Essential Well Being Information from Reliable Sources
for LGBTQI+ Asylum Seekers in the Netherlands
تطبيقات المترجم
⭑ يحتوي متصفح Google Chrome على مترجم مدمج، والذي يقوم تلقائيًا بترجمة صفحة الويب إلى لغتك الأم.
⭑ يقوم تطبيق Google Translate بترجمة النص الأجنبي الموجود على الصور وكذلك الكلام الأجنبي إلى
نص بلغتك الأم.
TRANSLATOR APPS
⭑ Google Chrome Browser has a built-in translator, which automatically translates web page into your native language.
⭑ Google Translate App translates foreign text on photos and also foreign speech into text in your native tongue.
VERTALER APPS
⭑ Google Chrome Browser heeft een ingebouwde vertaler, die webpagina's automatisch naar uw moedertaal vertaalt.
⭑ Google Translate-app vertaalt buitenlandse tekst op foto's en ook buitenlandse spraak naar tekst in uw moedertaal.
Site is under the construction
More articles about well being will appear soon
LGBTQI+ Refugees
ORGANIZATIONS
LGBT+ Asylum Support provides support through the asylum procedure. Sandro Kortekaas, the founder, helped for those, who undeservedly received a negative decision from IND. Fill the contact form to reach access to whatsapp groups, where you can find information about organization's activities and events.
Trans United Europe and TransAmsterdam are well-known trangenders’ communities in The Netherlands.
LGBTQI+ bi-cultural organisations in The Netherlands are Maruf, Respect2Love, Kleurrijk Roze, Connecting Differences, Sex Matters.
GGD in your municipality can provide men, who have sex with men with free Hepatitis B vaccination, which can prevent Hepatitis B. GGD pays the major part of the price of PrEP medication for you, which prevents HIV. GGD also does free tests for sexually transmitted diseases (STD) without any referral.
If you have suicidal thoughts feel free to connect Dutch organisation 113 by phone, chat or apply for a short online suicide prevention course. 113 do not charge for its services. Both Dutch and English languages are available.
More information
Zanzu: Multilingual picture guide for sexual health
The Genderbread Person version 4
LGBT+ Asylum Support provides support through the asylum procedure. Sandro Kortekaas, the founder, helped for those, who undeservedly received a negative decision from IND. Fill the contact form to reach access to whatsapp groups, where you can find information about organization's activities and events.
Trans United Europe and TransAmsterdam are well-known trangenders’ communities in The Netherlands.
LGBTQI+ bi-cultural organisations in The Netherlands are Maruf, Respect2Love, Kleurrijk Roze, Connecting Differences, Sex Matters.
GGD in your municipality can provide men, who have sex with men with free Hepatitis B vaccination, which can prevent Hepatitis B. GGD pays the major part of the price of PrEP medication for you, which prevents HIV. GGD also does free tests for sexually transmitted diseases (STD) without any referral.
If you have suicidal thoughts feel free to connect Dutch organisation 113 by phone, chat or apply for a short online suicide prevention course. 113 do not charge for its services. Both Dutch and English languages are available.
More information
Zanzu: Multilingual picture guide for sexual health
The Genderbread Person version 4
COA LGBTQI+ CONTACT PERSON
If you are LGBTIQ+ human, get acquainted with LGBTIQ+ contact persons of your AZC. They are COA employees, who trained and understand your needs and should support you with your issues. They provide the contacts of the COC Cocktail in your munisipality. Tickets for its monthly meetings will be given by COC or COA.
In the room you should live with the same LGBTIQ+ humans as you. Ask them to help you with access to LGBTIQ+ whatsapp groups to communicate and know about events.
DISCRIMINATION
It is not possible to destroy homo- and transphobia forever in the whole world. The question is how small are they in the society and what can each of us personally do in daily life to improve equality? The Netherlands was the first country in the world to legalise same-sex marriage and Amsterdam is called queer capital of Europe. But there are still some problems with equality and IND still uses stereotypes in its decisions according to LGBTIQ+ persons.
HOW TO REPORT?
If there are no reports about discrimination, the government doesn't see that the problem exists. And it do nothing. Only by collecting a large amount of reports we will be able to change things in a better way.
If you are LGBTIQ+ human, get acquainted with LGBTIQ+ contact persons of your AZC. They are COA employees, who trained and understand your needs and should support you with your issues. They provide the contacts of the COC Cocktail in your munisipality. Tickets for its monthly meetings will be given by COC or COA.
In the room you should live with the same LGBTIQ+ humans as you. Ask them to help you with access to LGBTIQ+ whatsapp groups to communicate and know about events.
DISCRIMINATION
It is not possible to destroy homo- and transphobia forever in the whole world. The question is how small are they in the society and what can each of us personally do in daily life to improve equality? The Netherlands was the first country in the world to legalise same-sex marriage and Amsterdam is called queer capital of Europe. But there are still some problems with equality and IND still uses stereotypes in its decisions according to LGBTIQ+ persons.
HOW TO REPORT?
If there are no reports about discrimination, the government doesn't see that the problem exists. And it do nothing. Only by collecting a large amount of reports we will be able to change things in a better way.
⭑ The Netherlands has a Pink in Blue police force. It consists of well-trained policemen and policewomen, who are often LGBTIQ+ themselves. Pink in Blue respects your privacy and you can count on sympathetic treatment. When you become the victim of a hate crime, call +31 88 16 91 234 and report this to Pink in Blue.
⭑ COA LGBTIQ+ contact persons will help you, if you face homo- and transphobia too.
⭑ Report discrimination to anti-discrim-ination center in your municipality.
⭑ Report to Sandro Kortekaas from LGBT Asylum Support. They collect their own statistics and make reports to the autorites directly.
⭑ Feel free to ask for psychological help online from your national LGBTIQ+ organisations. Dutch 113 is here for you for suicide prevention.
5D'S BYSTANDER INTERVENTION
What's worse than experiencing harassment related to your identity? Well, is being surrounded by bystanders who see it happening, but do nothing about it.
5D’s bystander intervention is a bunch of strategies you can use. They are Distract, Delegate, Document, Delay, and Direct. They are designed to be safe and not to escalate situations. When we intervent, not only do we reduce the trauma of harassment for the person who was harmed, we exclude traumatization of ourselves as a witness of emotional or physical violence. We also slowly chip away at the culture of harassment and replace it with one of humanity. By using 5D’s you emphasize that harassment is not okay, and demonstrate to people in your life that they have the power to make their community safer.
The 5D’s bystander intervention in detail
⭑ COA LGBTIQ+ contact persons will help you, if you face homo- and transphobia too.
⭑ Report discrimination to anti-discrim-ination center in your municipality.
⭑ Report to Sandro Kortekaas from LGBT Asylum Support. They collect their own statistics and make reports to the autorites directly.
⭑ Feel free to ask for psychological help online from your national LGBTIQ+ organisations. Dutch 113 is here for you for suicide prevention.
5D'S BYSTANDER INTERVENTION
What's worse than experiencing harassment related to your identity? Well, is being surrounded by bystanders who see it happening, but do nothing about it.
5D’s bystander intervention is a bunch of strategies you can use. They are Distract, Delegate, Document, Delay, and Direct. They are designed to be safe and not to escalate situations. When we intervent, not only do we reduce the trauma of harassment for the person who was harmed, we exclude traumatization of ourselves as a witness of emotional or physical violence. We also slowly chip away at the culture of harassment and replace it with one of humanity. By using 5D’s you emphasize that harassment is not okay, and demonstrate to people in your life that they have the power to make their community safer.
The 5D’s bystander intervention in detail
Transgender Refugees
HORMONE THERAPY
Sometimes GZA refuses to give hormone therapy for trangender persons or can’t refer them to the Gender Clinic. Sending an official request on e-mail to your camp’s GZA doctor should help. Describe your request in a polite tone and attach all documents, confirming you used to take hormonal therapy in the home country. It can be prescriptions, certificates, conclusions of an endocrinologist, etc. Indicate the name of the medicine, dosage, time interval between taking the medicine. You can find the email of your camp’s GZA here. If it will not work, you can make complaint via the form on website. This can be done in English or Dutch. Be prepared for the content of the complaint to become known to the person you are complaining about.
GENDER MARKER CHANGE
Only the first name and the gender column change without changing the last name. It can be important for those, who have a gender connotation last name. Transpersons should meet the following criteria for documents replacement:
⭑ be over 16 years old;
⭑ be legally in The Netherlands for at least a year;
⭑ a BSN;
⭑ a residence permit;
⭑ a certificate of passing the commission allows you to change documents. It costs 65 € and can be obtained through Trans Huis volunteers;
⭑ legalized or apostilled birth certificate;
⭑ legalized or apostilled parents' marriage certificate or certificate of adoption or absence of marriage;
⭑ a сertificate of name change, if name was changed in home country.
