In line with this narrative, a report published in the Asylum Seeker Resource Center (ASRC) stated that these children cannot recover from [their home country] because [their home country] is the cause of their trauma. Secondary symptoms may also appear such as weight gain, viral infections, skin sores, and muscular deterioration. [21]Bodegrd in Kenneth P. Nunn et al.Pervasive refusal syndrome (PRS) 21 years on: a re-conceptualisation and a renaming, European Child & Adolescent Psychiatry 23, no. They became catatonic, refusing to eat, talk or move, and often had to be fed via feeding tube and their condition could persist for years. 26 October 2017. Resignation syndrome appears to be a very specialized response to the trauma of refugee limbo, in which families, many of whom have escaped dangerous circumstances in their home countries, wait to be granted legal permission to stay in their new country, often undergoing numerous refusals and appeals over a period of years. In comparison, countries like Greece, Hungary, and Romania have always been known to have stricter immigration laws; therefore, refugees fleeing to those countries are aware that the chances of their asylum being granted is less. To reiterate, this hypothesis argues that the recently more restrictive changes to Swedens immigration laws, including a stricter asylum policy, explains Resignation Syndromes regional distribution. Two sisters lay in bed in Sweden after being struck down with resignation syndrome Credit: AP:Associated Press. Subsequently, there is also a manifesting fear of being deported back to the childs place of previously experienced trauma. In light of these weaknesses, the mental hypothesis arguably is not a compelling explanation for why Resignation Syndrome exists. An ENT surgeon before she retired, Hultcrantz is worried because Sophie does not ever open her mouth. In this scenario, the parents would not find mental health treatment necessary. Theyre in limbo, Samuelson notes. Remission happens after life circumstances improve and ensues with gradual return to what appears to be normal function.[1]. Resignation syndrome, called uppgivenhetssyndrom in Swedish, is an illness that causes people to shut down. [11] However, this renewed sense of security does not guarantee recovery, and if the child does recover, it takes a long time to feel secure as nightmares and stress continue to linger. If you want to think more about this puzzling question, I recommended a new article in Frontiers in Behavioral Neuroscience, with Karl Sallin (PhD student at CRB) as first author. Experiences in detention and processing centres also directly contribute to feelings of lack of safety, anxiety and confusion. The catatonia hypothesis can be tested, Sallin suggests, by trying treatments with known responses in catatonic patients, and by performing PET scans of the brain. Doctor Hultcrantz knows that the children can be healthy again, they are not damaged for life if you take care of them. Accordingly, there must be another hypothesis that explains why Resignation Syndrome does not transcend past Swedish boundaries. Pr Segerdahl is the editor of the Ethics Blog and its Swedish counterpart Etikbloggen. Put simply, they have resigned themselves to the point of lifelessness. For the current Nauru families, the lack of options and a loss of hope for the future is a major risk for mental breakdown and traumatic withdrawal. Through their parents tone, touch, and the general shift in the atmosphere resulting from good news, the children have a chance of coming out of their coma-like state. While many hypotheses have been presented, there is no definitive answer to why Resignation Syndrome does not exist outside of Sweden. Nonetheless, unique to this illness is the fact that all reported case has been within the national boundaries of Sweden. [10] She goes on to describes the afflicted childs recovery as more sound, more life in the house the siblings are more joyful the parents sit around the child and they touch the child and they hug the child. Accordingly, these restrictive laws foster a feeling of uncertainty amongst previously traumatized refugee children as their expectations of staying in Sweden are shattered. And there have also been cases of siblings where first one develops it and then the other. The Ethics Blog is published by the Centre for Research Ethics & Bioethics at Uppsala University. This theory is more preventative as it stipulates that had these refugee children received proper mental health treatment upon experiencing this trauma, they may have never fallen ill. [1], Depicted as a culture-bound syndrome, it was first observed and described in Sweden among children of asylum seekers from former Soviet and Yugoslav countries. Sophie's mother took her to a friend's home. Please refer to an authoritative source if you require up-to-date information on any health or medical issue. Sophie's mother can only repeat what she has heard from the doctor. FactCheck Q&A: Has the number of asylum seeker children in detention declined? Is anyone researching this phenomenon? WebAmid that uncertainty, Karen fell ill again. None of those stories were proven. WebResignation syndrome. But Sophie's eyes are closed. Director of the Centre for Womens Mental Health at the Royal Womens Hospital and Professor of Psychiatry, The University of Melbourne. The condition could persist for months or even years. Unique to this syndrome is that there have been no reported cases outside of Sweden. However, the tendency seems to be to point out Swedens crumbling self-image as the relevant cultural context for the disease. There is no definitive answer to that question, says Sallin, who is researching Resignation Syndrome for his PhD. In the UK, a similar condition - Pervasive Refusal Syndrome - was identified in children in the early 1990s, but there have been only a tiny handful of cases, and none of them among asylum seekers. "The patient is seemingly unconscious. 