hearings. “The interpretation service isn’t accurate, here in the centre or before the commission. I have a friend who
was refused because the translator didn’t speak his Arabic dialect;” “There isn’t a translator for every language and not
everyone speaks English. There are not enough translators, and they often speak different languages from ours or translate
wrong;” “The medical service never believes you have the problems you have. The translator doesn’t explain correctly or
almost always communicates with gestures.”
Similar to service users, service providers have also expressed concern about the level of language support available, and
the problems that a lack of a common language or an effective interpretation system can create. “An interpreter is an
important factor in the interview and should therefore be professional and capable enough to translate a conversation to
that what has been said. Unfortunately, not all the interpreters are capable enough to meet these requirements.” (service
provider in Italy)
A shortage of interpreters means that interpreters not suitable for a specific interview may be used. “It is possible that the
interpreter comes from a population the asylum seekers population is in conflict with” (service provider in the Netherlands).
This is an example that would make impartiality and neutrality difficult to ensure, and would likely make the interviewee
uncomfortable and unlikely to speak openly. Similarly, other service providers point to the challenges that the presence of
a male interpreter can create, if the service user is a female victim of violence for example, as the service user will not feel
comfortable speaking openly. It happens also that both state authorities and NGO’s use non-professional interpreters and
translators, who are often themselves refugees, or even minors, but have no background or training for this kind of work. It
becomes particularly difficult with vulnerable asylum seekers, those with complicated medical problems or in a therapeutic
context. Furthermore, interpretation is an issue of particular concern when it comes to minors, who rarely speak any English
or the host country’s language, and an interpreter should be trained to interpret in a way tailored for children, which has to
meet certain standards stricter than for adults.
The problem of poor interpretation services seems to be endemic throughout, and in some cases chronic, and it also
seems that both service users and providers are resigned to this situation despite the extent to which it hinders successful
communication. Target group discussions with service providers in Greece showed that they prefer to keep their expectations
low (for example not to expect it possible to have a woman interpreter), and research in the UK found that it had simply
been accepted as a difficult reality around which they had to work.
Where there are not interpretation services that span the entire gamut of languages spoken by the population, English
becomes a lingua franca in reception centres as the only means of communication between service users and providers. Of
course there is no guarantee that either speak English. Often service users arrange the translation of questions or requests
amongst themselves, relying on companions who speak English. Although some staff members take it upon themselves
to enrol in English language courses, because linguistic and communicative difficulties are considered among the main
obstacles to daily work and interaction – formal and informal – with beneficiaries, many reception centre staff have only a
passing knowledge of the language.
2. Issues of Trust
Closely related to the above is the issue of trust and consideration. Many of the respondents generally lamented that
service providers seem to be more interested on the symptoms of their suffering, rather than in openly discussing and
acknowledging the structural and political causes that motivates their suffering (which asylum seekers frequently refer to as
their past political activity). As a result, many asylum seekers do not feel believed or respected as individuals and are thus
less likely to communicate their needs. The system itself can breed mistrust: their future is uncertain, their plausibility is being
questioned by the very nature of the asylum process and they are insecure and trying to adapt to a new, and possibly
hostile, culture and way of life. These are all factors that can contribute to a feeling of mistrust and suspicion that can cause
service users to close down and not express their needs clearly.
‘Form fatigue’ was identified as a source of disappointment by asylum seekers, meaning that they were asked the same
questions over and over, without out anyone really listening to them outside the official parameters of the interview.
Furthermore, the very need to tell one’s story repeatedly (upon entrance to the various reception centres, informally to
refugee workers or other beneficiaries, in preparation for the hearing, before the commission, etc.) can be damaging as
it requires the individual to constantly relive the traumatic event, re-traumatizing them or making the trauma chronic. In a

context that tends to label and categorize people, listening to the applicant’s experiences encourages an open, systemic
and transformative approach. It encourages dialogue and breeds an atmosphere of greater trust in which service users are
more able to express their needs. It can also be therapeutic as the very act of being listened to and feeling that you have
been heard can fulfil a need in and of itself.
In other cases, service users are sometimes reluctant at first to speak openly, for example those who are victims of violence.
UK guidelines issued to service providers on how to interview victims of torture acknowledge that particular care and
sensitivity need be taken: ‘A torture victim’s potential shame, distress, embarrassment and humiliation about recounting
their experiences are difficulties which may need to be overcome. They may find it particularly difficult in the atmosphere of
officialdom. Those who have suffered at the hands of their own authorities may distrust officials here, despite travelling to
this country to seek refuge. In many ways, this is an intractable problem but common sense, awareness and sensitivity can
reduce its influence.’ (UK Border Agency guidelines)
It may take time for a relationship of trust to be established before the service user is able to confide and speak about what
has happened, although time constraints in the system do not always allow for this, and service providers are aware of this
problem. ”Sometimes people won’t tell you things in the assessment and so you will find out later. When they get to trust
you, slowly things start to come out.” (service provider in the UK)
A clear example of the uneasy attitude of some service users was shown during target group discussions carried out in the
Greek asylum seekers’ centre of Lavrion. Every time there was an effort to turn the discussion to matters dealt with by the
questionnaire the participants avoided giving answers, probably because they did not trust each other or the interpreter and
they were suspicious that such a discussion may reach the information services of their country of origin. A similar problem
of mistrust was encountered in the target group discussions in the Medecins du Monde polyclinic in Athens, attributed to
the fact that they are wary of sharing their experiences with other nationalities and also because their status is precarious
with their applications still pending.
Service users are not always aware of the rules on confidentiality and information sharing and so may be scared or
wary of the questions they are asked. A lack of transparency or clear information on the process (in a language they
can understand) can make service users reluctant to be open, which hinders their ability to express their needs. This is
exacerbated by the formality of the interview and reception process, which can render service users fearful of speaking
openly, scared that they might give the ‘wrong answer’. “Interviews and formal processes can be hard for asylum seekers.
They think everything is going to go back to the Home Office;” “There are some who are scared to talk about their issues
they think everything is going to go back to the home office;” “Some people when they are asked questions: they say are
you taking this to the Government?” (service users in the UK)
Service users may also be suffering from a ‘dashed-hope’ syndrome, having come to Europe with high expectations about
the standard of services they would find here. One Greek service provider suggests that it is normal to find that asylum
seekers display mistrust, reservation and have difficulty adapting due to the false information and impressions they had
about the material help they would be given by the Greek authorities.
One Nigerian service user in the Italian system explained his disappointment as follows: “Italy is one of the G8 countries;
it is one of the richest. We came here because the Italy that we expected was much different. We expected a Christian
Italy, that spoke English, like we do [Nigerians], but here no one talks to us, no one knows English. When we walk around,
people hold their noses. Is it because of the colour of our skin? Are we perhaps the wrong colour?”
This feeling of disappointment at the reality they face in the system and hostility of the host society can be exacerbated by
the involvement of the police in the asylum structure, adding to a general atmosphere of fear and mistrust. In Italy, service
users are transferred to CARA centres by police escort, in the UK police stations are often used as reporting stations.
Fear of detention was pointed to as a factor of vulnerability by service users, and can act as a significant stressor on the
psychosocial wellbeing of asylum seekers. “When I report I do not go on my own. Sometimes I take someone with me and
I say to them come with me today. They will detain me today and no one will know where I am” (service user in the UK). In
Greece, detention centre staff are forced to wear uniforms, gloves and masks because the police officers consider them as
a focus of germs due to the fact that they come in contact with the detainees. Being treated with such suspicion, as carriers
of disease first and foremost, will provoke an atmosphere of fear and mistrust.
3. Information issues
One unmistakable need that is not being addressed by the asylum seeker system is the need for clear and accurate
information, that can allow service users to get a hold of where they are in the process, what is still to come and what their
future options may or may not be. Information is a source of security and autonomy, and a lack of information is a source
of frustration, anxiety and fear. This is a theme that repeated itself throughout the research. “Security is not the absence of
threat; security is work, prospects, dignity. Uncertainty of information, of the commission’s decision about my future is not

