Border Pushbacks in Greece: Human Rights Violations and Psychological Impacts

Border Pushbacks

Border pushbacks have been standardised and normalised in Greece since the 2015 European refugee crisis and the EU-Greece-Turkey agreement (often referred to as the “statement”) in 2016 (Koros, 2021; Naoum, 2020). During these border pushbacks, border patrols do not assess the legal status of individuals before expelling them, thereby depriving migrants of the opportunity to apply for asylum or challenge their removal. Amnesty International (2020) reported that even those who have already applied for asylum, possess legal documentation, or are protected under international law fall victim to these illegal practices (Koros, 2021).

These illegal refoulements, though unofficial, function as a primary deterrence strategy along Greece’s borders, intensifying as refugee flows increase on the Greek islands. The New York Times published footage showing 12 migrants being forcibly placed on a boat from Lesbos and then abandoned at sea off the Turkish coast without navigation or a safety vessel (Stevis-Gridneff et al., 2023). Following the article’s release, the EU formally called upon Greece to initiate a thorough investigation, marking a potential turning point in addressing human rights violations associated with border pushbacks.

Human Rights Violations

At the end of 2023, an estimated 117.3 million people worldwide were forcibly displaced due to persecution, conflict, violence, and human rights violations. This included 43.4 million refugees and 6.9 million asylum-seekers (UNHCR, 2024). These figures highlight the gravity of forced displacement and the violent treatment of people on the move, underscoring the deep connections between migration and human rights.

Koros (2021) noted that the illegal refoulements at the Greek borders involved severe human rights violations committed by the Greek border authorities and law enforcement. Violations of fundamental human rights include the right to life, the prohibition of torture and degrading treatment, the right to asylum, liberty and security, privacy, family life, effective legal remedy, the prohibition of discrimination, and the duty to rescue at sea (European Convention on Human Rights,1950). Forced pushbacks of refugees and asylum seekers to unsafe countries, denial of asylum opportunities, and detention in inhumane conditions exemplify the disregard for the fundamental rights of people on the move at the Greek borders (Koros, 2021).

Moreover, violations of these fundamental rights often lead to deteriorating physical and mental health among those affected (Markovic et al., 2023). EU and Greek migration policies have, according to experts, perpetuated a mental health crisis among a significant number of people on the move in Greece (International Rescue Committee, 2020).

Psychological State of People on the Move

Refugees are often exposed to prolonged and repeated traumatic events throughout the migration process, leading to numerous negative effects on their well-being. Byrow et al. (2020) identified limited social support, fear for the future, and financial instability as primary factors contributing to the development of psychological disorders among refugees. Additionally, Satinsky et al. (2019) pointed out that past war-related experiences and fears of prosecution should also be considered as factors for increased risks of mental health problems among refugees alongside their inhumane living conditions, experiences of uncertainty, loss of livelihoods, and impoverishment. Bhugra et al. (2011) further noted that the lack of preparation for migration, the attitudes and culture of the host country, poor living conditions, limited employment opportunities, and inconsistent social support worsen the already vulnerable emotional health of refugees.

Most studies identified post-traumatic stress disorder (PTSD) and depression as the most common mental health disorders and problems experienced by refugees and asylum-seeking migrants (Bhugra et al., 2011; Kemmak et al., 2021; Satinsky et al., 2019). Anxiety was also prevalent, while others have experienced more severe mental health issues such as schizophrenia, psychosis, and suicidal ideation.

With the increased occurrence of maritime pushbacks in recent years, traumatic experiences such as life-threatening situations, psychological and physical violence, and neglected medical needs have also risen significantly (Markovic et al., 2023). Furthermore, individuals who have experienced pushback tended to be more psychologically vulnerable than those who have not (Markovic et al., 2023).

Psychological Services in Greece

People on the move in Greece face challenges in accessing psychological care and services (Satinsky et al., 2019). Dagalidi (2023) highlighted the ineffective and inadequate mental health support services on the Greek islands and mainland. Major obstacles include limited healthcare facilities, insufficient hospital services, and a lack of specialised mental health support, all of which contribute to flawed psychosocial assessments resulting in misdiagnosis or overdiagnosis of mental health conditions. Additionally, there is a lack of established protocols for psychiatric care and emergencies, nor appropriate accommodation for psychiatric patients (Dagalidi, 2023; Fenix – Humanitarian Legal Aid, 2022).