5.Catatonia: Symptoms, Causes, and Treatment. WebMD. Here Sallin hits on the main obstacle to understanding Resignation Syndrome - the lack of research into it. That if you provide the right sort of nourishment for those kinds of behaviours in a society, you will also see more cases," says Sallin. The oldest children are better able to comprehend the trauma they experience either directly or indirectly through their family members, and also run a greater risk of being exposed to such trauma. So we might take a little bit of Coca Cola, and put it in their mouth so they taste something sweet. Sweden, when you apply for asylum, it takes a long time for your case to be worked through. Last modified September 11, 2017. The acute threat of deportation back to the place of the trauma re-activates their unbearable fear and stress and causes the catatonia-like condition. WebIn English, this became resignation syndrome. But the child does not stir. Sweden Toughens Rules for Refugees Seeking Asylum. The New York 2.Times Breaking News, World News & Multimedia. As exemplified in this paper, there are many potential contributing factors for why Resignation Syndrome exists primarily amongst refugee children. Whilst the exact causes of Resignation Syndrome remain an enigma, it is generally thought to be brought on by a severe lack of hope and intense stress, fuelled by extremely distressing asylum processes, previous traumatic events, and social exclusion. This work takes a lot of energy because we have to live for the children until they start to live on their own.". But evidence from the town of Skara in the south of Sweden suggests that there is a way of curing children with Resignation Syndrome even if the family doesn't receive permanent residence. So I discovered this blog and article about this phenomena because we are seeing cases of catatonic depression in immigrant children in a small CT community. Last modified November 16, 2018. Last year, a new temporary law came into force that limits all asylum seekers' chances of being granted permanent residence. You read that right: in Sweden, not in other countries. This essay may contain factual inaccuracies or out of date material. Explore in 3D: The dazzling crown that makes a king. Karen, meanwhile, a 12-year-old boy seen in Life Overtakes Me, was nearly killed in an ambush that targeted his father. If it is believed that a pill will have a certain impact on health positive or negative the effect can be produced even if the pill contains only a medically inactive substance. This blog is published by the Centre for Research Ethics & Bioethics (CRB) at Uppsala University. Dr Olssen rolled up Nolas dress, exposing her bare stomach and revealing that she was wearing a nappy under her tights. To be more specific, before their immediate showing of symptoms, many of these adolescents had begun their assimilation into the Swedish culture and had sufficient fluency in the language. Dagson shares the view commonly held among doctors treating children with Resignation Syndrome, that recovery depends on them feeling secure and that it is a permanent residence permit that kick-starts that process. Here we might make a comparison with placebo and nocebo effects. [18] In light of this influx of immigrants, anti-immigrant sentiments began to grow in Sweden, causing the Swedish government to institute border controls. Write an article and join a growing community of more than 163,400 academics and researchers from 4,609 institutions. Required fields are marked *. [14] Gran Bodegrd, Pervasive loss of function in asylum-seeking children in Sweden, Acta Paediatrica 94, no. In Australia's offshore detention center for asylum-seekers on the island of Nauru, which has notoriously harsh conditions, the Economist reports that "traumatic withdrawal syndrome" has been seen among some child detainees. Sophie's parents have a terrifying story of extortion and persecution by a local mafia. Gjinovci first heard of resignation syndrome from a 2017 article in The New Yorker that focused on several refugee families in Sweden with children suffering from the malady. "That is sort of implicit in the model. One of these children was Karen, a twelve-year-old refugee from Eastern Europe and the oldest of three siblings. According to reports, the mystery illness was first seen in Sweden in the 1990s - but grew rapidly by the mid-2000s. For nearly two decades Sweden has been battling a mysterious