security;” “The information we need should be here – we shouldn’t have to look for it somewhere else;” “In the camp we
eat and sleep but we need information on our future and on our country” (service users in Italy).
It was often a common question, the way information is presented to service users. For example, legal information may be
distributed upon the beneficiary’s arrival at a centre, which is a very delicate time as they do not know where they’ll be
transferred nor do they know the characteristics of the reception centre in which they’ll be hosted. In this moment of anxiety
and uncertainty the beneficiary is rarely able to process the massive quantity of information provided. Too much information
is given at once, some of which is overly specific or technical.
Information most commonly travels informally between beneficiaries through word-of-mouth. In particular, asylum seekers
turn to residents who have been in the system longer or former residents. “Information is a problem. Here there is no
information or orientation and people don’t know what to do. We need information on the commission, on Italy, on life
outside the camp (where to live, where to look for work…). Instead there is no official information, only word-of-mouth”
(service user in Italy).
Furthermore, information is communicated verbally for groups of people and those who do not have access to a cultural
mediator for their language, are forced to ask for help from their fellow beneficiaries. This implies that, contrary to what is
written in the European and national legislation, not all parties receive information straight from the source in a language
that they understand.
The legal information offered to asylum seekers is often confused and insufficient also because of incoherent legislation that
is subject to continuous changes. In many cases the administrations do not possess, except in rare cases, updated paper
and video material to accompany the information given orally. Moreover, the disparity between what the law says and
what occurs in daily practice in the national reception system leads reception refugee workers to distance themselves from
the official information, preferring to offer asylum seekers a description of the actual state of things from the very beginning.
“We prefer to be sincere and tell it like it is rather than create unreal expectations” (service provider in Italy). However,
while this “sincerity” avoids the creation of false expectations among asylum seekers, it also causes feelings of anxiety,
disillusionment and failure and, at the same time, generates frustration among personnel, who are unable to fall back on
legislative instruments – nor justify their ineffectiveness – when faced with the problems raised by beneficiaries.
A lack of clarity as to what rights and services are available to service users upon their arrival inevitably effects the expression
of their needs – as they do not know who to approach or what is available to them. Minors, in particular unaccompanied
minors, are in need of special attention to ensure that they understand the system. The procedures that they are involved
in are daunting and should be explained to them in language tailored to their level of maturity and comprehension, so that
they feel comfortable and are able to express themselves clearly. Only when a child feels at ease and that he can trust the
person sitting in front of him will he talk about what has happened to him, allowing service users to identify and address
his needs.
Tied to uncertainty and a lack of clear information is the process of waiting, something torturous for many service users.
“Yes. It was very stress for me. Waiting. And the solicitor told me not allowed to bring your wife. And I said after four years
she can come. And she said I can’t answer you: maybe yes maybe no. ... really they put me in stress and I feel oh what is
gonna be and so on. And so my wife went to the embassy and they said no you can’t come because he has exceptional
leave to remain. And then she passed away in that time” (service user in the UK).
A further dimension of access to information includes the possibility of asking specific, individual questions and receiving
answers to them, and there was a feeling of frustration amongst service users that they are not being listened to. One
service user in Italy suggested that “everyone should be heard upon arrival” or at least everyone should have the possibility
to clarify his or her individual situation, since, even if asylum seekers are a population with similar legal characteristics, the
stories and destiny of each is individual.
One service user’s encounter with UK social services shows the extent to which feeling that you are being listened to can make
a difference: “The woman listened to me and I could see she was really listening. She was not just writing while I was talking”.
When she finished listening, the woman repeated back to her what she had said and this made the asylum seeker woman feel
that she was ‘heard’. The service user who told this story felt deeply touched that her worker paid so much attention to her.
4. Difficulty in identification
When vulnerability is not easily identifiable and does not fall into a pre-determined category (such as a pregnant woman
or an unaccompanied minor) it may be difficult for a service provider to spot. As outlined above, there is not always a
common concept of vulnerability and intuition is often used, which is not a reliable or accurate way to identify those service
users most in need of assistance. This is especially the case when it comes to mental illness or victims of violence which
needs specialist training to identify. Nearly all service providers expressed the desire to receive more training in how to

identify needs, and were often not confident in their abilities in this area. Psychologists and social workers, in particular,
have mentioned the need for courses and informational materials on trauma, torture and trafficking, as well as the possibility
to consult with specialists on these issues or assure their regular presence within the facility. As things stand, successful
identification of vulnerable people seemed not to rest on previous training or the possession of appropriate professional
tools, nor was it down to external supervision. It was instead often down to the refugee workers’ empathy, initiative and
generosity. “Where we are unable to be of service professionally, we try to be there as people” (service provider in Italy).
There tended to be an inclination for service providers to focus more on meeting needs and the identification of needs is
generally seen as less of a priority. While some aspects of vulnerability clearly require specialist knowledge such as the
diagnosis of mental health problems, frontline workers were not used to identifying areas outside their own zone of work.
They were unable to undertake comprehensive needs assessments and did not sometimes see any value in this process
either. Many front-line workers were often demoralised about the lack of facilities and resources and sometimes took the
view that it was of little benefit to identify needs that later could not be met for various reasons. “Sometimes you feel like,
what is the point of identifying needs you can’t meet?” (service provider in the UK).
A Greek social worker (working in Chios reception centre) explained that identifying who is and who is not vulnerable is not
her area of expertise, and that if she attempts to do so she would risk ‘dropping out cases.’ A doctor from the same centre
declared himself unable to identify a vulnerable person, due to a lack of training. He could not identify a torture victim, but
could reach the point of suspecting someone has been subjected to torture. Meanwhile, a service provider working in the
UK explained the lack of training and support for identifying needs: “As social workers we don’t get any training on asylum
seekers but we have to deal with them all the time. I mean we get training on children, vulnerable adults but there is nothing
on asylum seekers and it’s only by doing my placement here that I’ve realised what their needs are. And they’re massive.
But we don’t get to see any of that when we are training.” Thus front line workers learn on the job, but don’t receive the
formal training that they would like.
For the interviewing of children, special interview techniques that will simplify the questions to the level of maturity of the
child and make the child feel at ease are vital. If the child understands the process and the questions being asked it will be
easier for him to tell his story accurately, and it will reduce the stress of the interview situation as well.
5. Language and Cultural Awareness

Training in basic language was also pointed to by some service providers as something that would be useful, to allow some
simple direct communication with the service users, alongside the interpreter. The suggestion was raised also that familiarity
with the cultures of service users would be useful, as service providers need to be properly informed on the context from
which their clients have come and the way that they see they world so as to make communication and mutual understanding
easier.
Teachers from a primary school for migrants in the Netherlands explained: “I’ve done the preparation for this job myself,
I haven’t received any training. But such training is absolutely necessary. I once found out that the curl we give to children
who have done a good job, means in Somalia as much as: wrong. These are important things to know;” “The differences
in culture are sometimes huge. You have to realize that. Some of the children don’t look at you when they talk and others
don’t want to shake hands when you meet someone for the first time. If you insist on doing those things, the children will feel
very uncomfortable and have a feeling of distrust.”
It is also important in the context of therapy – often an alien concept in itself to those being treated. Sometimes cultural
diversity leads a psychologist to translate and adapt the tools of his or her chosen school of thought to references from the
culture of origin and to seek out new languages or new tools (such as the Bible and Mass for Catholic patients). This is only
possible however if the psychologist has some knowledge of the culture and background of the patient. It is known that in
many cultures the concept of psychological trauma does not exist.
6. Lack of coordination for holistic assessments of needs

Although the organizations working both within and outside reception facilities are very different from one another – in
terms of capacity, structure, organizational method and mandates, resources and relationship with the territory – there are
many common problems and the experiences of one organization might prove useful if shared with others. However, the
organizations and professionals working with asylum seekers are often not connected between themselves; they do not
communicate regularly nor do they hold periodic meetings. Contact between different organizations is indeed very rare
and limited to single cases, such as family reunification carried out between individual facilities. Staff from various service
providers commented that periodic meetings would be useful on specific themes (legal, healthcare, social). “I’d like to know
how the others do it. They must have our same problems, right? I would like for there to be meetings once in awhile, every
two months, for example, on various aspects of our work. The problem is that we often compete with each other for contracts
and are afraid to expose our weaknesses. This does not facilitate collaboration, when what would be really helpful are
opportunities to meet” (service provider in Italy).