Relevance of Research

The phenomenon of border pushbacks, a strategy increasingly used to reject asylum seekers, has become prevalent across different European Union states (Davies et al., 2023). While Greece and Turkey are linked by maritime routes, significant land routes for people on the move include borders in Croatia, Hungary, and Poland, with connections extending southward to Malta. These routes serve as primary gateways for entry into southern Europe. Pushbacks also occur along the Croatian-Bosnian border, where asylum seekers face harassment by border authorities, a situation well-documented in recent research (Davies et al., 2023). Similar human rights violations have also been documented along the Balkan route and in countries like Bosnia-Herzegovina, Serbia, Romania, Albania, Montenegro, North Macedonia, Bulgaria, Italy, Slovenia, and Hungary (Border Violence Monitoring Network, 2020).

Similarly, Latinx children and adults, one of the biggest minority groups in the United States (US), have suffered poor mental health and increased levels of psychological distress due to anti-immigrant policies from the Trump administration (Rabin et al., 2022). This highlights that the mental health impacts of migration are a global issue. Common issues among Latinx migrants include fear of deportation, limited healthcare access, family separation at borders, and uncertainty of residency status. These challenges lead to adverse mental health outcomes such as increased rates of depression, anxiety, stress, and behavioural difficulties, as well as internalising behaviours like social isolation, avoidance of authorities, reluctance to seek medical care, and hesitance to use government assistance (Rabin et al., 2022).

The psychological effects of border pushbacks and related human rights violations are deeply connected to the social and humanitarian sectors, as they involve protecting the rights and lives of vulnerable groups, in this case, people on the move. Furthermore, the documented human rights violations associated with pushbacks exacerbate inequalities against people on the move, with potential long-term impacts on their overall health. This study is, therefore, closely aligned with three key Sustainable Development Goals – SDG 3: Good Health and Well-Being; SDG 10: Reduced Inequalities; and SDG 16: Peace, Justice and Strong Institutions (United Nations, 2015).

Border Pushbacks and Human Rights Violations

The human rights violations identified in this study were evaluated within the framework of the European Convention on Human Rights (1950) and the European principles for fundamental rights protection. These violations occurred both during migrants’ transit from their countries of origin and within the host or in-transit country, Greece, with a specific focus on abuses suffered by refugees and asylum seekers during border pushbacks.

Border pushbacks themselves constitute violations of fundamental human rights, further compounding other human rights breaches along the borders. This was emphasised by Participant 1, who collected testimonies from people on the move. However, Participant 2, a MHPSS coordinator for a legal aid organisation, argued that despite the clear classification of pushbacks as rights violations under European and international human rights laws, Greek authorities continue to deny the practice, resulting in systematic neglect of these violations at Greek borders

Participants of this study, along with online pushback testimonies, detailed the following human rights violations that occur during border pushbacks:

• Denial of basic human needs, such as food, water, toilets, bathrooms, and bedding

• Denial of rightful asylum applications and prioritising asylum claims over others

• Outright denial of asylum applications

• Inhumane and degrading treatment by border officials

• Physical, emotional, and verbal violence and abuse, including kicking, beating, forced undressing, electric shocks, and threats with weapons

• Restricted access to fresh air

• Isolation in dark rooms for extended periods

• Reckless driving in overcrowded vans, with individuals “brutally crammed on top of each other” (BVMN, 2020, p. 578)

• Forceful family separations

• Lack of access to legal, educational, and medical services, including mental health support

• Lack of food and shelter during the COVID-19 pandemic

• Inadequate access to information

• Extended waiting periods for asylum decisions

• Taking personal information without consent

• Theft and destruction of personal belongings

These examples represented only a fraction of the human rights violations occurring at Greek borders. Such abuses persist and intensify throughout all stages of migration, severely impacting the psychological well-being of individuals seeking safe passage and better opportunities in Europe. Participant 1, Participant 2, and Participant 3, a psychologist, all agreed that the aforementioned examples clearly illustrated the “humiliating and degrading.” “dehumanising” and “inhumane” treatment towards the migrant population in Greece.