Sometimes GZA refuses to give hormone therapy for trangender persons or can’t refer them to the Gender Clinic. Sending an official request on e-mail to your camp’s GZA doctor should help. Describe your request in a polite tone and attach all documents, confirming you used to take hormonal therapy in the home country. It can be prescriptions, certificates, conclusions of an endocrinologist, etc. Indicate the name of the medicine, dosage, time interval between taking the medicine. You can find the email of your camp’s GZA here. If it will not work, you can make complaint via the form on website. This can be done in English or Dutch. Be prepared for the content of the complaint to become known to the person you are complaining about.
GENDER MARKER CHANGE
Only the first name and the gender column change without changing the last name. It can be important for those, who have a gender connotation last name. Transpersons should meet the following criteria for documents replacement:
⭑ be over 16 years old;
⭑ be legally in The Netherlands for at least a year;
⭑ a BSN;
⭑ a residence permit;
⭑ a certificate of passing the commission allows you to change documents. It costs 65 € and can be obtained through Trans Huis volunteers;
⭑ legalized or apostilled birth certificate;
⭑ legalized or apostilled parents' marriage certificate or certificate of adoption or absence of marriage;
⭑ a сertificate of name change, if name was changed in home country.
After legalization or apostelization, all documents must be translated from the original language into English or Dutch by national translators. The price is about 50€ per document. The procedure of changing takes about 3 months. The application form is here.
TIPS & TRICKS
⭑ TransUnited in connection with VWN is gonna help you and guide you through the process of documents replacement.
⭑ Asylum seekers, who have no BSN number, can apply for it through COA. Gender marker change in documents can be identified as the basis for priority receiving BSN. You should be six months or more in The Netherlands to have the right to apply for a BSN.
TIPS & TRICKS
⭑ TransUnited in connection with VWN is gonna help you and guide you through the process of documents replacement.
⭑ Asylum seekers, who have no BSN number, can apply for it through COA. Gender marker change in documents can be identified as the basis for priority receiving BSN. You should be six months or more in The Netherlands to have the right to apply for a BSN.
Dutch Language
Dutch language free courses are available in AZCs, universities, public libraries and digital apps.
BE KIND TO YOURSELF
BE KIND TO OTHERS
Inclusive language
Language can reinforce both negative and positive perceptions about others. Inclusive language acknowledges the unique values, culture and experiences of individuals or groups. Derogatory or discriminatory language undervalues individuals or groups, denigrates, humiliates and perpetuates stereotypes and inequality in society.
Gender-biased expressions like “He fights like a girl”, “In a manly way”, “Oh, that’s women’s work” reinforce gender stereotypes based on cis-gendered male supremacy over centuries. It is better to avoid them. Phrases such as ‘“You’re so gay!” and “That’s so gay!” are the most common forms of homophobic behavior. Unfortunately, people may not necessarily understand that their comments are inappropriate and perpetuates inequality in society. Calling people living with HIV, persons with mental illness or with disability as infected, mentally ill or invalids can be harmful and painful as much as reinforce stigma. People engaged in sex work or persons with a substance use disorder are not be called in offensive way as prostitutes and junkies.
Pronouns are one way people refer to each other and themselves. Most but not all men (including trans men) use the pronoun “he”. Likewise, most but not all women (including trans women) use the pronoun “she”. Some people use a gender-neutral pronoun such as “they”. For example, “Pip drives their car to work. They don’t like walking because it takes them too long”. If you’re unsure what someone’s pronoun is, you can ask them respectfully, and preferably privately. Use a question like: “Can I ask what pronoun you use?”.
Inclusive language can help to create a culture of mutual respect, dignity, inclusion, belonging and community. And each of us can contribute daily to it.
Guidelines for gender-inclusive language.
Disability-inclusive language guidelines.
LGBTIQ+ inclusive language guide.
Inclusive Language Guidelines.
Amnesty International Guide (Australia).
Gender-biased expressions like “He fights like a girl”, “In a manly way”, “Oh, that’s women’s work” reinforce gender stereotypes based on cis-gendered male supremacy over centuries. It is better to avoid them. Phrases such as ‘“You’re so gay!” and “That’s so gay!” are the most common forms of homophobic behavior. Unfortunately, people may not necessarily understand that their comments are inappropriate and perpetuates inequality in society. Calling people living with HIV, persons with mental illness or with disability as infected, mentally ill or invalids can be harmful and painful as much as reinforce stigma. People engaged in sex work or persons with a substance use disorder are not be called in offensive way as prostitutes and junkies.
Pronouns are one way people refer to each other and themselves. Most but not all men (including trans men) use the pronoun “he”. Likewise, most but not all women (including trans women) use the pronoun “she”. Some people use a gender-neutral pronoun such as “they”. For example, “Pip drives their car to work. They don’t like walking because it takes them too long”. If you’re unsure what someone’s pronoun is, you can ask them respectfully, and preferably privately. Use a question like: “Can I ask what pronoun you use?”.
Inclusive language can help to create a culture of mutual respect, dignity, inclusion, belonging and community. And each of us can contribute daily to it.
Guidelines for gender-inclusive language.
Disability-inclusive language guidelines.
LGBTIQ+ inclusive language guide.
Inclusive Language Guidelines.
Amnesty International Guide (Australia).
Evidence Based Medicine
Evidence-based medicine (EBM) is a type of medicine, which is based only on scientific proven treatments and diagnostic procedures. It was invented in 1990 and enables patients to receive effective, safe and personalized treatment based on proven data. The World Health Organization supports EBM as fundamental to improving health outcomes, guiding policy, and shaping global public health strategies.
THE INTERNATIONAL CLASSIFICATION OF DISEASES
The International Classification of Diseases (ICD) is The World Health Organization's globally endorsed coding system for diseases, symptoms, external causes, and health conditions. It helps your doctors make evidence-based decisions. Health planners, clinicians, insurers, and researchers rely on ICD-coded data to allocate resources, design interventions, conduct clinical research, and evaluate safety and effectiveness. The International Classification of Diseases, is revised approximately every 10 years to stay current with advances in medical science. It is done through the widest global consensus of scientists and practitioners from all countries, who work for years in revision committees. The ICD‑11 is the latest version and it officially entered into effect on 1 January 2022. The WHO anticipates the Netherlands fully implements ICD‑11 in doctors practice and other areas around 2026–2027. Meanwhile the Netherlands have to rely on ICD‑10 codes.
THE INTERNATIONAL CLASSIFICATION OF DISEASES
The International Classification of Diseases (ICD) is The World Health Organization's globally endorsed coding system for diseases, symptoms, external causes, and health conditions. It helps your doctors make evidence-based decisions. Health planners, clinicians, insurers, and researchers rely on ICD-coded data to allocate resources, design interventions, conduct clinical research, and evaluate safety and effectiveness. The International Classification of Diseases, is revised approximately every 10 years to stay current with advances in medical science. It is done through the widest global consensus of scientists and practitioners from all countries, who work for years in revision committees. The ICD‑11 is the latest version and it officially entered into effect on 1 January 2022. The WHO anticipates the Netherlands fully implements ICD‑11 in doctors practice and other areas around 2026–2027. Meanwhile the Netherlands have to rely on ICD‑10 codes.
Health Insurance Coverage
Asylum seekers provided by the government with free access to medical care. Your insurance company is RMA Healthcare. You are fully eligible for the provisions after 2 months. Until that time, you are only entitled to medically necessary care and care that can’t be delayed. The rule doesn’t apply to children.
CARE FOR CHILDREN
Children in a reception center get the same medical care as Dutch children. A family with children with disability can receive larger or adjusted accom-modation. COA can also place a special bed or sling hoist, or deploy home care to nurse the child. In all cases, COA discusses with the GZA what is medically necessary.
More about Health insurance.
Pharos
CARE FOR CHILDREN
Children in a reception center get the same medical care as Dutch children. A family with children with disability can receive larger or adjusted accom-modation. COA can also place a special bed or sling hoist, or deploy home care to nurse the child. In all cases, COA discusses with the GZA what is medically necessary.
More about Health insurance.
Pharos
DENTAL CARE
Adult asylum seekers (18+) are only entitled to dental care if they have serious pain and/or chewing complaints (emergency care), to a maximum of 250 euros per year. For children, there is more extensive dental care, including a preventive annual check.
More detailed information about the payment of dental care is available in the Medical Care for Asylum Seekers Regulations (RMA).
MEDICATIONS
Refugees, like the Dutch, receive free medicines in pharmacies with a prescription from a doctor. If you don't want to stand in line at GZA to get paracetamol, allergy medicine and other simple medications, you can buy them in supermarkets like Albert Heijn and Kruidvat.
Adult asylum seekers (18+) are only entitled to dental care if they have serious pain and/or chewing complaints (emergency care), to a maximum of 250 euros per year. For children, there is more extensive dental care, including a preventive annual check.