7. Excessive workload
Very high levels of distress and demoralization in service providers was registered, who frequently complain that they are
working under enormous pressures not only due to the demanding environment and range of needs they have to address,
but also due to the many difficulties they have in translating asylum laws into practice and the frustration resulting from their
inability to answer the many requests and questions posed to them by the asylum seekers.
There was a tendency for front line workers to use their personal resources to meet the needs of service users, whish in
part this reflects the nature of a system with many legal and bureaucratic barriers to meeting the needs of asylum seekers
to the extent that professionals that work with refugees are often providing a personal service to them to circumvent either
blocked avenues or cumbersome procedures. “We have people that we can call up and say ‘can you take someone for
the weekend. If it wasn’t for these members of the public we don’t know what we would do. I’ve taken in people as well.
They’ve stayed with me at my place” (service provider in the UK). Clearly the consequences of legislation and policy in
immigration should not be that the burden of support for asylum seekers is shifted from the state to private individuals.
Such a burden on service providers means that the risks of burnout were high, exacerbated by a lack of support or
supervision structures. Many expressed the desire for supervision, as an outlet for what is very often emotionally draining
and demanding work and also as a means to debrief and come up with solutions to common problems.
A service that is stretched too thin through short-staffing also inevitably damages the service provided and means that there
simply aren’t enough people to go around to meet the needs of asylum seekers. A shortage of interpreters has been outlined
above, but shortages of personnel are a problem across the board, very often owing to a lack of funding or resources.
This means that front line workers have to prioritise and some vulnerable cases may fall through the net. “We often have
to choose between adults who are clearly suffering from mental health problems and minors from who we think; he or she
can probably do this interview alone” (service provider in the Netherlands).
An excessive workload means that it is difficult for the needs of service users to be met properly, but it also has adverse
effects on the service providers themselves and burnout and demoralisation were commonly found among front line workers.
This is also a symptom of having to navigate a system where the legislation does not fit with the reality and where there isn’t
the necessary funding to fulfil the needs of the service users.

V. CONCLUSIONS

The conclusions of this study focus on the two broad areas discussed in the findings section: factors of vulnerability
and service provision. They are of course crucially linked, feeding into one another. In order to improve the
service provision, one must consider the way vulnerability is understood and dealt with in the system. Equally, to
address concerns that cause vulnerability for asylum seekers one must look at the way in which the system itself can
not only fail to address vulnerable cases but also how it can actually create vulnerability.
›› Factors of Vulnerability ‹‹
A Sudanese applicant in a wheelchair explained: “I am not vulnerable because I am in a wheelchair. I am vulnerable

because I do not have a job to support my family. I am vulnerable because I do not have a book to read, because I cannot
obtain the information I need – about procedures for example – or to control the timing or final outcome. The boredom of
this place and uncertainty regarding my life makes me vulnerable, useless, and incapable. Instead, I have a lot of interests
and I could do lots of things or at least be useful.”
This last observation shows that, from the perspective of asylum seekers, the definition of vulnerability heavily lies in
psychological and autobiographical components, i.e. life experience. This consideration integrates the socio-cultural and
structural aspects of vulnerability. Indeed a person’s well-being is defined by characteristics of their life context (economic,
environmental, social, political-institutional) as well as by personal and family history, individual attributes and perceptions
of oneself and one’s condition. These elements are much more relevant when they refer to the life experiences of asylum
seekers, whose autobiographical episodes, in their historic and psychological dimensions, determine migratory choices
and condition behaviour, define the way they interpret the events around them and invest in and give meaning to their
future.
Considering individual life experience in the definition of vulnerability means considering the point of view of the interested
parties, who have a specific perspective on their well-being or lack there of, and a “mixed” individual perspective which
stems from multiple socio-cultural associations. Vulnerability however, is also socially and culturally determined and it is the
society – as a combination of norms, values and language through which one interprets and acts on individual or collective
well-being – that gives the concept of vulnerability its meaning. The same categorization proposed by the UNHCR and
globally-recognized and adopted, is the result of a specific place and society, since the aetiology of a problem and its
treatments are socially and culturally defined.
What can be derived from this is the conclusion that vulnerability is not necessarily a ubiquitous concept perceived in the same
way across cultures and individuals, in particular vulnerability related to migration and exile. The socio-cultural dimension
and medical-healthcare dimension both differentiate and associate groups of human beings; a community, like the individual,
selects a group of references by which to define, manifest and recognize itself. Cultural identity defines a person in relation
to his or her society of origin, and is also flexible and mutable; it is linked to each person’s choices, groups of reference and
history. Migration complicates this concept, adding references from the host society to the original references and multiplying
the socio-cultural variables which define the migrant’s identity and on which he or she realizes the migratory project.
As was amply discussed above, physical and historic-temporal elements of the surrounding context can affect a person’s
vulnerability, increasing or reducing it. The structural component, in its legislative, spatial-temporal and functional aspects,
can cause vulnerability rather than serve as a tool to reduce and overcome it. These components not only influence the
well-being of the asylum seeker, but also that of the refugee worker who often define themselves as “victims” of the system’s
structure. Addressing the thorny institutional issues to which the migrant is subjected means, at the same time, acting on
factors that also distress refugee workers and affecting, by consequence, the relationship between the two.
›› Service Provision ‹‹
To ensure that the needs of vulnerable asylum seekers are met adequately, service-providers need to provide effective
assessment of vulnerability. However there has been a partial if not full collapse between the process of defining vulnerability
and the process of identifying vulnerability in the asylum seeker service provider field with many ‘automatic’ assessments
taking place that do not take into consideration the variety of contributing factors. This is in part caused by the way in which
assessments are made and the way that the system for assessment is organised. Prior to individual needs assessments (if
they take place at all) are strategic or structural identification procedures, whereby specialist service providers, whose raison
d’être is based wholly on the particular needs of one vulnerable group of people (for example trafficked women), assess
and label people, and so their needs are addressed according to these static definitions. Such fixed automatic definitions
do not take into account the fluid and situational nature of vulnerability and the contextual way in which needs shift.

