4. Research design
7.1 The unpredictable future
7. Future and health
After a long period of time, asylum seekers receive their request’s outcome. As discussed in Chapter 5, in case of denial they can claim appeal and therefore start a legal procedure which will last many years. After this extremely long period of time, asylum seekers receive a final indisputable outcome to their appeal claim. A positive result may represent a fundamental step towards a legal life in the host-country, while a negative one entails the declaration of illegality on Italian soil and withdrawal of every right and access to services. In the first part of this chapter I argue that even though the future is always uncertain, the recognition process’ final outcome represents a major source of future unpredictability in asylum seekers’ realities and a significant obstacle in planning life consequently. Moreover, its effects may manifest disruptively in the lives of asylum seekers who, after having spent many years in the host-country undergoing activities of self-improvement and
“autonomous life planning” (Retesai, 2016), are denied and therefore deprived of any right. The second part focuses on the effects of politics and uncertainty on asylum seekers’ health and mental health: a meaningful problem too often disregarded by the Italian reception system.
involved a huge amount of years of his or her life to settle and integrate in a state that is no more willing to grant him/her the right to stay. Being recognised as an irregular migrant on Italian soil is an extremely difficult situation. Even though refused asylum seekers are expected to be repatriated, many do not consider this option in planning their future and, on the contrary, decide to remain illegally, even if this means renouncing any possibility of working legitimately.
Thomas: If it’s negative I have no options. I cannot do anything about it. They call me:
“Thomas, negative.” I don’t know what to do about it. I should stay in Italy, I’m staying here. So I should work so I can eat, I can feel comfortable. Document is a problem, you know, […] because many jobs, if you don’t have the permit they can’t take you and if you want to do something, if you don’t have the permit they can’t take you. That’s the problem right now so I’m praying God so they can give me positive, they can give me a document, I’d be comfortable with it.
As Khosravi (2010:96) argues: “The life of undocumented migrants is unsettled, unpredictable, and erratic due to the condition of ‘deportability’ frequent moves, different jobs, detention and deportation”. The ones who decide to remain have to live with the constant risk of being controlled, detained in a CPR and eventually deported. These structures’s primary function is to detain the
“irregulars” for a limited period of time before deportation. These places, however, have been the object of many criticism and consequent activists’ protests due to their inadequate living conditions
67%
21%
7% 5%
Refugee Status Subsidiary Humanitarian Denied
77%
1%
12%
10%
81%
7% 1%
11%
Refugee Status Subsidiary Special protection Denied
Figure 7. A) Asylum requests' outcomes in 2018. B) Asylum request' outcomes in 2019. C) Asylum request’ outcomes in 2020 (Ministero dell’Interno, 2020 [2015]; ASGI, 2021b).
A) B) C)
and methods defined by many as human rights violations. Through the years, these facilities constituted the scenery of episodes of psychological breakdown, self-harm and suicidal cases. A small number of health care practitioners must ensure healthcare services to these overcrowded places in which many problematic and vulnerable people are waiting for months to be identified and deported. As Wendie, activist specialised in acquiring and reporting information regarding CPR’s living conditions, stated:
Wendie: There should be, in theory, a psychologist talking to people but this only happens in extreme cases, urged by external notifications which force them to do something but for many cases something like this does not even exist.
Another option that many consider is to enact a “second migration” process (Bang Nielsen, 2004), hence, to leave the country by crossing illegally the closest border and, if not rejected at the arrival, begin once again a process of recognition somewhere else.
Kaleb: I don’t want to go in another country because Italy and Italian people saved my life. Do you understand ? If there’s no permit I have to go in another country because I speak French and France is close but I don’t want to go. I want to live here with the Italian people. […] Now I’m waiting. If appeal has gone well I will be living here for a while and then I will be transferred to Turin or Orbassano, depends. If it’s gone bad and it is negative again I must go out and live by myself. […] If this result is negative again I definitely can’t work so I don’t have money to find a place to live in, I have to sleep outside.
Turin, the city in which this research’s fieldwork was developed, is a place geographically close to the French border. Many asylum seekers tried to reach the border through the perilous paths through the Alps: a dangerous journey in which many risk their lives (Modola, 2018).
Joseph: These people walked for who knows how many kilometres in the desert and then someone tells them that the French border is at seven kilometres. They risked to die in the sea but one can die also here. This situation just does not make sense. 5
He refers to the situation in which asylum seekers, after having survived a long and perilous journey to request asylum
5
in Europe, have to put their life at stake once again due to the Italian approach on migration.