More detailed information about the payment of dental care is available in the Medical Care for Asylum Seekers Regulations (RMA).
MEDICATIONS
Refugees, like the Dutch, receive free medicines in pharmacies with a prescription from a doctor. If you don't want to stand in line at GZA to get paracetamol, allergy medicine and other simple medications, you can buy them in supermarkets like Albert Heijn and Kruidvat.
FLU VACCINATION
In autumn you will get an invitation letter from your general practitioner (GZA) for flu vaccination, if you have certain health problems or you are 60 years of age or older.
SEXUAL HEALTH
By having sex you can get an sexually transmitted disease (STD). Especially if you don’t use a condom. Sometimes STDs will cause symptoms, but not always. With an STD test you will know for sure if you have an STD or not. Most STDs are treatable with medication. Some STDs never heal.
Zanzu: Multilingual picture guide for sexual health
TIPS & TRICKS
If you have any doubts about whether this is included in your insurance or GZA nurse or doctor refuses to provide you with any services, you can always call the insurance company or check it on the RMA Healthcare site. In some cases GZA hotline can be useful too.
In autumn you will get an invitation letter from your general practitioner (GZA) for flu vaccination, if you have certain health problems or you are 60 years of age or older.
SEXUAL HEALTH
By having sex you can get an sexually transmitted disease (STD). Especially if you don’t use a condom. Sometimes STDs will cause symptoms, but not always. With an STD test you will know for sure if you have an STD or not. Most STDs are treatable with medication. Some STDs never heal.
Zanzu: Multilingual picture guide for sexual health
TIPS & TRICKS
If you have any doubts about whether this is included in your insurance or GZA nurse or doctor refuses to provide you with any services, you can always call the insurance company or check it on the RMA Healthcare site. In some cases GZA hotline can be useful too.
HIV ISN'T FATAL
HIV is a virus that can be get through unprotected sex or blood. The best protection are condoms, PrEP or PEP.
Nowadays, when modern treatment for HIV is available, people live long and productive lives with HIV as a chronic disorder, which is less dangerous than diabetes. Persons, who have HIV and regularry take medicine and whose viral load is undetectable, can’t transmit HIV even having sex without a condom. They can born children without HIV virus.
What makes people living with HIV suffer now, is stigma. HIV stigma is negative attitudes and beliefs about people with HIV, which based on stereotypes. Stereotypes are untrue, illusory and irrational statements. HIV stigma comes from lack of education and wrong information, which does not match scientific data.
HIV is a virus that can be get through unprotected sex or blood. The best protection are condoms, PrEP or PEP.
Nowadays, when modern treatment for HIV is available, people live long and productive lives with HIV as a chronic disorder, which is less dangerous than diabetes. Persons, who have HIV and regularry take medicine and whose viral load is undetectable, can’t transmit HIV even having sex without a condom. They can born children without HIV virus.
What makes people living with HIV suffer now, is stigma. HIV stigma is negative attitudes and beliefs about people with HIV, which based on stereotypes. Stereotypes are untrue, illusory and irrational statements. HIV stigma comes from lack of education and wrong information, which does not match scientific data.
HIV TRANSMISSION
HIV is found mostly in blood and sperm. You can get HIV through sex:
⭑ Anal or vaginal sex without condom
⭑ Cum in mouth. Chances are very small in this case
You can also get HIV from a dirty needle. For example, if you:
⭑ Inject drugs with a needle used by someone else before
⭑ Get a tattoo in a foreign country. Sometimes this is not safe
⭑ Get a blood transfusion in a hospital in a foreign country. Not every country checks blood properly for HIV
HIV is found mostly in blood and sperm. You can get HIV through sex:
⭑ Anal or vaginal sex without condom
⭑ Cum in mouth. Chances are very small in this case
You can also get HIV from a dirty needle. For example, if you:
⭑ Inject drugs with a needle used by someone else before
⭑ Get a tattoo in a foreign country. Sometimes this is not safe
⭑ Get a blood transfusion in a hospital in a foreign country. Not every country checks blood properly for HIV
NO WAY
You don’t get HIV by getting close to people. Virus can't live in atmosphere. So you will not get HIV, for example, from:
⭑ A toilet seat
⭑ Shaking or holding hands
⭑ Hugging and cuddling
⭑ French kissing (tongue kissing)
⭑ Dishes or towels
If someone with HIV takes medication, they can't pass on HIV anymore, even if having unprotected sex.
N = N
More information
You don’t get HIV by getting close to people. Virus can't live in atmosphere. So you will not get HIV, for example, from:
⭑ A toilet seat
⭑ Shaking or holding hands
⭑ Hugging and cuddling
⭑ French kissing (tongue kissing)
⭑ Dishes or towels
If someone with HIV takes medication, they can't pass on HIV anymore, even if having unprotected sex.
N = N
More information
HIV-TREATMENT
Asylum seekers in The Netherlands, living with HIV, receive the medication for free trough insurance. Moreover everyone has a right to medical help, even when they are briefly or temporarily uninsured. Make a GZA appointment and the doctor will refer you to the hospital. There a nurse does blood-testing and after receiving results you will get medication. Be calm, if you are not taking medicine for 1 to 10 days or even more because of your flee from the country of origin. Most likely the viral load will remain undetectable for a long time and resistance won't definitely develop. What is dangerous and totally prohibited to do is to take half of daily dose or take HIV-medicine not on a regular basis. For example, one day you take, another two days don't take, another day take, then again don't take for a day or several days. It causes resistance to the medicine, so it will not work for you anymore.
Asylum seekers in The Netherlands, living with HIV, receive the medication for free trough insurance. Moreover everyone has a right to medical help, even when they are briefly or temporarily uninsured. Make a GZA appointment and the doctor will refer you to the hospital. There a nurse does blood-testing and after receiving results you will get medication. Be calm, if you are not taking medicine for 1 to 10 days or even more because of your flee from the country of origin. Most likely the viral load will remain undetectable for a long time and resistance won't definitely develop. What is dangerous and totally prohibited to do is to take half of daily dose or take HIV-medicine not on a regular basis. For example, one day you take, another two days don't take, another day take, then again don't take for a day or several days. It causes resistance to the medicine, so it will not work for you anymore.
WORKSHOPS & EVENTS
You live with HIV and are curious about the latest medical developments and aspects of living with HIV in The Netherlands, aren’t you? Do you want to know how to come to terms with HIV and feel positive about it? Then the Positive Living workshop series is made for you!
The power of love (in Dutch)
Share the power
Peer counseling
Poz & Proud
HIV Association
SOAIDS
You live with HIV and are curious about the latest medical developments and aspects of living with HIV in The Netherlands, aren’t you? Do you want to know how to come to terms with HIV and feel positive about it? Then the Positive Living workshop series is made for you!
The power of love (in Dutch)
Share the power
Peer counseling
Poz & Proud
HIV Association
SOAIDS
Refugees with Disabilities
PEOPLE WITH REDUCED MOBILITY
Most AZC buildings are not suitable for persons with reduced mobility. So you can ask to receive larger or adjusted accommodation from COA or transfer for another camp. First you should give COA permission to access your health information from GZA and then they discuss the request.
Insurance can afford you, for example some physiotherapy and weekles. You can order delivery and return of weekles by yourself by phone or ask COA to assist you with that. To be sure what is included and in which amount call the insurance company or check it on the RMA Healthcare site. In some cases GZA hotline can be useful too.
SPECIAL HEALTH CONDITIONS
Sometimes because of your health conditions you need assistance from volunteers. Ask your nurse or doctor at the hospital to connect you with volunteers’ organisations for that. Sometimes GZA and COA can be helpful for it too.
Most AZC buildings are not suitable for persons with reduced mobility. So you can ask to receive larger or adjusted accommodation from COA or transfer for another camp. First you should give COA permission to access your health information from GZA and then they discuss the request.
Insurance can afford you, for example some physiotherapy and weekles. You can order delivery and return of weekles by yourself by phone or ask COA to assist you with that. To be sure what is included and in which amount call the insurance company or check it on the RMA Healthcare site. In some cases GZA hotline can be useful too.
SPECIAL HEALTH CONDITIONS
Sometimes because of your health conditions you need assistance from volunteers. Ask your nurse or doctor at the hospital to connect you with volunteers’ organisations for that. Sometimes GZA and COA can be helpful for it too.
HOUSING INTERVIEW & SMA
If an asylum seeker wishes to be eligible for resettlement in a specific area, has the right to fast track housing, a specific type of home or assisted living due to medical and/or psychosocial circumstances, an independent social health advice SMA from MediFirst is required. Read more in "Housing Interview" Article on The United refugees site below.
INTEGRATION
Имейте в виду, что муниципалитет должен учитывать ваши особые потребности при создании и реализации ПГИ. При необходимости вы можете попросить врачей и медсестер принять участие в этом процессе. Для получения более подробной информации прочтите статью о гражданской интеграции Нидерландов на сайте United Refugees ниже.