A politically charged atmosphere often surrounds the asylum system and it is in this context that needs are identified and
addressed. One of the biggest structural problems is the gap between policy and practice, which can be attributed to a
lack of funding or resources to implement policy as well as to constantly shifting legislation that causes confusion on the
ground and becomes difficult to put into practice. The result is that legislation does not effectively or coherently regulate the
asylum process, damaging both service providers and users. Service providers are placed in a difficult situation, becoming
frustrated by their lack of power to act and individual staff members defend themselves by handing problems off from
one to the other, or delegating them to social workers with diverse, wide-ranging profiles. The impossibility of managing
beneficiaries’ needs efficiently is usually attributed to legislative and structural deficiencies, a justification that gradually
leads to a helpless and resigned attitude: “This is the law and we can’t change it;” “I didn’t write the law, I can’t do anything
about it;” “Everyone is equal under the law; we can’t change it just for you” (service providers in Italy).
This research points to two personas that refugee workers may take on in the face of this frustration: the “functionary” or
the “philanthropist.” The former manages the situation and defends themselves by maintaining distance from the service
users. Meanwhile the latter’s approach is more emotionally-involved, and entails proposing ad hoc and one-off solutions
to help service users (such as finding illegal work). This creates an environment of preferential treatment and does not lead
to practical or repeatable solutions, and furthermore can clash with the official organisational methods of the institution. A
lack of adequate legislative, budgetary and professional tools prevents staff from effectively carrying out their role, making
them weak and ambiguous in the eyes of beneficiaries. The impotence of service providers to assist service users can be
very harmful to relations between the two, adding to the atmosphere of mistrust and uncertainty that makes service users
reluctant to express their needs in the first place, and encourages them to give into feelings of despair and hopelessness.
Service users find that they wait far longer than is expected – they may be detained for periods of time longer than that
permitted by law or their stay in a centre may be up to ten times that which is foreseen in legislation. “Initially, many guests
thought that the entire asylum process would take around 30 days, in fact the pamphlet they are given by the police
mentions that the maximum time allowed for review of the asylum request is 21 days. This figure is quite far from the reality,
as the guests of the centres experience first hand. It actually takes between 3 to 4 months and the times are always getting
longer; in fact the personal kit given to guests on their arrival is not sufficient for the duration of their stay as foreseen in the
CARA regulations” (service provider in Italy).
This puts staff in a difficult position, and many are unsure how to present the reality of the situation to asylum seekers: “What
information are we supposed to provide, the real or the institutional version?”; “We prefer to tell them how things actually
are, not how they should be or what is foreseen by law” (service providers in Italy).
Another symptom of the unintelligibility of the legal system is the fact that there is often a disparity between judgements of
different territorial commissions and certain national or ethnic groups are denied status more than others. Refugee workers
in the Italian system noted that Nigerian and West African asylum applications are denied 99% of the time, which does not
point to a coherent or neutral system.
Policy that changes constantly also effects the provision of services. “It’s very ad hoc... the way things work. We are waiting
for one council to go to court to see how they interpret it. I go to HIV care management meetings and the last case as soon
as the law changed lots of people had the councils turned around and say to them ok you just take away that community
care from those people [asylum seekers]. They are no longer eligible to have it. But people were saying no hang on. We
do an assessment of needs first” (service provider in the UK).
Not only is practice inconsistent with national legislation, but the national legislation itself is not always harmonised to
international standards. In Greece, for example, the asylum system is run almost entirely by the NGO sector and staffed
predominantly by volunteers. There is in fact no official system for identifying needs and needs are met by different NGOs
who run centres across the country. Thus there is no uniform standard when it comes to assessing or addressing needs, and
this does not meet international standards.
Even where the structure to assess needs is more formalised, the lack of a coherent or joined-up system was another issue
unearthed by the research in each country. Although there are different levels of coordination amongst organisations and
different structures in place, a more comprehensive needs assessment was felt to be needed across the board.
Greater coordination to address needs is vital, as while some needs can be more easily spotted and addressed, others
are much more difficult to be treated “in-house” and thus require energies and expertise that unless the system provides
for cannot actually be met by a single organization or individual. Thus effective local referral systems are necessary to
address needs. However, local mainstream services are incapable of meeting the requests for more specialised treatments
for reasons of funding, time, or lack of specific cultural competences to deal with the particular problems asylum seekers
face.

The lack of an effective referral system highlighted difficulties and some tensions between different organisations as service
providers may rely heavily on making referrals back out to external organisations in order to meet the needs of service users.
However, the lack of feedback from the organisations they referred clients to made it difficult to know whether the service
users’ needs were actually met and if this was an effective way of meeting the needs of vulnerable asylum seeking persons.
Some people suggested that service providers would sometimes make referrals in order to ‘get rid of problems’ rather than
to genuinely meet the needs of vulnerable asylum seekers. There was also particular concern over referrals to the health
sector with complaints that workers in the health sector were often confused over the entitlement of asylum seekers at various
stages in the process of free health care.
A lack of communication between different relevant organisations is exacerbated by the fact that very often there are too
many organizations involved with the asylum procedure all of which work on a small part of the process. For asylum seekers,
this is difficult to understand and for every part of their procedure, they have to go to another office. The organizations do
not cooperate well with each other and can become so focussed on their part of the process that they don’t see the bigger
picture.
There was also evidence of active uncooperativeness from some organisations, who are resistant to ‘interference’ from
outside sources in their field of work. “We have often expressed our concerns to Youth Care about some children. We
asked Youth Care if they could have a closer look at these children. They never listened. They tell us our only task is teaching
and that we should not interfere with their task” (teacher at a Dutch migrant school). Such an attitude suggests that the best
interests of the child have got lost in the system.
Dispersal policies add to the problem of inadequate collaboration between organisations as it often happens that when
problems are finally identified service users are relocated to other areas within the country. Indeed, a ‘floating’ population
is hard to keep track of. “NAS don’t inform us where their hostels are in the borough or when there is someone with HIV
living in one. I never know where they are. There is no handover. We don’t know where they are” (service provider in the
UK). This illustrates the lack of connectedness between different parts of the system. One must also remember that needs
change according to location, and a service user might become vulnerable when moved to a new location.
One experienced worker from one of the most important services for asylum seekers in the UK put it succinctly when she
suggested that it is essential to develop urgently common EU procedures and practices for assessing the age of asylum
seekers, as well as addressing issues pertaining to guardianship, detention, returns, family reunion and Dublin 11 cases.
All these are specific areas that require attention not only in terms of their own merit but also because, remaining unclear,
they often become sources of vulnerability in asylum seekers.
What are also needed are better links between organisations and partnership-working such as joint intakes, integrated
working and the development of multidisciplinary teams with common assessment approaches, joined up services, and
more flexible ways of engaging with service users would improve the current situation.
Another key issue explained in the findings of this research is that of language and cultural barriers. It is a problem that
has been usually addressed in Europe through the use of cultural mediators, such as migrants from the same Countries
of the service users, trained for the purpose, who could mediate between the provider and the beneficiary, not only
translating but also bridging their cultural differences. This system was put in a serious crisis by the proliferation of migrant-
refugee populations and the differentiation of their mobility paths. Indeed it would be nowadays logistically and financially
impossible to identify, hire, train and maintain over time cultural mediators for each and any of the populations serviced by
each and every service, whether that was possible few years ago, when populations were less and usually following more
standardized migration paths and clear geographical and urban distributions. Moreover, the issue of delegating to a third
figure the understanding of the culture and specificities of the beneficiary is considered potentially harmful as it downplays
individual differences and sub-cultural values, and could cause stigmatization.
An alternative model is in fact one of cultural competence of the service provider, that is competence in creating interactive
acknowledgement of individual cultural differences between the provider and the receiver, eventually accompanied by
translation only. This competence would not therefore be population-culture specific, but help the provider in acknowledging
the possibility of differences and tackling it in his-her help relation with the beneficiary in a participatory manner. This model
is certainly more sustainable than the previous, but still requires the presence of translators, and investments in training.
An added dimension to intercultural communication and mediation is the non-verbal, and it is especially important for
vulnerable persons. This means that paralinguistic systems, kinesics and proxemics must be taken into account as part of a
cultural mediation service so as to allow full communication between service provider and user.