illness. Swedens Mystery Illness: Resignation Syndrome. Doctors of the World. In other words, the child identifies with his or her parents loss of hope, and internalizes their trauma, slowly withdrawing from the world. Bodegrd, Gran. [3] It was also suggested to be on the 'refusal-withdrawal-regression spectrum'. The concept was first developed in Sweden in the mid-1990s, after the children of asylum-seekers began exhibiting strange symptoms. Frontiers in Behavioral Neuroscience 29, January 2016, childrenconsciousnessHuman Brain Projectneuroethicsneuroscienceresignation syndrome. Send us a tip using our annonymous form. Report calls for royal commission into children in immigration detention: experts respond. Yes, these children must, of course, be offered care. He stopped talking, eating, and walking; soon after that he became diagnosed with Resignation Syndrome. New cases stopped occurring. In more precise words, the hypothesis suggests that Resignation Syndrome could have been avoided if parents or other family members had provided sufficient mental health treatment for their children who had suffered from past trauma. The Trauma of Facing Deportation. The New Yorker. If you've never heard of resignation syndrome, you're not alone. Parents require treatment for their own mental health issues and support in providing care for their child. We see apathetic refugee children as symbols of our own moral failure to treat them and their families Resignation syndrome is a strange disorder thats been occurring in Sweden for decades in the child and adolescent refugee population. Louise Newman is affiliated with the human rights group Doctors for Justice and is a past advisor to the Department of Immigration on the mental health of asylum seekers and refugees. Of the 35 children Calshamre has met over the years, one of them got permission to stay in Sweden while still at Solsidan. Either their families request for asylum is denied, they are not granted permanent residency, or they receive a notice of imminent deportation. These childrens toolbox for coping with such trauma is much less than their parents; thus, they run the greatest of falling victims to conditions like Resignation Syndrome. (Perhaps I should point out that Sallin emphasizes that psychological causes are not to be understood in terms of a mind/body dualism.). [3] Karl Sallin et al., Resignation Syndrome: Catatonia? The National Justice Project, a legal centre, has brought 35 children from Nauru this year. Notwithstanding, the family was granted a temporary thirteen-month residency in Sweden and Karen began improving, assimilating in the Swedish school system and learning the language. A book - The Way Back - has recently been published about Solsidan, but its work is not well-known. He initially adjusted well after resettlement in Sweden, but then, like Daria, he too fell into a catatonic state and now must be nourished through a feeding tube threaded down his nose. Nola didnt resist the intrusion. But then when their visa is denied and theyre told they have to go back to their home country, the fact that they actually had a good life in Sweden is in striking contrast to what they would be going back to., One doctor in Life Overtakes Medescribes the psychological reality this way: Your child is laying here like Snow White because everything is so terrible around her that this is a way of protection. Sophie heard everything in that meeting with the Migration Board, and it was at this point that she stopped speaking and eating. Resignation syndrome is an almost-entirely mysterious condition that had never been diagnosed until the 1990s, and is not officially recognized anywhere outside of Sweden. A certain way of reacting or responding to traumatic events seems to be legitimised in a certain context.". Learn how your comment data is processed. While theyre there, Swedens taking care of themtheyre housed, they have medical care. But offering treatment also causes new cases. The trauma of the migrant journey is another unavoidable stress factor for refugee children. The UNHR says that there are around 24.5 million refugees and 3.1 asylum-seekers worldwide in 2019, displaced from their homes by war, disaster or persecution. WebHave you heard of Resignation Syndrome? 2023 BBC. Pr. In the early stages of the Syndrome, there was a lot of public speculation regarding the childrens condition. This period is marked by a painful period of hopelessness, helplessness and indeterminate time perspective as an asylum-seeker in a foreign country. Karen, meanwhile, a 12-year-old boy seen in Life Overtakes Me, was nearly killed in an ambush that targeted his father. Twenty months is a very long time for a child of her age to be disengaged from the world. Common features are the ongoing nature of the trauma and the childs feelings of hopelessness and helplessness in the face of inescapable stress. In the past two decades, more than one thousand children have taken anxiety and dread deep into their bodies, falling into what has been named uppgivenhetssyndrom, a giving-up we translate as resignation syndrome.. [8] Life Overtakes Me, directed by Kristine Samuelson. The introduced diagnosis, resignation syndrome, is