If an asylum seeker wishes to be eligible for resettlement in a specific area, has the right to fast track housing, a specific type of home or assisted living due to medical and/or psychosocial circumstances, an independent social health advice SMA from MediFirst is required. Read more in "Housing Interview" Article on The United refugees site below.
INTEGRATION
Имейте в виду, что муниципалитет должен учитывать ваши особые потребности при создании и реализации ПГИ. При необходимости вы можете попросить врачей и медсестер принять участие в этом процессе. Для получения более подробной информации прочтите статью о гражданской интеграции Нидерландов на сайте United Refugees ниже.
Refugees with Mental &
Neurocognitive Disorders
Neurocognitive Disorders
DUTCH MENTAL HEALTH SYSTEM
Mental health care in the Netherlands meets modern international quality standards and is based on the diagnostic criteria of ICD-10 and DSM-5-TR. National treatment recommendations are based on WHO recommendations, so the effectiveness of a treatment for a particular mental disorder have be evidence based. Unfortunately, the shortage of specialists in providing mental health care, growing demand and financial reasons caused by health insurers leads to long queues. Access to psychiatry is difficult both for refugees and for residents. Waiting lists of Dutch mental health clinics are from 2 months till 1 year or even more. Also, training and retraining of mental health specialists in new modern diagnostic and treatment protocols sometimes remains at an insufficient level compared to leading international clinics. Another problem is the inflexible and long-unupdated care protocols issued by the Dutch Ministry of Health. Burnout of overloaded mental health workers is added to the general list of problems. Therefore, for now, the best mental health care is provided in private clinics in the Netherlands..
HOW TO GET HELP AT REFUGEE CAMPS
ACCOMODATION
SUICIDAL THOUGTS
If you have suicidal thoughts feel free to call to 113 Suicide Prevention. They employ psychologists and psychiatrists and a large group of fully trained volunteers who provide round-the-clock confidential support through chats and phone calls.
PSYCHOEDUCATION
Psychoeducation is a first recommended treatment for any disorder. Psychoeducation mean to receive contemporary scientific information about your disorder, treatment and efficiency of self-help techniques from reliable sources or mental health providers. For example, Mind Project.
PSYCHOTHERAPY
Mental health care in the Netherlands meets modern international quality standards and is based on the diagnostic criteria of ICD-10 and DSM-5-TR. National treatment recommendations are based on WHO recommendations, so the effectiveness of a treatment for a particular mental disorder have be evidence based. Unfortunately, the shortage of specialists in providing mental health care, growing demand and financial reasons caused by health insurers leads to long queues. Access to psychiatry is difficult both for refugees and for residents. Waiting lists of Dutch mental health clinics are from 2 months till 1 year or even more. Also, training and retraining of mental health specialists in new modern diagnostic and treatment protocols sometimes remains at an insufficient level compared to leading international clinics. Another problem is the inflexible and long-unupdated care protocols issued by the Dutch Ministry of Health. Burnout of overloaded mental health workers is added to the general list of problems. Therefore, for now, the best mental health care is provided in private clinics in the Netherlands..
HOW TO GET HELP AT REFUGEE CAMPS
- If you know the name of the medication that helped you in the country of departure and it’s certified in The Netherlands, a general practitioner from GZA will prescribe it to you. Especially, if you have an old prescription or package of your medicine or letter from psychiatrist from abroad.
- If your symptoms are mild, you can usually be treated by GZA GP (general practitioner, "home doctor"). E.g. antidepressants can be prescribed by GP for mild depression and\or anxiety disorders with mild symptoms.
- It is recommended by WHO and APA to start taking antidepressants with a gradual increase in dose. Remember that most antidepressants have a withdrawal syndrome and should not be stopped abruptly too.Benzodiazepine tranquilizers are addictive and can not be used more than 2 weeks. Read more about antidepressants here.
- Praktijkondersteuner Huisartsen Geestelijke Geestelijke GezondheidsZorg (POH GGZ) refers to GP Practice Support – Mental Healthcare.These professionals work within GP practices to address psychological or psychosocial complaints like stress, mild depression, anxiety, grief, and burnout, provide short-term interventions and guide referrals if needed, are not doctors and do not prescribe medication; they work under GP oversight and also maintain confidential records within the GP’s system.
- GZA GP or POH GGZ are not trained to diagnose complicated cases and have to refer you to the mental health clinic. Sometimes, they refuse to send people to metal health clinics. In case of severe symptoms, you should insist on referring you to the mental health clinic, voice your request several times and give arguments in favor of the severity of your symptoms and difficulties in functioning, sending request by e-mail to GP.
- You can contact with mental health clinics via phone or email in advance to clarify if they take a new patients, what is the waiting lists for your disorder and ask your GZA GP or POH GGZ to refer you in a particular clinic.
- Everything that you say will be written in GZA computer system and GP and people from GZA-office have access to it.
- Emergency psychiatric care can be reached through GZA Hotline or 112 phone number.
ACCOMODATION
- Today in The Netherlands there are no special asylum routes and facilities for asylum seekers with mental disorders as the most vulnerable group. But, if according medical reasons you need a separate room, COA should provide you with it. Ask for a paper from your GZA GP or POH GGZ with the demand and send it by e-mail to your COA contact person and\or the local manager of the camp.
- United Refugees have encountered cases when refugees were refused, citing a lack of available rooms, or request being resolved within a couple of months. Sometimes you have to be persistent. Make your repeated requests with explanation, why you need it but in polite manner.
SUICIDAL THOUGTS
If you have suicidal thoughts feel free to call to 113 Suicide Prevention. They employ psychologists and psychiatrists and a large group of fully trained volunteers who provide round-the-clock confidential support through chats and phone calls.
PSYCHOEDUCATION
Psychoeducation is a first recommended treatment for any disorder. Psychoeducation mean to receive contemporary scientific information about your disorder, treatment and efficiency of self-help techniques from reliable sources or mental health providers. For example, Mind Project.
PSYCHOTHERAPY
- Different types of cognitive behavioural therapy (CBT) is evidence-based method for most of mental disorders. You can read more about it at Dutch Mental Health Quality Standards. Just choose your diagnosis.
- It is important to understand that for each specific mental disorder, certain types of psychotherapy are effective. Therefore, it is very important to get a correct diagnosis from a psychiatrist first.
- First session is mostly for getting acquainted with each other. So tell not only about yourself and ask a specialist, you have been referred from GZA, about his\her\their education and how exactly he\she\they can help you. You both will find a better way to support you. Remember responsibility for your health relies on you, firstly.
SUBSTANCE USE DISORDER
Substance use disorder (SUD) is a complex condition in which there is uncontrolled use of a substance, such as alcohol, tobacco, or other psychoactive substances, despite harmful consequences.
In the Netherlands you can find multiple clinics, which can help you with addiction. Medications are sometimes used to relieve withdrawal symptoms and help in stopping consumption of several substances. Psychotherapy and support from trained peers who have coped with this disorder or support from a social worker are part of the treatment and prevention of relapses. It is better for your family members and friend be trained in clinic how to help you with SUD.
Drug Addicts Anonymous and Alcoholics Anonymous approach is not evidence bases medical intervention. Safety and efficiency are still questioned, while the groups of DA and AA are quite popular.
While you are in refugee camp or on a waiting list to the clinic SMART Recovery can be useful service to confront an addiction. SMART Recovery is a free online meetings, where you can learn evidenced-based recovery tools, listen about others recovery experience or share yours. It is anonymous and does not require anything other than your willingness to attend the meetings.
TIPS & TRICKS: MEDIFIRST
Medifirst assessment is not mandatory and you can refuse this service. That's why authorities have to receive your written permission for it. MediFirst nurses and doctors check whether the asylum seeker is physically and mentally capable of participating in hearings and whether there are any medical limitations that should be considered during hearings and when making decisions. After the MediFirst examination, most asylum seekers receive a letter with a scheduled second interview with IND in a period of 6 - 12 weeks.
Your interview will be postponed for six months or less if you
⭑ say to the MediFirst practitioner that you have suicidal thoughts;
⭑ have an exacerbation of mental disorder(s).
If you have a mental disorder and didn’t receive treatment, you should convince the MediFirst practitioner, that your state is stable and you are capable of going through an interview.
It is important for people with mental health problems to be interviewed quickly to gain access to the treatment they need. Uncertainty and life in a camp not suitable for people with mental disorders often only worsen their condition.
If you decide to go to the MediFirst assessment, think in advance about how your specialties can interfere with the interview and interrupt receiving the positive decision. Wright for yourself what needs to be done to help you during hearings. Some people need breaks every hour, some need a room with a window, and some have memory problems and find it difficult to accurately remember dates or names and this should definitely be voiced during the Medifirst assessment.