The perspective of these sceneries and unknown others represent a constant meaningful source of worrisome in asylum seekers reality. Nevertheless, it is worth mentioning that achieving protection does not mean escaping uncertainty. Uncertainty does not revolve exclusively around the possibility of being rejected and labelled as “illegal”. On the contrary, receiving protection and being allowed to settle in Italy, even if it represents the most desirable outcome, is an occurrence extremely veiled by senses of uncertainty because of the numerous and complex requirements that maintaining this status comports (Giudici, 2013). In order to do so, asylum seekers need to acquire knowledge regarding these requirements and to autonomously look for a job and a place to stay: a very difficult process with unpredictable results. After receiving the residency permit, the new status holders may remain in a reception facility for a limited period of time before autonomously having to find a place to live in.
Thomas: If the result is positive they will give me just three months or four months...
Francesco: Then you have to go ?
Thomas: Yeah. Go. So in fourth months I should prepare myself because I can’t sleep outside, I can’t go in the street. I should work and I should find a job before I leave the CAS. So I should find a job so I could pay my bills, taxes and...
Francesco: Sure.
Thomas: So, you know, I can’t work like, you know, and maybe my boss already knows, maybe the boss already knows my situation and is going on, I don’t know, maybe is going on, I don’t know.
As reported in Chapter 6, finding a permanent occupation in Italy, in order to fulfil the requirements to rent a place for living, is not easy and even for the ones that do or already had a job, the salary is often limited.
Kaleb: What I am thinking about now is that if I don’t work, and I cannot even do a hard job because I underwent surgery on my back. I need an easy job to do right now but it is not easy to find a job like this. For this reason I am thinking a lot about this.
The case of Russel is a clear example of how difficult living reception can be. In fact, after having obtained protection and left the SPRAR, Russel had to live for some time in squats or in small
apartments with many other people while trying to find an occupation. In recounting his experience he highlights how imperfect knowledge regarding employment processes and related places or structures represented a significant obstacle.
Francesco: Were there ever times in which you had to wait and you didn’t know for how long? For example for the issuance of certain documents or the response of a job ? Russel: Mhm, no, like mhm… Yes, when I finished the internship I did working in a hotel, when I finished that I remained at home. But it's true that, I always want to be honest, I didn't know the job sites, how to look for jobs, so I stayed home for a couple of months and it was tough anyway. Even though we were seven people living in a one-room apartment, at the end of the month we all had to pay the rent, so not having a job, that moment was hard there, not knowing how to look for a job. After that I found an internship in a factory. I did that for a few years, then I was unemployed and I was at home again.
Therefore, even though receiving protection is the most hoped outcome, worrisome regarding the difficult path to settle in Italy characterised by complex requirements and bureaucratic dimensions, need for a professional occupations and a place to stay, represents a prominent element of uncertainty in asylum seekers’ life. Therefore, asylum seekers period of waiting with feelings of being stuck by long and complex procedures is particularly worsened by the worrisome regarding an outcome which may irreversibly change their life. On the one hand, it could mean the beginning of a hard, precarious path towards the building of a new life, on the other it may entail the denial and obliteration of achievements endured in years of waiting.
7.2 “Headache”
Asylum seekers have been defined as one of the most vulnerable groups in the world with significantly high rates of long-term traumas derived by experiences of displacement (UNHCR, 2015; Almohamed, Vyas, 2016). However, various studies pointed out how a singular perspective focusing on trauma of displacement may present a limited understanding of how different factors interweave in conditioning asylum seekers’ mental health (Maercker, Heim, & Kirmayer, 2018;
Tessitore, Margerita, 2020). In fact, exposure to post-displacement stressors may play a fundamental role in causing experiences of psychological distress and foster common or even severe mental disorders (Nosè et al., 2018; Tessitore, Margherita, 2020). As noted by many
scholars, long periods of waiting in uncertainty, resettlement stress, perceived stigma, discrimination, social insecurity and lack of access to basic services, added to displacement-related traumas, represent determinant factors in causing experiences of psychological distress and mental disorders (Dupont, 2005; Laban, Komproe, Gernaat, & de Jong, 2008; Ryan, Benson, & Dooley, 2008; Carswell, Blackburn, & Barker, 2011; El-Shaarawi, 2015; Li, Liddell, & Nickerson, 2016).