Participant 4, an emergency projects coordinator at an international NGO, described the situation at Greek, — and, more broadly, European — borders as the establishment of a “culture of fear”. According to her, Europe is currently building high walls and inappropriate, unhealthy camps (literally) for those seeking refuge and safety, aiming to deter others from attempting the same journey. Refugees and migrants are forced to wait interminably, treated like animals and criminals, their rights repeatedly violated, and subjected to anti-rescue policies. This criminalisation of migrants, Participant 4 argued, serves to further “feed” and entrench the desired “culture of fear.”

Furthermore, humanitarians and human rights defenders at the Greek borders are constantly being criminalised and arrested for championing the rights of those who are unable to advocate for themselves, compounding the “culture of fear.” Participant 4 explained the tough situation in which human rights activists find themselves:

Border Pushbacks and Psychological Impacts

Generally, people on the move experience a “tremendous amount of trauma” throughout their journey – from fleeing their countries of origin and crossing numerous borders to arriving in Europe and attempting to integrate into a host society or, continuing onward, often to Central European countries. Participant 5 shared this insight from his experience volunteering as a psychologist at the Moria refugee camp in Lesbos, Greece. When crossing Greek borders, refugees and asylum seekers are profoundly affected by the violence and human rights violations they endure. Participant 1 emphasised that pushbacks, in particular, exacerbate these negative psychological effects, leaving individuals in an “extremely vulnerable position and fragile state.”

Data analysis revealed common emotions experienced by people on the move during and after pushbacks. Participants and online testimonies frequently described feelings of frustration, sadness, anger, fear, hopelessness, exhaustion, aggression, instability, loneliness, and a lack of control, capturing the psychological toll of illegal refoulements. One migrant expressed this anguish, stating,

Participant 5 lamented that the forced separation of families during border pushbacks severely impacts the psychological well-being of migrants. He explained that migrants often flee with their families, hoping for a better future and improved opportunities for all of them in the new country. However, when the authorities do not allow them to continue their journey with their loved ones, they are forced to be by themselves, which evokes feelings of loneliness, sadness, loss of control, and alienation. Moreover, Participant 6, a coordinator at an organisation that provides medical care for those whose human rights are at risk, clarified that many others, often young men between the ages of 20 and 30, flee alone, seeking financial stability to support families back home. Participant 6 further noted that these individuals frequently mask the challenges and hardships of border crossings by presenting a more “good-looking and happy picture” to their families, hiding the reality of their struggles. According to Participant 3, this reluctance to share their true journey experiences intensifies feelings of loneliness and vulnerability.

Furthermore, Participant 1 observed that denial of access to basic human needs and services, such as food, water, sanitation, clothing, and housing, tends to dehumanise migrants, leaving them feeling diminished and unworthy. Common descriptions in online pushback testimonies reflected this experience, with many refugees and asylum seekers reporting that they felt treated “like an animal” by Greek border officials, both at the borders and in detention centres (BVMN, 2020). Some also mentioned verbal abuse from authorities who repeatedly labelled them as criminals, which eventually impacted how they viewed themselves. Participant 1 noted that over time, some actually started believing they were criminals, highlighting that it is “normal” for a person to start believing repeated assertions about themselves, even if untrue.

People on the move were already in a vulnerable position even before experiencing pushbacks. However, as Participant 7, a programme manager at a humanitarian organisation, argued, this illegal practice further increases their vulnerability and heightens their risk of developing psychological disorders. She and other experts interviewed for this study, including Participants 2, 3, 5, and 6, identified several mental health disorders commonly observed among refugees and asylum seekers, including anxiety, depression, PTSD, sleeping disorders, panic attacks, psychosis and suicidal ideations.

Increased Need for Psychological Services in Greece

With the increased migration flow into Greece, the compounding negative experiences of migrants, the rise in human rights violations at the borders and the associated psychological impacts, Participant 2 insisted that there is an urgent “need for mental health support” for people on the move. However, Greece, already facing a shortage of mental health professionals, has a significant gap in providing adequate psychological services for migrants at the borders. As a result, this need remains largely unmet.