HOUSING INTERVIEW & SMA
If an asylum seeker wishes to be eligible for resettlement in a specific area, has the right to fast track housing, a specific type of home or assisted living due to medical and/or psychosocial circumstances, an independent social health advice SMA from MediFirst is required. Read more in "Housing Interview" Article on The United refugees site below.
INTEGRATION
It is important for refugees living with mental, behavioral, and neurodevelopmental disorders to involve psychiatrists, psychologists, and social workers from your mental clinics. Municipality employees are not trained to work with people with mental disorders and are required to involve practitioners from your mental clinic to receive recommendations for conditions and achievable goals of integration, because of your special needs and disabilities, and also to help with the creation of PIP, to support of PIP implementation, to define the suitable stage of your treatment for the start of PIP. For more details read the Dutch Civic Integration article on The United Refugees site below.
Substance use disorder (SUD) is a complex condition in which there is uncontrolled use of a substance, such as alcohol, tobacco, or other psychoactive substances, despite harmful consequences.
In the Netherlands you can find multiple clinics, which can help you with addiction. Medications are sometimes used to relieve withdrawal symptoms and help in stopping consumption of several substances. Psychotherapy and support from trained peers who have coped with this disorder or support from a social worker are part of the treatment and prevention of relapses. It is better for your family members and friend be trained in clinic how to help you with SUD.
Drug Addicts Anonymous and Alcoholics Anonymous approach is not evidence bases medical intervention. Safety and efficiency are still questioned, while the groups of DA and AA are quite popular.
While you are in refugee camp or on a waiting list to the clinic SMART Recovery can be useful service to confront an addiction. SMART Recovery is a free online meetings, where you can learn evidenced-based recovery tools, listen about others recovery experience or share yours. It is anonymous and does not require anything other than your willingness to attend the meetings.
TIPS & TRICKS: MEDIFIRST
Medifirst assessment is not mandatory and you can refuse this service. That's why authorities have to receive your written permission for it. MediFirst nurses and doctors check whether the asylum seeker is physically and mentally capable of participating in hearings and whether there are any medical limitations that should be considered during hearings and when making decisions. After the MediFirst examination, most asylum seekers receive a letter with a scheduled second interview with IND in a period of 6 - 12 weeks.
Your interview will be postponed for six months or less if you
⭑ say to the MediFirst practitioner that you have suicidal thoughts;
⭑ have an exacerbation of mental disorder(s).
If you have a mental disorder and didn’t receive treatment, you should convince the MediFirst practitioner, that your state is stable and you are capable of going through an interview.
It is important for people with mental health problems to be interviewed quickly to gain access to the treatment they need. Uncertainty and life in a camp not suitable for people with mental disorders often only worsen their condition.
If you decide to go to the MediFirst assessment, think in advance about how your specialties can interfere with the interview and interrupt receiving the positive decision. Wright for yourself what needs to be done to help you during hearings. Some people need breaks every hour, some need a room with a window, and some have memory problems and find it difficult to accurately remember dates or names and this should definitely be voiced during the Medifirst assessment.
HOUSING INTERVIEW & SMA
If an asylum seeker wishes to be eligible for resettlement in a specific area, has the right to fast track housing, a specific type of home or assisted living due to medical and/or psychosocial circumstances, an independent social health advice SMA from MediFirst is required. Read more in "Housing Interview" Article on The United refugees site below.
INTEGRATION
It is important for refugees living with mental, behavioral, and neurodevelopmental disorders to involve psychiatrists, psychologists, and social workers from your mental clinics. Municipality employees are not trained to work with people with mental disorders and are required to involve practitioners from your mental clinic to receive recommendations for conditions and achievable goals of integration, because of your special needs and disabilities, and also to help with the creation of PIP, to support of PIP implementation, to define the suitable stage of your treatment for the start of PIP. For more details read the Dutch Civic Integration article on The United Refugees site below.
Major Depression Disorder
MAJOR DEPRESSION DISORDER (MDD)
is a malfunction in the human nervous system that indicates both or one of basic symptoms:1) having a depressed mood (e.g. depressed, feels sad, empty, hopeless, low mood, appears tearful, ets.) and 2) losing interest and enjoyment in all, or almost all, activities, which you were interested and enjoyed before. Other 3 - 4 of more symptoms of the following should be present for MDD diagnosis according to DSM-5TR:
⭑ Significant weight loss when not dieting or weight gain (e.g., a change of more than 5% of body weight in a month), or decrease or increase in appetite.
⭑ Insomnia or hypersomnia.
⭑ Feeling either agitated and restless or slowed down in both movement and thinking, which is noticeable to others.
⭑ Fatigue or loss of energy.
⭑ Feeling worthless or overwhelmed by guilt. Sometimes these guilt feelings can even seem unreasonable or untrue, especially for others, who know you and your life well. This can feel more intense than just commonly blaming yourself for something you did or done or being sick.
⭑ Diminished ability to think or concentrate, or indecisiveness.
⭑ Recurrent thoughts of death which is not just fear of dying, recurrent suicidal thoughts
⭑ ICD-11 adds here the feeling of hopelessness, but DSM-5TR includes it in basic symptom “Depressed mood”.
These conditions should last most of the day, nearly every day for at least 2 weeks.
SEVERITY
How intense the symptoms you experience, and how much they affect your daily life, how long they last can vary greatly. If you experience milder depression, you might have a low mood but still be able to carry on with your daily life. But things may feel harder and less worthwhile. If you have more severe depression, you might find day-to-day life much more difficult. You may also experience suicidal feelings.
FAMOUS PEOPLE WITH DEPRESSION
Some public figures are open about their mental health, that helps us to understand that depression is not attached to social financial status and success in career or personal life.
⭑ Billie Eilish, Grammy-winning singer-songwriter, has battled “debilitating depression” and an “impending-doom feeling” since early teens. Billie manages her depression through regular therapy, strong family support, and careful control over her schedule and public exposure. She’s had multiple relapses, especially around 2018 and 2023. Despite this, she became the youngest artist in history to win all four major Grammy categories in one night at age 18.
⭑ Cara Delevingne, model, actress, and LGBTQ+ activist, experienced severe depression as early as age 15, including suicidal thoughts and a breakdown. Medication and therapy helped stabilize her, though she had relapses in early 2020s tied to substance use. Now sober, she focuses on long-term wellness. Despite these challenges, she became one of the world’s highest-paid models and a lead actress in major films.
⭑ Lady Gaga, award-winning musician and actress, has endured severe depression, dissociation, and what she once described as a “psychotic break.” She manages her condition with medication, including antipsychotic olanzapine, intensive therapy, and structured routine. The episodes recur alongside chronic pain but are controlled now. Despite her mental health battles, she has won an Academy Award, 13 Grammys and created the Born This Way Foundation while championing mental-health awareness.
SELF ASSESSMENT
The United Refugees recommends Hospital Anxiety and Depression Scale (HADS) for self assessment. If you have scored more than 11 on the depression scale, make an appointment with your general practitioner and bring the results of HADS. Together you will decide what to do next.
The world health organisation
Short video with basic information about depression
Video testimonial of Indian girl about her past depression
Other evidence based treatments for depression
Self-care for depression
For friends and family
is a malfunction in the human nervous system that indicates both or one of basic symptoms:1) having a depressed mood (e.g. depressed, feels sad, empty, hopeless, low mood, appears tearful, ets.) and 2) losing interest and enjoyment in all, or almost all, activities, which you were interested and enjoyed before. Other 3 - 4 of more symptoms of the following should be present for MDD diagnosis according to DSM-5TR:
⭑ Significant weight loss when not dieting or weight gain (e.g., a change of more than 5% of body weight in a month), or decrease or increase in appetite.
⭑ Insomnia or hypersomnia.
⭑ Feeling either agitated and restless or slowed down in both movement and thinking, which is noticeable to others.
⭑ Fatigue or loss of energy.
⭑ Feeling worthless or overwhelmed by guilt. Sometimes these guilt feelings can even seem unreasonable or untrue, especially for others, who know you and your life well. This can feel more intense than just commonly blaming yourself for something you did or done or being sick.
⭑ Diminished ability to think or concentrate, or indecisiveness.
⭑ Recurrent thoughts of death which is not just fear of dying, recurrent suicidal thoughts
⭑ ICD-11 adds here the feeling of hopelessness, but DSM-5TR includes it in basic symptom “Depressed mood”.
These conditions should last most of the day, nearly every day for at least 2 weeks.
SEVERITY
How intense the symptoms you experience, and how much they affect your daily life, how long they last can vary greatly. If you experience milder depression, you might have a low mood but still be able to carry on with your daily life. But things may feel harder and less worthwhile. If you have more severe depression, you might find day-to-day life much more difficult. You may also experience suicidal feelings.
FAMOUS PEOPLE WITH DEPRESSION
Some public figures are open about their mental health, that helps us to understand that depression is not attached to social financial status and success in career or personal life.
