Although they have high expectations for good healthcare, many refugees also harbor feelings of mistrust toward western medicine and, therefore, toward the Italian healthcare system. In some cases, refugees had trouble understanding that a family member’s condition was treatable, but incurable, even in Italy. This was a source of frustration for some refugees. One father, from Eritrea, expressed his dismay in an interview:
"I have only one son, but he’s not well. […] I hoped that they would cure him in Italy, but they didn’t. […] He was injured with a knife six years ago. […] The boy did not get what he deserves."
Other refugees expected Caritas to cover all medical expenses, even specialized treatments like physiotherapy. As one refugee wrote in a text:
"I have a problem here. I saw a physiotherapist and he prescribed gymnastics and equipment for my back. But Caritas told me, ‘we can’t give you money [for that].’"Most of the diocesan Caritas branches did not foresee the extent of the health problems that frequently came to light only after medical testing in Italy, and they were not able to cover the expense of specialized private care. Another factor was that some specialized treatments involved travel and recovery periods far from the host dioceses, and entailed travel and housing expenses, as well as the provision of cultural mediators and other forms of assistance to navigate the hospital stay.
It was particularly common for mental problems or psychiatric disturbances to arise, as a result of the violence the refugees had experienced, and the years they spent in the refugee camps. The tight link with these health issues has been studied extensively, because they tend to be common to people who have experienced violence, persecution, and extended stays in refugee camps.
Kirmayer and Young (L. J. Kirmayer and A. Young, “Culture and Somatization: Clinical, Epidemiological, and Ethnographic Perspectives,” in Psychosomatic Medicine, 1998, 60(4), pp. 420-430) and Fox and Tang (S. H. Fox and S. S. Tang, “The Sierra Leonean Refugee Experience,” in The Journal of Nervous and Mental Disease, 2000, 188(8), pp. 490-495) talk about the higher incidence of anxiety and depression during the resettlement of refugees. Isolation is one of the principal factors correlated with mental illness, and it is aggravated by the fact that refugees are often unaware of their problems and of the possibilities to obtain psychological help (A. Van Heelsum, “Aspirations and Frustrations: Experiences of Recent Refugees in the Netherlands, in Ethnic and Racial Studies, 2018, (40)13, pp. 2137-2150).
Mental health was also a factor in a number of cases in which beneficiaries had failed to mention their mental health issues to their host communities, either because they were unaware of the fact that healthcare in Italy could include mental health services, or because they did not recognize that their symptoms were red flags for mental illness. In the words of one social worker:
"Sometimes the pain and brokenness only comes out later […] We don’t know what they went through because they never said much about it […] The starting point is that they tend to be more fragile […]. The Human Corridors take the individuals who are in the weakest positions […] so, as a starting point, there is a very high level of fragility."
Mental health problems can be difficult to discern and understand, as one volunteer explained:
"A week later […] she seemed down, and then this happened again and again. For example, today is a good day – she’s upbeat and happy, but then the next day she might break down over some issue, or over issues that aren’t real except inside […]. We called on the mediator because we couldn’t understand [what was going on]."