Participant 5 opined that the psychological services currently available for people on the move in Greece are “very limited” and “undermined,” with many reports of misdiagnoses and underdiagnoses. Many services are located outside refugee camps and detention centres, making them difficult and sometimes unsafe to access. In other instances, essential services are simply not available for those who are in need. Participant 6 noted that the lack of professionally trained interpreters who could facilitate communication between psychologists and people on the move further hampers access to effective care and discourages many from seeking support.

In many cases, individuals who ask for psychological help are forced to wait months, sometimes years, to access care. According to Participant 2, this delay violates their right to medical care and “creates and escalates their issues.” Participant 1 added that detainees in detention centres also reported being denied access to psychologists, even when one was available on-site. Furthermore, detainees have reported being injected with unknown substances by officers in camps, raising significant ethical and health concerns.

Participants 1, 2 and 3 emphasised that the mental health services available in Greece are simply “not enough” to meet the needs of migrants. Moreover, Participant 7 argued that more psychological support for migrants is urgently needed across the Greek islands and mainland, as the scarcity of such services not only constitutes a violation of human rights but also exacerbates the ongoing mental health crisis. She clarified that part of the issue lies in the general lack of mental health care for the local Greek population, a shortage that directly affects the level of care available to newly arrived migrants.

Participant 7 identified additional barriers preventing people on the move from accessing psychological services. These include cultural differences, discriminatory treatment by border officials, external stigmatisation, internal stigmatisation (although not so often observed), and shame. Other challenges, such as long waiting periods for mental health care (in some cases, years), limited information on available support, language barriers, and inadequate facilities, further widen the gap in access to psychological services. As Fenix – Humanitarian Legal Aid (2022) highlighted in their report, limited access to healthcare, the flaws in the psychosocial assessments, and the lack of established protocols for psychiatric care and emergencies are some of the principal reasons why people on the move do not receive mental health support.

Mental Health Crisis

The current migration policies in Greece and, generally, across the European Union have contributed to a growing mental health crisis among people on the move (International Rescue Committee, 2020). With the rising influx of migrants into Greece and the increasing occurrences of human rights violations at its borders, people on the move are far more vulnerable to developing psychological disorders (Markovic et al., 2023). This vulnerability is worsened by the limited availability of mental health services, particularly the scarcity of effective psychological support tailored to migrant populations.

Unfortunately, the pushbacks tend to bring incremental negative psychological effects, placing individuals, in the words of one participant of this study, in an “extremely vulnerable position and fragile state.” Similarly, Markovic et al. (2023) found heightened levels of depression, anxiety, and PTSD symptoms among individuals who have experienced and survived these border pushbacks.

In addition to the psychological impacts of human rights violations, other factors also contribute to the worsening mental health of people on the move. Key factors identified in this study and supported by relevant literature include:

• Uncertainty related to when they can continue their journeys safely, what their futures may hold, the possibility of reuniting with family members, the outcome of their asylum request, and the chance to integrate into society. This state of “not knowing” heavily influences their thoughts and feelings, negatively impacting their psychological state (Participant 7; Byrow et al., 2020).

• Lack of control over their lives, from daily choices like what to eat to complex decisions of family reunification. The inability to make personal choices and decisions often lowers self-esteem, impacting mental health and heightening vulnerability to severe psychological disorders (Participant 3; Bhugra et al., 2011).

• Living conditions in refugee camps, detention centres, and on the streets, where many people are crowded into small spaces and provided with few necessities. Conditions often include a lack of mattresses, inadequate food, water, and sanitary facilities (such as toilets and bathrooms), preventing any semblance of “a normal lifestyle,” routine, or social engagement (Participant 7; BVMN, 2020; Satinsky et al., 2019).

• Family separations cause profound trauma, intensify loneliness and fear, and significantly increase the risk of psychological disorders. Such separations often bring lasting emotional distress, compounding the challenges migrants already face (Participant 3; Participant 6; Kemmak et al., 2021).

• Lack of integration into Greek society due to limited integration programmes, the unwillingness of the local population to welcome newcomers, and the various challenges that they face while trying to adjust to a new culture that is much different from their own (Participant 2). These barriers weaken migrants’ sense of safety, security, and control, impeding their ability to achieve mental stability and well-being (Bhugra et al., 2011).