⭑ Billie Eilish, Grammy-winning singer-songwriter, has battled “debilitating depression” and an “impending-doom feeling” since early teens. Billie manages her depression through regular therapy, strong family support, and careful control over her schedule and public exposure. She’s had multiple relapses, especially around 2018 and 2023. Despite this, she became the youngest artist in history to win all four major Grammy categories in one night at age 18.
⭑ Cara Delevingne, model, actress, and LGBTQ+ activist, experienced severe depression as early as age 15, including suicidal thoughts and a breakdown. Medication and therapy helped stabilize her, though she had relapses in early 2020s tied to substance use. Now sober, she focuses on long-term wellness. Despite these challenges, she became one of the world’s highest-paid models and a lead actress in major films.
⭑ Lady Gaga, award-winning musician and actress, has endured severe depression, dissociation, and what she once described as a “psychotic break.” She manages her condition with medication, including antipsychotic olanzapine, intensive therapy, and structured routine. The episodes recur alongside chronic pain but are controlled now. Despite her mental health battles, she has won an Academy Award, 13 Grammys and created the Born This Way Foundation while championing mental-health awareness.
SELF ASSESSMENT
The United Refugees recommends Hospital Anxiety and Depression Scale (HADS) for self assessment. If you have scored more than 11 on the depression scale, make an appointment with your general practitioner and bring the results of HADS. Together you will decide what to do next.
The world health organisation
Short video with basic information about depression
Video testimonial of Indian girl about her past depression
Other evidence based treatments for depression
Self-care for depression
For friends and family
CAUSES OF MDD
Depression doesn't usually stem from a single cause. Instead, it's often the result of a mix of factors that can vary from person to person, sometimes even without an obvious trigger. According to the current scientific medical model, both environmental and biological factors contribute to all mental health disorders. Brain chemistry and regulation issues are part of the picture, but not the full story. Things like loneliness, financial hardship, poor housing or experiencing discrimination also contribute.Possible contributing factors include:
⭑ Childhood experiences. Difficult events like abuse, neglect, or loss can increase vulnerability later in life.
⭑ Life events. Things like bereavement, job loss, money worries, relationship problems, or big life changes can be triggering, especially when combined with low support.
⭑ Styles of thinking. Negative patterns, like self-blame or repetitive worrying, can boost the risk of depression too.
⭑ Other mental health issues. Conditions like anxiety often coexist and can worsen depression. For instance, Post traumatic stress disorder contains depressive symptoms itself.
⭑ Physical health problems. Chronic or serious illnesses (e.g., heart disease, thyroid issues, chronic pain) increase the likelihood of depression.
⭑ Family history and genetics. A family history of depression raises the risk, with genetics accounting for about 40% of the risk.
⭑ Medications. Some drugs (like beta-blockers, interferon, isotretinoin or hormonal treatments, ets.) can have depression as a side effect.
⭑ Recreational drugs and alcohol. Substance use, especially long-term, can both trigger and worsen depression.
⭑ Sleep, diet and exercise. Lack of sleep, poor nutrition, and inactivity disrupt mood regulation.
ANTIDEPRESSANTS FOR MDD
If you’ve tried other treatments but they haven’t helped, for moderate and severe depression, or depression accompanied by anxiety, PSTD and other mental disorders, or depression with intense feelings of self guilt, worthless, suicidal thoughts or behavior antidepressants are essential according to NICE guidelines. Antidepressants also most helpfulIf, if you’ve tried lifestyle or therapy approaches without success, when physical symptoms (pain, sleep problems) are severe and if you have had repeated episodes or a strong family history of depression.
If you don't have bipolar disorder, you will benefit from any type of antidepressants. The most popular group is selective serotonin reuptake inhibitors (SSRIs)
and serotonin and norepinephrine reuptake inhibitors (SNRIs). In the European Union they can be prescribed by a psychiatrist or even your GP. They might offer medication as a treatment on its own. Or they might recommend taking medication as well as having talking therapy, do aerobic exercises (biking, swimming, running, ets.) or sunbathing or use 10 000 lumen lamps.
In some cases, your doctor may also prescribe aripiprazole or lithium alongside antidepressants. This is most likely if you have severe depression, or your depression keeps coming back. And it is usually when you have tried two types of antidepressants on their own at maximum bearable dosage and they aren't working.
MDD TREATMENT DURATION
Some people find an antidepressants helps right away, while others may need to try a few different options before finding what works best. You can talk to your doctor about the choices available and what might suit you. NICE guidelines recommend that you keep taking antidepressants for at least 6 months after an episode of depression ends. Some people following the advice of the psychiatrist may choose to stay on medication longer-term, especially if they've experienced multiple episodes of depression in the past. In these cases, continuing medication can help reduce the risk of future relapses.
ANTIDEPRESSANTS DISCONTINUATION
If you’re taking medication for depression, it’s important not to stop it suddenly. Stopping abruptly can lead to withdrawal symptoms that may be difficult to manage—and with some antidepressants, it can even be dangerous. If you’re thinking about coming off your medication:
⭑ Talk to the healthcare professional who prescribed it.
⭑ Come off gradually, over time, with medical guidance.
⭑ Understand the possible risks and how to reduce them safely.
Cooperating with your doctor ensures the process is as safe and comfortable as possible.
Depression doesn't usually stem from a single cause. Instead, it's often the result of a mix of factors that can vary from person to person, sometimes even without an obvious trigger. According to the current scientific medical model, both environmental and biological factors contribute to all mental health disorders. Brain chemistry and regulation issues are part of the picture, but not the full story. Things like loneliness, financial hardship, poor housing or experiencing discrimination also contribute.Possible contributing factors include:
⭑ Childhood experiences. Difficult events like abuse, neglect, or loss can increase vulnerability later in life.
⭑ Life events. Things like bereavement, job loss, money worries, relationship problems, or big life changes can be triggering, especially when combined with low support.
⭑ Styles of thinking. Negative patterns, like self-blame or repetitive worrying, can boost the risk of depression too.
⭑ Other mental health issues. Conditions like anxiety often coexist and can worsen depression. For instance, Post traumatic stress disorder contains depressive symptoms itself.
⭑ Physical health problems. Chronic or serious illnesses (e.g., heart disease, thyroid issues, chronic pain) increase the likelihood of depression.
⭑ Family history and genetics. A family history of depression raises the risk, with genetics accounting for about 40% of the risk.
⭑ Medications. Some drugs (like beta-blockers, interferon, isotretinoin or hormonal treatments, ets.) can have depression as a side effect.
⭑ Recreational drugs and alcohol. Substance use, especially long-term, can both trigger and worsen depression.
⭑ Sleep, diet and exercise. Lack of sleep, poor nutrition, and inactivity disrupt mood regulation.
ANTIDEPRESSANTS FOR MDD
If you’ve tried other treatments but they haven’t helped, for moderate and severe depression, or depression accompanied by anxiety, PSTD and other mental disorders, or depression with intense feelings of self guilt, worthless, suicidal thoughts or behavior antidepressants are essential according to NICE guidelines. Antidepressants also most helpfulIf, if you’ve tried lifestyle or therapy approaches without success, when physical symptoms (pain, sleep problems) are severe and if you have had repeated episodes or a strong family history of depression.
If you don't have bipolar disorder, you will benefit from any type of antidepressants. The most popular group is selective serotonin reuptake inhibitors (SSRIs)
and serotonin and norepinephrine reuptake inhibitors (SNRIs). In the European Union they can be prescribed by a psychiatrist or even your GP. They might offer medication as a treatment on its own. Or they might recommend taking medication as well as having talking therapy, do aerobic exercises (biking, swimming, running, ets.) or sunbathing or use 10 000 lumen lamps.
In some cases, your doctor may also prescribe aripiprazole or lithium alongside antidepressants. This is most likely if you have severe depression, or your depression keeps coming back. And it is usually when you have tried two types of antidepressants on their own at maximum bearable dosage and they aren't working.
MDD TREATMENT DURATION
Some people find an antidepressants helps right away, while others may need to try a few different options before finding what works best. You can talk to your doctor about the choices available and what might suit you. NICE guidelines recommend that you keep taking antidepressants for at least 6 months after an episode of depression ends. Some people following the advice of the psychiatrist may choose to stay on medication longer-term, especially if they've experienced multiple episodes of depression in the past. In these cases, continuing medication can help reduce the risk of future relapses.
ANTIDEPRESSANTS DISCONTINUATION
If you’re taking medication for depression, it’s important not to stop it suddenly. Stopping abruptly can lead to withdrawal symptoms that may be difficult to manage—and with some antidepressants, it can even be dangerous. If you’re thinking about coming off your medication:
⭑ Talk to the healthcare professional who prescribed it.
⭑ Come off gradually, over time, with medical guidance.
⭑ Understand the possible risks and how to reduce them safely.
Cooperating with your doctor ensures the process is as safe and comfortable as possible.