VI. DEVELOPING INSTRUMENTS TO ASCERTAIN VULNERABILITY
IN ASYLUM SEEKERS

Central to the aims of this project was the need to identify the vulnerable asylum seekers and their needs.
Consequently, on the basis of the findings, three groups of instruments were developed. These can be found in
the ‘EVASP Trainers’ Handbook’ that can be accessed on the internet. Please visit this website: http://www.
evasp.eu/aspis/
Nevertheless, the key issues are going to be mentioned here and the main instrument, the ‘Asylum Seekers’
Vulnerability Indices’ (ASPIS) will be discussed more extensively.
›› Ascertaining Vulnerability in Asylum Seekers ‹‹
Essentially, three groups of instruments were developed. Initially, based on the understanding that vulnerability in
asylum seekers is not a singular but a complex and composite phenomenon that combines both ‘external’ and ‘internal’
elements, nine clusters of factors were identified which were called ‘dimensions’ and each dimension consisted of
several more specific ‘categories’.
On the basis of these dimensions that emerged from the research, a graph was drawn to list these dimensions marking
the degree of vulnerability on the vertical axis. This was called the ‘Asylum Seekers’ Vulnerability Profile’ (ASVUP).
ASVUP was formed in two versions:
a. ASVUP: where the degree of vulnerability can be assessed according to five possible degrees on a scale from
0 to 5, i.e. maximum, minimum, average, above average and below average, and
b. ASVUP-P: where P stands for ‘Provision’; this version had the same scale of assessment (i.e. from 0 to 5) but for
each dimension of vulnerability there are were three sub-divisions: the first assessing the situation of the asylum
seeker one is working with, the second assessing the degree of existing provision in relation to that dimension
of vulnerability, and the third assessing the potential or planned future provision for that same dimension of
vulnerability. In this way, the vulnerability was directly connected with the degree of actual and potential
provision. This was a concrete way of devising an instrument that took into account the relational and interactive
nature of vulnerability which was one of the important considerations that emerged from the research.
Then, another instrument was developed the ‘Asylum Seekers’ Vulnerability Assessment Scale’ (ASVAS) that was
essentially the same as ASVUP-P but offered a more precise way of determining the degree of vulnerability by altering
the scale to percentages, i.e. from 0 to 100, instead of the ASVUP scale from 1 to 5. The intention was that ASVAS
would be scored in a comparable way to the widely used Global Assessment of Functioning (GAF) Scale and
the children’s version, the Children’s Global Assessment Scale (CGAS). Similar to GAF and CGAS, ten sets of
indicative criteria were developed for each dimension (each covering 10 percentage units).
Following further feedback and consideration, it became evident that it is indeed very difficult to achieve the accuracy
of assigning a percentage value for each dimension of vulnerability and a new instrument was developed, the ‘Asylum
Seekers’ Protection Index’ (ASPI) that attempted to take on board all the other characteristics of vulnerability that
emerged in the research. More specifically,
a. The most important innovation that ASPI introduced was that it re-focused on the protective function that it should have
in relation to asylum seekers. Consequently, the emphasis was not only on vulnerabilities but also included positive
factors connected with each facet of life that it addressed.
b. The emphasis on measurement was reduced and instead of having a scale at the end of each dimension there is a
line on which the worker can mark the degree of concern rather than the degree of vulnerability.
c. Not only dimensions but also some of the most important constituent categories of each dimension are also included.
d. Finally, appreciating the difficulties profiling a person in relation to his/her vulnerabilities, ASPI indicates his or her
vulnerable position in relation to the services available. It is for this reason that the instrument was then named an
‘index’, because it indicates in a systematic way rather than measures.
Following further feedback from the final project conference, in Rome in July 2010, additional modifications were made
to ASPI and it was renamed to ASPIS (Asylum Seekers’ Protection Indices). These modifications are the following:
a. the plural of index (i.e. indices) was introduced because it was appreciated that not only an indication of the
vulnerable positions of the asylum seekers should be included but also another type of index, a Vulnerability
Grid which is an adapted form of the Trauma Grid.
b. A Vulnerability Grid is introduced as another indication of additional important areas of the asylum seekers’
range of functioning. This Grid tabulates the range of responses to vulnerability by including three columns
(negative responses, resilient characteristics and adversity-activated development (AAD) functions; the same

number of columns as the Trauma Grid is retained (for the individual, family, community and society/culture).
The negative column is marked by a line from ‘Most severe’ to ‘Least severe’ negative responses whereas the
other two columns are open spaces for the worker to make notes of specific resilient and AAD characteristics.
c. A summary sheet is included that systematises all the other information that is gathered by the instrument in
order to facilitate the grasp of the main themes.
A note about the very name ASPIS is needed: ‘Aspis’ is the ancient Greek work for ‘shield’, so it was considered appropriate
for an instrument that is intended to protect asylum seekers to have this name!
Apart from these innovations, ASPIS retains all the positive elements of ASPI, i.e.
a. The wide spectrum of dimensions and some of their more important constituent categories,
b. Its interactional and contextual nature insofar as it related to the available and future services,
c. Its non-pathologising position as it includes not only the negative but also the positive facets of each category,
and lastly,
d. Its central character that it is not a measuring assessment tool but an instrument that indicates in a systematic way the
vulnerable positions within which the asylum seeker is located.
The last point requires further explanation: The EVASP project showed clearly that given the complexity, multifaceted and
polymorphous nature of the concept of vulnerability, it is impossible to devise a single instrument to measure it. However,
this does not mean that workers should give up attempting to grasp the various facets of vulnerability associated with the
asylum seekers they work with.
Therefore, ASPIS aims to offer a systematic framework to indicate not the asylum seeker’s vulnerabilities
but the vulnerable positions within which he or she is located by a series of factors and circumstances
during a certain period of his or her life.

VII. SUMMARY OF KEY ISSUES AND RELEVANT RECOMMENDATIONS

On the 5th and 6th of July 2010, an International Conference was organized in Rome by the EVASP project
in order to present the key findings of the project and further explore and compare with other experiences and
practices from all over Europe some of the key themes and issues which have emerged throughout the present
study.
The Conference was attended by over one hundred participants coming from different EU MS, including experts
representatives from national asylum agencies, academic institutions, service providers in the areas of social and
mental health, education, reception policies, law, representatives of International and national NGOs working
with and representing asylum seekers as well as local projects and a number of asylum seekers themselves.
The Conference allowed for an in-depth discussion and exploration of the following three key themes:
»» Current conceptualizations and working definitions of vulnerability in asylum seekers

»» Current practices in the provision of (psychosocial) services to vulnerable asylum seekers
»» Key challenges and identification of key recommendations on best practice of service provision to
vulnerable asylum seekers
The way both asylum seekers and service providers seem to conceptualise vulnerability leads us to conclude
that it would be more appropriate to talk about composite factors of vulnerability rather than of vulnerability of
individuals, i.e. dimensions of vulnerability with their constituent categories. Amongst the most common factors,
social isolation and marginalization, the inability to communicate and being understood effectively, discrimination
and the absence of information and access to available services have been more frequently highlighted in
interviews and focus groups held throughout this project. The overall impression we had, was that regardless
of their past experiences, the current contexts in which asylum seekers live presented them with significant
additional stressors that at different times affect both positively and negatively their capacity to cope. This in
many cases also holds true for service providers who have in particular to struggle with many inconsistencies the
law poses them with.
Increasing the level of protection for asylum seekers in Europe thus remains a crucial challenge in the construction
of the CEAS. Consistent with similar researchers and projects conducted in Europe and elsewhere in recent years
on the topic of vulnerability in asylum seekers, there is indeed substantial evidence to affirm that some of the
current policy measures and several limitations connected with the quality and relevance of service provision,
contribute to the creation of additional physical and psychological problems in individuals seeking refuge in
Europe as well as exacerbating previous problems in those who are already suffering from traumatic experiences
connected with their pre-migratory experiences.
In the following paragraphs, with a view to contributing to recent efforts by the EU in recasting the building blocks
of its Asylum Acquis9 and based on the EVASP research findings and the extensive discussion and exchanges
occurred during the Final Conference of the project, we would therefore like to propose a series of key conclusions
and recommendations drawn from this study aimed to improve future EU and MS policy making and actual
service provision available for vulnerable asylum seekers 10.
›› KEY ISSUE 1: Current Conceptualizations and assessments of vulnerability ‹‹
Very often current practices in the assessment of vulnerability rely heavily on external categories based on biographical
factors (as with minors and the elderly) or based on the composition of the family nucleus (single-parent families with
dependent children, families with minor children, unaccompanied minors) and are concentrated on the individual
with narrowly defined risk assessment. Although current efforts in conceptualising and addressing the special needs
of vulnerable asylum seekers are commendable, it is important not to neglect also the psychological dimensions, the
way one experiences and is affected by the external events and conditions. This means that it is essential that we
conceptualise vulnerability as a combination of both external and internal factors.
9 At the time of writing, the European Commission has presented proposals for amendments of the Regulation determining the Member State
competent for the examination of an asylum application (Dublin II Regula¬tion), for the Directive on minimum standards for the Reception of asylum
seekers (Reception Directive), together with the proposals for a regulation establishing the European Support Office (EASO), the recasts of the
Directive on minimum standards on procedures for granting and withdrawing refugee status (Asylum Procedures Directive) and of the Directive on
minimum standards for the qualification and status of third country nationals or stateless persons as refugees or as persons who otherwise need
international pro¬tection (Qualification Directive).
10 More specific recommendations for the 4 countries object of this study can be found in each of the four National Report available at: www.evasp.eu