Similarly, Rabin et al. (2022) identified immigration enforcement in the US and the fear it generates as the primary stressor that worsens mental health and leads to negative psychological impacts among the Latinx migrant community. Additional stressors include fear of deportation, limited access to healthcare, family separations at the border, and uncertainty surrounding residency status. Such research affirms the findings of this study that harmful policies and practices by the Greek state negatively impact the psychological health of refugees and asylum seekers.

Moreover, Greece is experiencing a significant gap in the provision of effective psychological support services for people on the move, with current resources on the islands and mainland described as very limited, undermined, inefficient, and insufficient. Barriers such as lack of information, language challenges, lack of trained interpreters, and inadequate facilities further exacerbate the challenges in accessing and providing necessary psychological support. Without clear information on available services, physical locations to access them, or capable interpreters, migrants’ willingness and ability to receive mental health support diminish, worsening their psychological well-being.

The increasing psychological challenges among the migrant population create a critical need for more accessible and effective psychological services. Denial of such services not only violates migrants’ human rights to universal medical care but also perpetuates the ongoing mental health crisis among people on the move.

Recommendations to the Greek Authorities

The Greek authorities play a huge role in exacerbating the challenges faced by people on the move. This includes violations of their fundamental rights throughout various stages of migration, inhumane treatment, and inadequate psychological support. Based on the data collected and analysed, several recommendations for Greek authorities have been identified and summarised below:

1. Cease border pushbacks and group deportations

2. Take accountability for past actions regarding border pushbacks and associated human rights violations

3. Adhere to European and international laws and conventions on the protection of fundamental human rights of refugees, asylum-seekers, and migrants

4. Implement an independent border monitoring system to observe and report without biases the border situation in Greece, including any illegal activities

5. Improve and stabilise migration policies in Greece in accordance with European policies, laws, and regulations

6. Investigate and prevent all forms of border violence, including physical, mental, and verbal abuse of newcomers, and hold perpetrators accountable for human rights violations

7. Release detainees held in degrading detention centres on the Greek islands and mainland, ensuring their legal and social protection as per European laws

8. Invest in integration programs for individuals with international protection status, including pathways for societal integration, education, and entry into the labour force

9. Develop accessible psychological support programmes for migrant groups by ensuring that trained professionals such as psychologists and interpreters are available and by providing appropriate facilities and resources for effective treatments and interventions.

Finally, it is important to mention that while Greek authorities are involved in perpetuating pushbacks, border violence, and the ongoing mental health crisis, other parties also play a significant role in establishing sound systems that prevent these violations. Other governmental bodies, including the European Union, other European parliaments, the Council of Europe, the European Court of Human Rights, and the United Nations, must bring more attention to these issues and hold accountable all individuals and nations that violate European and international laws (Amnesty International, 2020; BVMN, 2020).

Limitations and Recommendations for Future Studies

This study was limited by its small scale and constraints on time and resources. Expanding it into a bigger research project with extended timelines and more participants and testimonies could significantly enrich the findings and scope of the research. The perspectives of refugees and asylum seekers were gathered indirectly through an online database of pushback testimonies to ethically access these voices. However, if primary data collection included direct one-on-one interviews with people on the move (or alternative methods such as focus group discussions), it could have provided more valuable insights, further enhancing the depth and quality of the research.

Moreover, the population sample in this study was limited to experts (academics and practitioners) in the fields of migration, human rights, and mental health, which is a small fraction of those involved in the refugee situation. A larger sample that includes government officials and representatives from migration organisations and a wider cross-section of the initial sample could have provided a more comprehensive perspective, helping draw more balanced, credible conclusions.

The migration sector in Greece, especially in relation to human rights and mental health, is a broad field involving various sub-sectors and disciplines. This study can thus serve as a foundation for addressing knowledge gaps in both academic literature and field practices, benefiting academics, practitioners, volunteers, and public officials alike. It also presents opportunities for future studies, such as examining the prevalence of psychological disorders among people on the move in Greece, analysing the current integration gap and its effects on migrants, or further exploring this issue with a larger data pool and expanded analytical methods.