Autism Spectrum Disorder
AUTISM SPECTRUM DISORDER (ASD) is a neurodiverse condition that shapes the way a person thinks and responds to the world around them. ICD-11 and DSM-5-TR recognizes ASC as a neurodevelopmental disorder, which indicates that genetic impact in this syndrome is great and symptoms start in infancy and preschool years. ASD begins before age 3. Some children show symptoms in the first 12 months, others after 24 months. According to the newest research and wide consensus of the professional bodies, autism is caused by approximately 80% of genetics and only 20%of environmental factors contribute to development for Autism spectrum disorder development. That is why autism can appear in several people from the same family. Autism is not caused by parenting styles or any vaccines. In the past, some people heard the term Asperger’s syndrome, but this term is no longer used. About 1–2% of people worldwide are on the autism spectrum. More boys and men receive a diagnosis than girls and women, but many girls and women are missed.
FAMOUS PEOPLE WITH ASD
Spectrum in the name of Autism Spectrum Disorder means it affects people in different ways. For example, Naoki Higashida, a non-speaking author from Japan, uses a letter board to communicate and wrote the bestselling book The Reason I Jump at age 13, offering deep insight into his inner world. Temple Grandin, an American professor of animal science, thinks in pictures and uses her visual mind to design humane systems for livestock handling, she often says her autism helped her see what others missed. In May 2023 Australian singer and songwriter Sia told Rob Has a Podcast: “I’m on the spectrum… only in the last two years have I become fully myself.” Sia shared that she masked her autism for decades and experiences sensory overload, but credits her intense focus and creative drive for much of her success. Greta Thunberg and Elon Musk live with ASP too and are open about it. During his Saturday Night Live monologue on 8 May 2021, Musk announced, “I’m the first person with Asperger’s to host SNL.” He has since discussed growing up with “literal thinking” and masking social cues at TED 2022 and other interviews. Greta Thunberg, known for climate-change advocacy, channels her laser-like focus and literal honesty into weekly protests and has led a global youth movement, not in spite of autism, but because of it.
ASD SYMPTOMS
Despite people with Autism being very different, something that unites them. Common experiences of a person living with autism is described below.
A. Ongoing difficulties with talking and connecting with other people in many situations. Back and forth communication is hard. For example, a person with autism may start a chat in an unusual way or give no reply. They may share less about their interests or feelings. They may find it hard to begin or answer in social moments. Body language is hard to use or understand. For instance, eye contact, gestures, or tone of voice may not match spoken words. A person with autism may not point or follow someone’s pointing or eye gaze. Facial expressions might be missing or look different. Building and keeping relationships is hard. For example, people with ASD may not change behaviour for different places, social roles. They may struggle with pretend play in childhood or making friends. They may show little interest in people of the same age.
B. Repeated actions, interests, or routines. Repeated movements, use of objects, or words: hand flapping, lining up toys, or echoing words. Many individuals with autism spectrum disorder learn to suppress repetitive behavior in public. In these individuals, repetitive behaviors like rocking or finger flicking may serve a self-soothing function and cope with anxiety. People with autism very often have a strong need for sameness. This can be greatly upset at small changes, need the same route or food, and set greeting rituals. Deep or narrow interests are the next trait of ASD: a very strong focus on unusual things or topics.Environmental activist Greta Thunberg has described her intense, lifelong focus on climate science as a “special interest” that drives her daily routine and keeps her campaigning even under pressure. Another example of intense interest is that some autistic children develop a deep knowledge of dinosaurs. They memorise scores of Latin species names and geological periods, because the clear categories and rich detail fit their learning style. One eight-year-old in a UK case study could recite entire passages from palaeontology textbooks and built social confidence by giving “dinosaur tours” to classmates. Person with autism can have unusual reactions to sounds, lights, touch, taste, or smell: feeling no pain, strong dislike of certain sounds or textures, or smelling or touching objects a lot.
FAMOUS PEOPLE WITH ASD
Spectrum in the name of Autism Spectrum Disorder means it affects people in different ways. For example, Naoki Higashida, a non-speaking author from Japan, uses a letter board to communicate and wrote the bestselling book The Reason I Jump at age 13, offering deep insight into his inner world. Temple Grandin, an American professor of animal science, thinks in pictures and uses her visual mind to design humane systems for livestock handling, she often says her autism helped her see what others missed. In May 2023 Australian singer and songwriter Sia told Rob Has a Podcast: “I’m on the spectrum… only in the last two years have I become fully myself.” Sia shared that she masked her autism for decades and experiences sensory overload, but credits her intense focus and creative drive for much of her success. Greta Thunberg and Elon Musk live with ASP too and are open about it. During his Saturday Night Live monologue on 8 May 2021, Musk announced, “I’m the first person with Asperger’s to host SNL.” He has since discussed growing up with “literal thinking” and masking social cues at TED 2022 and other interviews. Greta Thunberg, known for climate-change advocacy, channels her laser-like focus and literal honesty into weekly protests and has led a global youth movement, not in spite of autism, but because of it.
ASD SYMPTOMS
Despite people with Autism being very different, something that unites them. Common experiences of a person living with autism is described below.
A. Ongoing difficulties with talking and connecting with other people in many situations. Back and forth communication is hard. For example, a person with autism may start a chat in an unusual way or give no reply. They may share less about their interests or feelings. They may find it hard to begin or answer in social moments. Body language is hard to use or understand. For instance, eye contact, gestures, or tone of voice may not match spoken words. A person with autism may not point or follow someone’s pointing or eye gaze. Facial expressions might be missing or look different. Building and keeping relationships is hard. For example, people with ASD may not change behaviour for different places, social roles. They may struggle with pretend play in childhood or making friends. They may show little interest in people of the same age.
B. Repeated actions, interests, or routines. Repeated movements, use of objects, or words: hand flapping, lining up toys, or echoing words. Many individuals with autism spectrum disorder learn to suppress repetitive behavior in public. In these individuals, repetitive behaviors like rocking or finger flicking may serve a self-soothing function and cope with anxiety. People with autism very often have a strong need for sameness. This can be greatly upset at small changes, need the same route or food, and set greeting rituals. Deep or narrow interests are the next trait of ASD: a very strong focus on unusual things or topics.Environmental activist Greta Thunberg has described her intense, lifelong focus on climate science as a “special interest” that drives her daily routine and keeps her campaigning even under pressure. Another example of intense interest is that some autistic children develop a deep knowledge of dinosaurs. They memorise scores of Latin species names and geological periods, because the clear categories and rich detail fit their learning style. One eight-year-old in a UK case study could recite entire passages from palaeontology textbooks and built social confidence by giving “dinosaur tours” to classmates. Person with autism can have unusual reactions to sounds, lights, touch, taste, or smell: feeling no pain, strong dislike of certain sounds or textures, or smelling or touching objects a lot.
C. These signs showed up in early childhood, even if they became clearer later when social life became harder or the person learned to hide them. But why, if these signs appear so early, are lots of people being diagnosed only in adulthood? Common reasons for late diagnoses include lack of information about ASD, when these people were growing, unavailable health care or not developed mental health systems in some countries, subtler presentations in women and successful masking. When social life gets harder, in school years and further some people will learn to hide their autistic traits.
D. To get an official diagnosis of Autism spectrum disorder described symptoms should make daily life at home, work, school, or\and with friends hard.
COMORBID CONDITIONS
Some people with autism also have language or thinking difficulties. Skills can be uneven: a person may be very strong in one area and need help in another. Movement differences like clumsiness or toe walking are common. Self injury or strong distress can happen, especially in children and teenagers. Autism is not a mental health issue, but a person with autism is more likely to experience mental health conditions such as depression or anxiety. They may also have other conditions, like Attention Deficit Hyperactivity Disorder (ADHD), learning disabilities, or learning difficulties such as dyslexia.
There are several social possible reasons for anxiety and depression:
⭑ Negative attitudes from other people. People who are not autistic may not understand or accept differences. A person with autism can face stigma, discrimination, trauma, and loneliness, all of which can harm mental health.
⭑ Differences in interacting with the world. Many places are designed without sensory, processing, or communication needs in mind. Public transport might be stressful, phone calls hard, and some forms confusing.
⭑ Misdiagnosis. Some experiences of autism look like symptoms of mental health problems. This confusion can lead to the wrong diagnosis, delay the right help, and increase stress and depression.
SUPPORT
It is important that people give a person with autism the support they need to live the life they choose. Some people need very little help; others may need regular support from a carer. Getting the right support for both autism and mental health can be difficult. It can take a long time to receive an autism diagnosis, especially as an adult. Mental health and social care services may not understand the best way to help. Services can avoid taking responsibility, and a person may be passed between teams. These barriers and misunderstandings can add to anxiety, low mood, and poor mental well-being. With understanding, acceptance, and the right support at the right time, a person living with autism can thrive and lead the life they want.