In addition to feelings of distress derived from reception spatial dimensions and co-habitative relations, the most prominent causes of stress and suffering observed in this research are represented by uncertainty and feelings of being limited. As underscored by El-Sharaawi (2015),
“hybrid and contradictory temporal experience of living in a temporary situation for an unexpectedly long period had effects on these refugees’ well-being”. The case of Martin and his feelings towards his current condition, clearly reflects the disruptive power of similar dynamics:
Martin: When I think about the document, about the things that I can or cannot do, my head feels stress. The right path for me, because now I am thinking about having a document, I am thinking about going to school, I am thinking about my family in Africa and many other things that come to my mind and spin around in my head every day and I cannot even sleep at night. I am more than thirty and I do not have a penny in my pocket. It is not like I have an account with two thousand or three thousand euros. When I think and talk about this, I need to make some money and keep studying to go on and achieve a right place and a right path in my life. This is my dream.
Francesco: So you are saying that the obstacle for the realisation of your dream is the permit ?
Martin: Yes, yes, indeed, indeed. This is my headache, this is my headache. […] I need to go on with my life, but here in Italy the time…The possibilities that I had when I was younger are gone. I am afraid that it will be useless.
As he recounts, feelings of being limited by the long procedures while many significant years are passing without any guarantees of being allowed to continue the path towards his “dream”
afterwards are a constant presence in Martin’s life and a meaningful source of distress. These experiences can be understood as an experiential temporality which Griffiths (2014:1996) defined as “suspended time”: a sense of directionless stasis in which the waiting person tends to see no purpose, fairness or progression.
In addition to feelings of being limited, senses of uncertainty may represent a pervasive factor influencing asylum seekers’ psychological health (Dupont, 2005; El-Sharaawi, 2015, Nosè et al., 2018). As observed, the approaching conclusion of the recognition process is a meaningful determinant of future’s unpredictability which increasingly pervades asylum seekers lives creating a worsening sense of distress.
Thomas: If you don’t have the document they put you outside, outside of the project because you have a contract [entitlement to reception] for maybe five years and then it’s finished, so go. No document, no work, nothing. This is where I’m going right now. So right now things are making me crazy because I don’t know, I don’t know if the court could accept my story and give me the document, I don’t know maybe the [reception]
project could say: “Thomas, your project is finished so go.” So it’s difficult and it’s a problem.
Similarly to what El-Sharaawi (2015) pointed out in her work with Iraqi refugees in Egypt: the uncertain future is a cause of ill-health. On the contrary, self-improvement and experiences of development towards the building of a stable and decent future increase positive feelings and represent a powerful element to contrast worrisome regarding the unpredictable forthcoming.
Martin: Sometimes, everyday when I am in my bed, even my blood don’t like this situation but I need to carry on, or with the school or with something else. My very soul is in this. I am not looking for doing things otherwise. I just try to do things with my brain. When my brain engages my experience develops.
All these factors and their disruptive effects may overlap with traumatic experiences derived by displacement-related dynamics, worsening even more asylum seekers’ conditions by fostering ill health and psychological distress. Therefore, competent and effective services of mental healthcare for these particular groups of people are at least required. However, in spite of the great need of these kinds of assistance, a lack of related structures, professionals and treatments characterises the Italian reception landscape. Professionals working in shelters situated in Turin or in its surroundings have to rely on Centro Fanon’s and few others’ help that, due to the high number of cases and lack of services’ availability. It is worth mentioning that, as some of the professionals who participated in
this research stated, the presence of similar specialised clinics is not common on a national scale and the vast majority of reception centres in Italy cannot rely on similar services. Sadly, too often the only solutions consist in compulsory medical treatments or permanently removing the problematic people from the facility, forcing them in the streets where the only services available are the ones offered by volunteerism, in spite of the great vulnerability of these people.
Darleene: We always had to rely on friends working in the Centro Frantz Fanon or Marco Cavallo, video-calling them saying: “tell me what to do” because there are no services.
Francesco: So you always found solutions autonomously ? Carol: We have not always found a solution.
[…]
Darleene: Were I work the only solution are the compulsory medical treatment.
[…]
Patrizia: This is to let you understand that for psychiatric cases there are no solutions but the street or a structure in Turin with twenty places which is always full. This is a problem that we saw through the years.
Carol: Two years ago I had to expel a person for the same reasons. After trying for months to find a structure for him he still lives in the street, literally in the street.
Francesco: What kind of services are available for the ones living in the streets?
Carol: Nothing but voluntary services and you can imagine how little self-aware this person can be. He refuses any help.
Patrizia: As a metter of fact, there are many people with psychiatric problems living in the street.
In this sceneries, Italian politics’ paradoxes manifest again. On the one hand, different dynamics regarding Italian processes of migration recognition and management overlap influencing and potentially worsening asylum seekers mental health while, on the other, services of mental healthcare are insufficient and an effective provision of related therapies is highly disregarded.