Indeed, the manner in which service providers and service users define vulnerability is central to the identification and
proper assessment of vulnerability. Time and time again asylum seekers participating to this project emphasised that
they did not feel as vulnerable because of their past experiences, as much as in relation to their current circumstances.
Even though “traditional” key factors that influence vulnerability need to be identified, such as age, gender or social
status, it is also very important to examine the contextual, relational and dynamic nature of the interaction between
the conditions, circumstances, services available and the individual’s explanatory frame of reference and responses.
In this sense, it is useful to hold in mind that asylum seekers are one of the most vulnerable but also resilient members
of society and these paradoxical states co-exist without conflict within most asylum seekers in different measures.
It is for this reason that identifying both strengths and weakness in asylum seekers is central to the provision of
a comprehensive and effective support. Based on the above considerations, the following recommendations are
therefore put forward:
1.1 The assessment of asylum seekers’ needs should be comprehensive of the totality of their experience, both
in terms of past, present and future expectations, vulnerabilities but also strengths and resources that can be
activated for the resolution of their problems;
1.2 Assessment of needs should be able to capture the reality of resources that are available within the immediate
context where the asylum seeker live, identifying potential gaps in service provision that the system around the
asylum seeker can and should activate;
1.3 The specific needs of asylum seekers should be properly addressed within broader discourses on their integration
within host societies;
1.4 Increased assessment capacity should be promoted by strengthening interagency and interdisciplinary capacity
and collaboration both at local and national level between a number of different professionals and organizations
with different skills and operating in different sectors;
1.5 The social and cultural systems of asylum seekers, the supports of family, employment, religion and spirituality,
governmental and non governmental services and benefits are areas of understanding the protective factors of
asylum seekers’ wellness which should further be investigated at EU level under similar and different conditions
in order to test the reliability and improve the usefulness of studies for future policy making.
1.6 Reiterating the aims of ASPIS, it is important to appreciate the value of developing a systematic framework
that indicates the various vulnerable positions within which asylum seekers are located by
a series of factors and circumstances during a certain period of their lives, instead of attempting
to measure their vulnerabilities.
1.7 Vulnerability in asylum seekers will need to be understood contextually i.e. in relation to the uniqueness of each specific
context, relationally and interactively i.e. in relation to the specific interactions asylum seekers have with individuals
and services, and dynamically i.e. as changing in time and responding to the ever changing circumstances.
›› KEY ISSUE 2: Addressing social marginalization and exclusion ‹‹
As amply reported throughout this present study, there is an urgent need for addressing the feeling of social exclusion
and marginalization felt by many asylum seekers and for promoting their full integration into host societies. This
would in particular require readdressing some of the key structural factors that contribute to increasing the social
marginalization of asylum seekers in many EU MS. In particular, there is sufficient evidence to suggest that policies of
detention and forced dispersal, the practice of accommodation provided in isolated and remote areas and destitution
as a result of lack or limited access to employment, all are key factors in producing both short and long-term negative
impact on asylum seekers’ physical and mental health. It is therefore recommended that:
2.1 Detention of asylum seekers will be used as an extreme ratio and only after first reviewing all other alternatives
and finding that there is no effective one. Vulnerable people should never be placed in detention and specifically,
unaccompanied minors should never be detained;
2.2 Dispersal measures should be implemented through the active involvement and in full consultation with both
asylum seekers and health and social professionals involved in their care;

2.3 Access to work and meaningful education should be promoted also as means of prevention of psychosocial
distress and illness and for improving the rehabilitation outcomes for people with mental health problems;
2.4 Asylum seekers should be accommodated within an environment that is as normal and stable as possible, and
that promotes opportunities for them to socialize and engage in meaningful activities that help them to better
cope with their past and present experiences and future expectations;
2.5 Awareness of the specific situation faced by asylum seekers, their reason for fleeing their country and their
present situation should be raised amongst local host population.
›› KEY ISSUE 3: Ensuring greater convergence between entitlement and

access to services ‹‹
As highlighted in the present report there is a particular need for mainstream and specialised services to be truly
accessible and available to asylum seekers. This would entail in particular differentiating between what occurs at the
level of access and that of entitlement. Indeed wide disparities have been reported in relation to potential and actual
discrepancies existing between legal entitlements to service provision and the actual lived experience of access to
services by asylum seekers. In general, asylum seekers often pointed out several difficulties they have in accessing
and finding appropriate care when needed and difficulty in understanding the roles of different professionals and
services available to them. In this context, the level of access to service seems to be greatly affected and dependant
on the amount and quality of information made available about existing services and their cultural appropriateness
and sensitivity with regard to the needs of the beneficiaries and the way to reach them. For these reasons, it is
recommended that:
3.1 Specialised single points of access and information on social, legal and medical services that do not duplicate
existing local arrangements should be established nearby reception centres and local referral systems;
3.2 Increased access to mental health and social services and support for asylum seekers should be enhanced
through the availability and quality of professional interpretative and cultural mediation services and free
transportation means when needed;
3.3 Asylum seekers should be involved as much as possible in the organisational management and day to day
running of reception centres by giving them the opportunity to express their needs and participate in the
practical maintenance and improvement of the centres where they are hosted;
3.4 Independent audits should be carried out in particular on interpretation services provided in the health and
legal services to ensure interpretation is of good quality and redress complaints;
›› KEY ISSUE 4: Building capacity and coordination ‹‹
The provision of care in asylum seekers’ services varies on the ground from broadly based assessment of clients’ needs
to coordinating services and training staff across a range of service providers, including for example counsellors and
providers of material care. It is here assumed that given the wide range of causes and symptoms of psychosocial
distress and the range of needs that asylum seekers experience, high quality service response needs to be holistic in
its theoretical and practical approach and involve a number of different professionals working at different levels and
sectors. As discussed throughout this report, isolated service provision is indeed unlikely to be able to offer good
quality reception and care. However, very often the problem of providing care for this group, is to integrate the
many different perspectives that exist, in order to ensure that all the different problems asylum seekers can have are
tackled in a coherent way, rather than being fragmented between services that are more inclined to compete with
each other than to cooperate. In relation to this, one aspect which has proven to be particularly deficient is also the
actual participation of asylum seekers in service design and implementation. It is well known that participation can
take many forms, from mere ‘tokenism’ to asylum seekers assuming a genuinely active role. Participation of the latter
kind should always be promoted as it can help service providers in devising more appropriate services by having an
improved understanding of the real needs and experiences of the people they are meant to assist. Related to these,
the following recommendations can be put forward:

4.1 Interagency collaboration between different social, legal and medical care services and actors should be
promoted and institutionalised in each MS in order to foster and facilitate information and best practice
exchanges, allow for the definition of common assessment and intervention strategies and well-rounded plans
to address the needs of asylum seekers at different levels;
4.2 All health and social care practitioners should receive constant training to increase their knowledge of social
care and welfare entitlements, and awareness of the experiences and needs of asylum seekers with special
needs;
4.3 Free basic language training and basic skills in dealing with foreign cultures, in particular for general refugee
workers with whom asylum seekers enter into most frequent contact in reception facilities should be established
( and a minimum “EU” level of proficiency should actually be part of the TOR for staff)
4.4 Reception staff should receive external support in the form of “supervision” (meaning a method of counselling/
coaching and guided self-reflection), with particular attention paid to signs of distress or “burn out”. This
coaching should be paid for by the organisation and take place during working hours.
›› KEY ISSUE 5: Building up sound evidence on effectiveness and

responsiveness ‹‹
As a last consideration, there is a need for building up further evidence of what works best in assessing the special
needs of vulnerable asylum seekers, and the kind of care and service provision which has proven to be more effective
in meeting these needs. Fundamental to this will be in particular the commissioning of national and transnational
cross-organizational and cross-disciplinary qualitative and quantitative research on needs, service utilisation and
effectiveness of different approaches to assessment and treatment available to asylum seekers. In particular the validity
of assessment and diagnostic instruments as well as of the concepts on which these are based need to be further
investigated and cross-validated through pilot experiences in different contextual settings. Once again, participatory
methods involving asylum seekers may also be useful for better evaluating service provision. If services have to be
adapted to suit the needs of users, then it is inevitable that users must be more closely consulted about how this should
be done. More specifically it is recommended that:
5.1 European-wide scientific networks, involving both academics from relevant disciplines, policy makers and
practitioners on matters of vulnerability should be established and periodic thematic meetings involving different
expertises should also be promoted;
5.2 An independent monitoring body to monitor services delivery in particular in accommodation and reception
centres should be established in each MS, in order to enhance respect of contractual obligations and allow for
effective monitoring of complaints resolution;
5.3 The value of services provided to asylum seekers should be assessed externally by standards of care judged
acceptable by national and international standards and fully acknowledging clients’ perspectives;
5.4 Different MS should benefit from more frequent and structured exchange and sharing of personnel, case
management strategies and skills development. In this context, more targeted and more effective use of existing
EU and national funding mechanisms should also be used to improve performance and overcome financial
barriers to high quality service provision.

›› Bibliography ‹‹
AA.VV., Limes, Il mondo in casa, n°4/2007, Gruppo Editoriale l’Espresso;AA.VV., Practitioner Commentaries on the EU
Acquis on Asylum, European Commission, Vienna 2000
Amnesty International (2006). Italia, Invisibili. Minori migranti detenuti all’arrivo. Rome: EGA Editore.
Anderson, A. C. (1984). “Some reflections on the acquisition of knowledge,” Educational Researcher (13) pp.5-10.
Andolfi, M. (ed.) (2004). Famiglie immigrate e psicoterapia transculturale. Milan: Franco Angeli
Arendt, H. (1973). The Origins of Totalitarianism (2nd ed.). New York: Harcourt, Brace, Jovanovich.
Bascherini, G. (2007). Immigrazione e diritti fondamentali. L’esperienza italiana tra storia costituzionale e prospettive
europee. Naples: Jovene editore
Bennagadi, R. (2009). Cultural Competence and Training in Mental Health Practice in Europe: Strategies to Implement
Competence and Empower Practitioners. Bruxelles: IOM.
Betancourt, J., Green, A., & Carrillo, E. (2002). Cultural competence in health care: emerging frameworks and practical
approaches. Washington: The Commonwealth Fund.
Bichi R. & Valtolina G. (2005). Nodi e snodi. Progetti e percorsi di integrazione degli stranieri immigrati. Milan: Franco Angeli.
Brekke J.P. (2004). While we are waiting. Oslo: Institute for Social Research.
Brik, E., Colmenero, A., Benedicto, J.M., Martinez, J. & Sancho, C. (1988). “An analysis of psychiatric ailments among
refugees and asylum seekers in Spain.” In: Miserez, Diana (ed.), Refugees the Trauma of Exile. The humanitarian role of
the Red Cross and Red Crescent. Dordecht: Maritnus Nijhoff Publishers. pp. 179 – 191.
Cannon, T. 1994. Vulnerability analysis and the explanation of ‘‘natural’’ disasters. In Disasters, development and
environment, ed. A. Varley, 13–30. Chichester, U.K.: Wiley.
Commission of the European Communities (2007) GREEN PAPER on the future Common European Asylum System
http://eur-lex.europa.eu/LexUriServ/site/en/com/2007/com2007_0301en01.pdf
Elbert, T., & Schauer, M. (2002). “Burnt into memory,” Nature (October 2002) (419)
Fassin, D. and D’Halluin, E. (2005). “The Truth from the body: Medical Certificates as Ultimate Evidence for Asylum
Seekers,” American Anthropologist (107:4) pp. 597-608.
Finch, H. & Lewis, J. (2003). “Focus Groups”. In: J.Ritchie & J. Lewis (ed.s.), Qualitative Research Practice: A guide for
social scientists and researchers. London: SAGE. pp. 170−198.
Hein, J. (1993). “Refugees, immigrants, and the state,” Annual Review of Sociology (19) pp. 43-59.
IOM (International Organization for Migration) (2002). Torniamo all’asilo. Uno studio per il Programma Nazionale
Asilo. Rome.
Karpman, S. (1968). “Fairy Tales and Script Drama Analysis,” Transactional Analysis Bulletin (7:26) pp. 39-43.
Keller, S. (1975). Uprooting and Social Change: The Role of Refugees in Development. Delhi: Manohar.
Kira, I (2004). Secondary trauma in treating refugee survivors of torture and their families. Torture, 14, 38-44.
Kirsch, I., Lynn, S.J., Vigorito, M. & Miller, R.R. (2004). “The role of cognition in classical and operant conditioning,”
Journal of Clinical Psychology (60) pp. 369 – 392.
Kramer, S. & Bala, J. (2004). “Managing Uncertainty: Coping Styles of Refugees in Western Countries,”
Intervention (2:1) pp. 33-42.

Krueger, R. A. & Casey, M. A. (2000). Focus groups. A practical guide for applied research (3rd ed.). Thousand Oaks: Sage.
Losi, N. (2006) Lives Elsewhere: Migration and Psychic Malaise. London: Karnac.
Losi, N. & Papadopoulos, R.K. (2004). “Post-conflict Constellations of Violence and the Psychosocial Approach of the
International Organization for Migration (IOM)”. In: Book of Best Practices. Trauma and the Role of Mental Health in Post-
Conflict Recover. Rome: International Congress of Ministers of Health for Mental Health and Post-Conflict Recovery.
Martin C., & Phelan, M. (2009). “Interpreters and Cultural Mediators-Different but Complementary Roles,” in
Translocations: Migration and Social Change (6:11). Dublin: Dublin City University.
Maslow, A. H. (1943). A Theory of Human Motivation, Psychological Review 50, 370-96.
Morgan, D. L. (1998). Planning Focus Groups. Thousand Oaks: Sage.
Nathan, T. (2003). Non siamo soli al mondo. Turin: Bollati-Boringhieri.
Niessen, J., Huddleston, H. & Citron L. (2007). Migrant Integration Policy Index. Brussels: British Council and Migration.
O’Doherty, K. & Augoustinos, M. (2008). Protecting the nation: Nationalist rhetoric on asylum seekers and the Tampa.
Journal of Community & Applied Social Psychology. 18, 576-592.
Papadopoulos, R.K. (1997). “Individual identity and collective narratives of conflict,” Harvest: Journal for Jungian Studies
(43:2) pp. 7-26.
Papadopoulos, R.K. (2000) A Matter of Shades: Trauma and Psychosocial Work in Kosovo. In Psychosocial and Trauma
Response in War-Torn Societies; the Case of Kosovo, edited by N. Losi. Geneva, I.O.M.
Papadopoulos, R.K. (2001a) Refugees, therapists and trauma: systemic reflections. Context; the magazine of the
Association for Family Therapy, No. 54, April, pp. 5-8. Special issue on Refugees; edited by G. Gorell Barnes and R. K.
Papadopoulos.
Papadopoulos, R.K. (2001b) Refugee Families: issues of systemic supervision. Journal of Family Therapy, vol.23, No. 4,
405- 422.
Papadopoulos, R.K. (2002) Refugees, home and trauma. In Therapeutic Care for Refugees. No Place Like Home, edited
by R. K. Papadopoulos. London: Karnac. Tavistock Clinic Series.
Papadopoulos, R. K. (2004). Trauma in a systemic perspective: Theoretical, organizational and clinical dimensions.
Paper presented at the 14th Congress of the International Family Therapy Association, Istanbul.
Papadopoulos, R.K. (2006). ‘Refugees and psychological trauma: Psychosocial perspectives’. Invited contribution
to ‘Good Practice Website Project’. Can be accessed at http://www.ncb.org.uk/dotpdf/open%20access%20-%20
phase%201%20only/arc_1_10refandpsych.pdf
Papadopoulos, R.K. (2007). “Refugees, trauma and Adversity-Activated Development,” European Journal of
Psychotherapy and Counselling (September 2007) (9:3) pp. 301–312.
Papadopoulos, R.K (2008). “Systemic Challenges in a Refugee Camp”, Context (August 2008) pp 12-15.
Papadopoulos, R.K. (2010). Identifying psychosocial vulnerabilities in asylum seekers. PowerPoint presentation at the
EVASP Final Conference in Rome.
Papadopoulos, R.K., Ljubinkovic, A. & Warner, S. (2007). Report on assessment of psychosocial needs at the Dadaab
refugee camps. University of Essex: Report.
Peterson, C., Maier, S.F. & Seligman, M.E.P. (1995). Learned Helplessness: A Theory for the Age of Personal Control.
New York: Oxford University Press.