American Psychiatric Association
The World Health Organisation
National Library of Medicine about ASD
CDC about ASD
Magazine People About Greta Thunberg
D. To get an official diagnosis of Autism spectrum disorder described symptoms should make daily life at home, work, school, or\and with friends hard.
COMORBID CONDITIONS
Some people with autism also have language or thinking difficulties. Skills can be uneven: a person may be very strong in one area and need help in another. Movement differences like clumsiness or toe walking are common. Self injury or strong distress can happen, especially in children and teenagers. Autism is not a mental health issue, but a person with autism is more likely to experience mental health conditions such as depression or anxiety. They may also have other conditions, like Attention Deficit Hyperactivity Disorder (ADHD), learning disabilities, or learning difficulties such as dyslexia.
There are several social possible reasons for anxiety and depression:
⭑ Negative attitudes from other people. People who are not autistic may not understand or accept differences. A person with autism can face stigma, discrimination, trauma, and loneliness, all of which can harm mental health.
⭑ Differences in interacting with the world. Many places are designed without sensory, processing, or communication needs in mind. Public transport might be stressful, phone calls hard, and some forms confusing.
⭑ Misdiagnosis. Some experiences of autism look like symptoms of mental health problems. This confusion can lead to the wrong diagnosis, delay the right help, and increase stress and depression.
SUPPORT
It is important that people give a person with autism the support they need to live the life they choose. Some people need very little help; others may need regular support from a carer. Getting the right support for both autism and mental health can be difficult. It can take a long time to receive an autism diagnosis, especially as an adult. Mental health and social care services may not understand the best way to help. Services can avoid taking responsibility, and a person may be passed between teams. These barriers and misunderstandings can add to anxiety, low mood, and poor mental well-being. With understanding, acceptance, and the right support at the right time, a person living with autism can thrive and lead the life they want.
American Psychiatric Association
The World Health Organisation
National Library of Medicine about ASD
CDC about ASD
Magazine People About Greta Thunberg
Dutch Сivil Integration
The civil integration requirement does not apply to citizens of European Union countries, Liechtenstein, Norway, Iceland, Switzerland, and Turkey. Except for some other groups, foreign permanent residents of the Netherlands have an obligation for civil integration. Dutch Civil Integration aimed to help refugees with language learning and professional adaptation to a new society.
In this article integration due to Civil Integration Law 2022 is described. The old Civil Integration Law 2013 continues to apply to people who were already subject to the civil integration requirement before 1 January 2022.
THEE INTEGRATION ROUTS
⭑ The B1 route is for newcomers, who are going to learn the Dutch language at the B1. At the same time, they can participate through voluntary or paid work.
⭑ The Onderwijs route. This education route is mainly for young people who are in the Netherlands attending tertiary education. They learn the Dutch language at level B1 or higher.
⭑ The zelfredzaamheidsroute route. The self-reliance route is for newcomers, who can learn the Dutch language only at the A1 level. This route prepares them in a more straightforward manner to participate in Dutch society.
BREDE INTAKE & PIP
To start mandatory integration you should receive a BSN, residence permit, and register with the municipality. Your assigned municipality invites refugees for a meeting, called Brede intake. Its purpose is to obtain information from refugees to create The Personal Integration and Participation Plan, PIP. This plan tells what needs to be done to integrate and in what time frame.
Brede intake includes the following.
⭑ LBT, leerbaarheidstoets is the learning test, that indicates the level can be achieved in Dutch. Refugee, who has a visual or a hearing impairment, or is considered unable to pass the test, is given an exemption from it;
⭑ a survey about education and work experience in the country of origin;
⭑ examination of personal circumstances, including physical and mental health, in order to propose individual solutions in the integration process;
⭑ exploring opportunities for a refugee child to participate in preschool education.
In this article integration due to Civil Integration Law 2022 is described. The old Civil Integration Law 2013 continues to apply to people who were already subject to the civil integration requirement before 1 January 2022.
THEE INTEGRATION ROUTS
⭑ The B1 route is for newcomers, who are going to learn the Dutch language at the B1. At the same time, they can participate through voluntary or paid work.
⭑ The Onderwijs route. This education route is mainly for young people who are in the Netherlands attending tertiary education. They learn the Dutch language at level B1 or higher.
⭑ The zelfredzaamheidsroute route. The self-reliance route is for newcomers, who can learn the Dutch language only at the A1 level. This route prepares them in a more straightforward manner to participate in Dutch society.
BREDE INTAKE & PIP
To start mandatory integration you should receive a BSN, residence permit, and register with the municipality. Your assigned municipality invites refugees for a meeting, called Brede intake. Its purpose is to obtain information from refugees to create The Personal Integration and Participation Plan, PIP. This plan tells what needs to be done to integrate and in what time frame.
Brede intake includes the following.
⭑ LBT, leerbaarheidstoets is the learning test, that indicates the level can be achieved in Dutch. Refugee, who has a visual or a hearing impairment, or is considered unable to pass the test, is given an exemption from it;
⭑ a survey about education and work experience in the country of origin;
⭑ examination of personal circumstances, including physical and mental health, in order to propose individual solutions in the integration process;
⭑ exploring opportunities for a refugee child to participate in preschool education.
Based on Brede intake, the municipality determines the following.
⭑ The integration route to be followed by a refugee;
⭑ The necessary support and guidance for this;
⭑ The intensity of the education process and the module “Labor Market and Participation”;
⭑ The agreements were concluded with the refugee regarding the participation of his child in preschool education.
INTEGRATION PERIOD
The Integration Course can be taken in class or independently. At the end of the course within three years you must take an exam. The period begins on the day after the date of the Personal Integration Plan (PIP). The municipality pays for the integration course for holders of asylum status. The first 2 attempts to pass each exam are free.
FINES
A fine of €250 euros is imposed on a refugee who fails to show up for a wide reception or if they do not cooperate sufficiently in the wide reception process, for example by refusing to take a learning ability test. In the decision on the fine, the municipality sets a new period of no more than two months, during which the refugee must come to a meeting or begin to cooperate.
Fines of €340, €800, or €1,000 may be levied if the refugee fails to comply or does not cooperate sufficiently with the support and guidance offered, doesn't complete training, violates PIP.
TIPS & TRICS
It is important for refugees living with mental, behavioral, and neurodevelopmental disorders to involve psychiatrists, psychologists, and social workers from your mental clinics. Municipality employees are not trained to work with people with mental disorders and are required to involve practitioners from your mental clinic to receive recommendations for conditions and achievable goals of integration, because of your special needs and disabilities, and also to help with the creation of PIP, to support of PIP implementation, to define the suitable stage of your treatment for the start of PIP.
Wet Inburgering 2021
inburgeren.nl
Partisipation
⭑ The integration route to be followed by a refugee;
⭑ The necessary support and guidance for this;
⭑ The intensity of the education process and the module “Labor Market and Participation”;
⭑ The agreements were concluded with the refugee regarding the participation of his child in preschool education.
INTEGRATION PERIOD
The Integration Course can be taken in class or independently. At the end of the course within three years you must take an exam. The period begins on the day after the date of the Personal Integration Plan (PIP). The municipality pays for the integration course for holders of asylum status. The first 2 attempts to pass each exam are free.
FINES
A fine of €250 euros is imposed on a refugee who fails to show up for a wide reception or if they do not cooperate sufficiently in the wide reception process, for example by refusing to take a learning ability test. In the decision on the fine, the municipality sets a new period of no more than two months, during which the refugee must come to a meeting or begin to cooperate.
Fines of €340, €800, or €1,000 may be levied if the refugee fails to comply or does not cooperate sufficiently with the support and guidance offered, doesn't complete training, violates PIP.
TIPS & TRICS
It is important for refugees living with mental, behavioral, and neurodevelopmental disorders to involve psychiatrists, psychologists, and social workers from your mental clinics. Municipality employees are not trained to work with people with mental disorders and are required to involve practitioners from your mental clinic to receive recommendations for conditions and achievable goals of integration, because of your special needs and disabilities, and also to help with the creation of PIP, to support of PIP implementation, to define the suitable stage of your treatment for the start of PIP.
Wet Inburgering 2021
inburgeren.nl
Partisipation
SUPPORT YOURSELF
SUPPORT OTHERS
- ANTONY CHERENKOVFOUNDER & CHIEF EDITOR
Antony received the title of Master of Psychology in 2008 in Russia. He improved his qualifications at Moscow State University on the course "Psychiatry for Psychologists" in 2023. He work in The United Refugee as not BIG-registered volunteer, life-style coach in peer-support service for asylum seekers and undocumented migrants with challenges related to stress, mood, anxiety, ets. The service is aimed to help the most vulnerable groups to get mental health help in The Netherlands. Main occupation of Antony is screenwriting, film and TV direction.
- GRACIA ALCAIDE CASTELLANOAUTHOR
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