8. Conclusions
As discussed in this research, seeking asylum in Italy may be a complex, long and difficult journey.
Through their path towards protection, asylum seekers undergo an intricate process of classification in order to be “recognised”, hence, labelled and managed consequently (Zetter, 2007, D’Angelo, 2018). In the meanwhile, they are channelled into the reception system where the majority wait years in order to receive the international protection’s final outcome, hosted in extraordinary structures designed as “temporary” allocations (D’Angelo, 2018; Campomori, Ambrosini, 2020).
When the request final outcome is produced, on the one hand, asylum seekers who achieved protection are expected to leave and autonomously face the precariousness of a life with few guarantees and numerous requirements to maintain the status (Giudici, 2013). On the other hand, the denied requesters are labelled as illegal on Italian soil and therefore deprived of all rights and access to any services and entitled to be detained and deported. During this difficult path experiences of uncertainty are not uncommon. The role played by politics of recognition and management in shaping experiences of uncertainty is meaningful. In this research I argued that politics of recognition and management interweave in shaping and influencing asylum seekers’
lived experiences of uncertainty with particular strengths in three main ways. Firstly, they influence uncertainty by not providing adequate information and counselling during the recognition process, especially for what concerns the initial steps, therefore enhancing senses of confusion and imperfect knowledge (Williams and Baláž, 2012; Horst, Grabska, 2015). Secondly, they manifest in limiting self-improvement and path towards “autonomous life planning”, even though similar terms are widely used to point out the main objectives of reception processes. In doing so, they enhance feelings of being stuck in spatial and temporal senses with imperfect knowledge and incapacity of predicting the future, therefore creating a dimension of “protracted uncertainty” (Horst, Grabska, 2015). Finally, in designating asylum seekers as “illegal”, therefore nullifying every step they took in the host-country and obstacoling future’s predictability.
During their journey to request protection in Italy asylum seekers are caught between Italian system and politics’ multiple paradoxes and ambiguities which limit possibilities of legally achieving a decent autonomous life and enhance senses of uncertainty. The first paradox regards recognition.
The process to achieve protection is not a static journey in which the asylum seekers must wait passively in order to be judged and therefore recognised. On the contrary, requesters are asked to collaborate actively during the first, vital steps of the recognition process by reporting clearly their personal data, stories and reasons of border crossing. Moreover, after a period that may take years,
requesters are asked to detailedly describe their personal history and reasons of migration to the Territorial Commission in order to be judged, basing on changeable and unclear criteria, and receive an outcome which is likely to be negative in case of inconsistencies in requester’s narratives. In case of a negative outcome, asylum seekers have to enter an even more complex bureaucratic dimension in which they will need to cooperate with a lawyer in order to claim and hopefully win appeal. In this process the effects of politics of recognition and management clearly manifest in influencing asylum seekers’ experiences of uncertainty by forcing them into a long procedure, related to an extremely complex bureaucratic dimension, without providing adequate information especially during the first most important phases (Giudici, 2013; Giudici, 2021).
Another meaningful paradox regards politics of management and the so-called “integrated reception”. Even though asylum seekers may undertake a series of activities which should help them to achieve a stable life and a certain level of independence, the lack of documents and the extremely long periods of waiting preceding the final outcome limit their path. Asylum seekers often remain stuck within the reception system for years before receiving an outcome even after completing their educational and professional training and finding an occupation. At this point, politics of recognition reiterate their power by limiting asylum seekers’ path towards an autonomous life, enhancing senses of being stuck and temporal stasis (Griffiths, 2014). This situation of protracted uncertainty is a major source of frustration and stress, both for the asylum seekers and the professionals working every day with them (El-Shaarawi, 2015, Giudici 2021).
Moreover, during this difficult waiting, which may last years, they must cope with potentially difficult living conditions due to their management into the reception system. In fact, they are arbitrarily moved into different areas and structures of a reception system mainly based on extraordinary emergency facilities who host the majority of asylum seekers, without considerations towards cultural, language or vulnerability conditions, while only few access to the last level of the
“normal” reception as it was ideally designed (D’Angelo, 2018; Campomori, Ambrosini, 2021).
After many years of being stuck waiting for an outcome, the Italian process of recognition manifest its power in granting protection or, for the majority, nullifying every achievement by declaring the requester as illegal, withdrawing every right, access to service and confining him or her into inadequate detention centres in which many commit suicide or self-harm. This particular dynamic is extremely meaningful because of the com-penetration between recognition and supposed
“integration” as non-sequential processes. Recognition is not a preliminary phase which precedes