Proudfoot, M. (1956). European Refugees: 1939-52—A Study in Forced Population Movement. London: Faber & Faber.
Ryan, D, Dooley, B. & Benson, C. (2008), “Theoretical Perspectives on Post-Migration Adaptation and Psychological Well-
Being among Refugees: Towards a Resource-Based Model,” Journal of Refugee Studies (March 2008) (21) pp. 1-18.
Schouten, B. & Meewuwesen, L. (2006). “Cultural Differences in Medical Communication,” Patient Education and
Counselling (64) pp.21-24.
Stein , B.N. (1981). “Documentary note: refugee research bibliography,” International Migration Review (15:l) pp. 331-
93.
Stein, B.N. (1981).” The refugee experience: defining the parameters of a field of study,” International Migration Review
(15:l) pp. 320-30.
Stein, B.N. (1986). “Durable solutions for developing country refugees,” International Migration Review (20:2) pp.
264-82.
Touzenis, K.: Trafficking in human beings: human rights and transnational criminal law, developments in law and
practices, UNESCO migration studies series number 3, 2010
UNHCR (ed.s) (1979). Handbook on Procedures and Criteria for Determining Refugee Status. Geneva.
Van Selm J. (2005). “European refugee policy: is there such a thing?” In: New Issues in Refugee Research (UNHCR
Working Paper No. 115, May 2005).
Vanistendael, S. (1998). La resilience ou le realisme de l’esperance. Geneva: BICE.
Watts, M. and H. G. Bohle (1993). “The space of vulnerability: the causal structure of hunger and famine,” Progress in
Human Geography (17:1) pp. 43-67.

Notes:

EVASP Transnational Research

Hochgeladen von

Dokumentinformationen

Originalbeschreibung:

Copyright

Verfügbare Formate

Dieses Dokument teilen

Dokument teilen oder einbetten

Freigabeoptionen

Stufen Sie dieses Dokument als nützlich ein?

Sind diese Inhalte unangemessen?

Copyright:

Verfügbare Formate

EVASP Transnational Research

Hochgeladen von

Copyright:

Verfügbare Formate

›› Preface ‹‹

Orso Muneghina Renos K Papadopoulos

AAD Adversity-Activated Development

I. EVASP: ENHANCING VULNERABLE ASYLUM SEEKERS’ PROTECTION 8

Background, aims and objectives of the EVASP project 9

The Concept of Vulnerability 12

III. RESEARCH METHODOLOGY 24

VI. DEVELOPING INSTRUMENTS TO ASCERTAIN VULNERABILITY IN ASYLUM SEEKERS 41

VII. SUMMARY OF KEY ISSUES AND RELEVANT RECOMMENDATIONS 44

KEY ISSUE 1: Current Conceptualizations and assessments of vulnerability 45

EVASP | Enhancing Vulnerable Asylum Seekers Protection | Transnational Report 2009-2010 3

Consequently, the aims of the EVASP project were to:

The EVASP project consisted of the following phases:

I. Preliminary consultations: Preliminary meeting in Paris in February 2009

4 EVASP | Enhancing Vulnerable Asylum Seekers Protection | Transnational Report 2009-2010

A. Research (January - November 2009):

B. Capacity building (November 2009 - March 2010):

C. Dissemination (March - July 2010):

factors of vulnerability service provision

EVASP | Enhancing Vulnerable Asylum Seekers Protection | Transnational Report 2009-2010 5

6 EVASP | Enhancing Vulnerable Asylum Seekers Protection | Transnational Report 2009-2010

EVASP | Enhancing Vulnerable Asylum Seekers Protection | Transnational Report 2009-2010 7

8 EVASP | Enhancing Vulnerable Asylum Seekers Protection | Transnational Report 2009-2010

Based on the above, the project aims were

1. With reference to the definition of vulnerability in asylum seekers

EVASP | Enhancing Vulnerable Asylum Seekers Protection | Transnational Report 2009-2010 9

3. With reference to the addressing of the needs of vulnerable asylum seekers

4. With reference to the dissemination of findings, to maintain

10 EVASP | Enhancing Vulnerable Asylum Seekers Protection | Transnational Report 2009-2010

EVASP | Enhancing Vulnerable Asylum Seekers Protection | Transnational Report 2009-2010 11

›› The Concept of Vulnerability ‹‹

a. the state or condition of the subject of vulnerability (i.e. a person or a group),

12 EVASP | Enhancing Vulnerable Asylum Seekers Protection | Transnational Report 2009-2010

Phases of the asylum seekers’ experience

EVASP | Enhancing Vulnerable Asylum Seekers Protection | Transnational Report 2009-2010 13

14 EVASP | Enhancing Vulnerable Asylum Seekers Protection | Transnational Report 2009-2010

EVASP | Enhancing Vulnerable Asylum Seekers Protection | Transnational Report 2009-2010 15

Political vs psychological approaches

16 EVASP | Enhancing Vulnerable Asylum Seekers Protection | Transnational Report 2009-2010

›› The Asylum Seeker Vulnerability ‹‹

Construction and Co-construction of vulnerability

EVASP | Enhancing Vulnerable Asylum Seekers Protection | Transnational Report 2009-2010 17

The Victim triangle and Victim Identity

The dynamics of this triangle are very important in the understanding

This triangular relationship also illustrates how important it is to

18 EVASP | Enhancing Vulnerable Asylum Seekers Protection | Transnational Report 2009-2010

Levels Negative effects ‘Neutral’ effects Positive effects

EVASP | Enhancing Vulnerable Asylum Seekers Protection | Transnational Report 2009-2010 19

20 EVASP | Enhancing Vulnerable Asylum Seekers Protection | Transnational Report 2009-2010

I. Vulnerability as entitlement (or lack of entitlement)

EVASP | Enhancing Vulnerable Asylum Seekers Protection | Transnational Report 2009-2010 21

22 EVASP | Enhancing Vulnerable Asylum Seekers Protection | Transnational Report 2009-2010

EVASP | Enhancing Vulnerable Asylum Seekers Protection | Transnational Report 2009-2010 23

24 EVASP | Enhancing Vulnerable Asylum Seekers Protection | Transnational Report 2009-2010

»» Vulnerability cannot be adequately identified if it is not adequately or appropriately defined.

EVASP | Enhancing Vulnerable Asylum Seekers Protection | Transnational Report 2009-2010 25

»» Working group meetings

TABLE 1: OVERVIEW OF RESEARCH PARTICIPANTS ACROSS THE FOUR COUNTRIES

SP >Service Providers (Staff) SU > Service Users (Asylum Seekers)

26 EVASP | Enhancing Vulnerable Asylum Seekers Protection | Transnational Report 2009-2010

EVASP | Enhancing Vulnerable Asylum Seekers Protection | Transnational Report 2009-2010 27

28 EVASP | Enhancing Vulnerable Asylum Seekers Protection | Transnational Report 2009-2010

1. Loss of supportive networks and contacts