therefore inappropriate. The syndrome, also known as Uppgivenhetssyndrom in Swedish, causes children to stop walking, The children get up every day. It estimates that seven had RS, and three had psychosis. (2019; Sweden: Netflix, 2019), Film. Elisabeth Hultcrantz: Children disconnect the conscious part of their brain, Annica Carlshamre: This sickness has to do with trauma, not asylum, The secret mine that hid the Nazis' stolen treasure. WebAmid that uncertainty, Karen fell ill again. Children may remain in a comatose state for weeks and gradually emerge. [2], The phenomenon has been called into question, with two children reporting that they were forced by their parents to act apathetic in order to increase chances of being granted residence permits. But if it were true, the syndrome should occur also in other countries. No-one has done follow-up on what happens to these children, but we do know that they survive. Karen had found security in Sweden, making friends and moving on from the trauma he experienced back in Ukraine. They proceed to exhibit deterioration in their motor skills as they slowly lose the ability to speak, eat, and drink all together. "Typically a depressive onset is followed by gradual withdrawal progressing via stupor into a state that prompts tube feeding and is characterized by failure to respond even to painful stimuli," a study of the phenomenon in Frontiers In Behavioral Neuroscience found in 2016. So why is the syndrome common only in Sweden? All Rights Reserved. Children with resignation syndrome assessed and cared for by CAMHS had similar need of outpatient care as other children of the same origin who had been treated Are doctors ethically obliged to keep at-risk children out of detention. Feeding tubes help sustain the life of the child, but it does not serve as a medical treatment. The others recovered before their asylum status was assured. We want to hear from you! There were reports the children were faking it, and that parents were poisoning their offspring to secure residence. [2] A report published in August 2018 suggested there were at least 30. However, the currently prevailing stress hypothesis fails to account for the regional distribution (see Epidemiology) and contributes little to treatment. Previous trauma before ones migration as well as the trauma of leaving your home and immigrating to a new country can place an immense amount of stress onto a child. Whats more, beyond the trauma experienced back home, these refugee children also face the trauma of the journey [and] the trauma of detention at some point, the bucket is full. The rate of recovery varies, but some children need support for 12 months. [1][6], Currently, diagnostic criteria are undetermined, pathogenesis is uncertain, and effective treatment is lacking.[1]. A final contributing factor frequently cited by medical researchers for why Resignation Syndrome exists is a theory of mental health. "I can't say it's not possible, but it all depends how the parents sense this - are we going to stay after these 13 months? Does the severity of an illness qualify the moral motivation to act? In recent years hundreds of kids around the Scandinavian country have slipped into a mysterious, coma-like state lasting many months or moretransformed from bright, active youngsters into limp creatures in need of round-the-clock care. The mystery remains. https://www.crb.uu.se/personal/karl-sallin/, Uppgivenhetssyndrom hos flyktingbarn en ny hypotes | ETIKBLOGGEN, Only in Sweden - Bioethics Research Library, The New Yorker features resignation syndrome | Bioethics Research Library, Centre for Research Ethics & Bioethics (CRB), Taking care of the legacy: curating responsible research and innovation practice. The reference to Snow White is apt, because there is a fairytale-like quality to the documentary, evoking ancient tales of children menaced by dark, mysterious forces. Here you can choose which regional hub you wish to view, providing you with the most relevant information we have for your specific region. From simple essay plans, through to full dissertations, you can guarantee we have a service perfectly matched to your needs. He initially adjusted well after resettlement in If you need assistance with writing your essay, our professional essay writing service is here to help! For nearly two decades Sweden has been battling a mysterious illness. These contributing factors include, but are not limited to 1) the immense amount of stress placed on refugee children, 2) an ensuing lack of proper mental health treatment for the stress the child is under as well as the past trauma he or she has experienced, and 3) a psychodynamic hypothesis in which the migrant mother (or even father), often the subject of physical abuse or sexual assault, projects his or her trauma onto the child, who subsequently adopts this trauma as its own. Numerous conditions resembling Resignation Syndrome have been reported before - among Nazi concentration camp inmates, for example. This refugee childs traumatic resurface risks transforming into Resignation Syndrome. Their children are going to school. Identifying the cause has proven elusive. This could be dangerous, because if there were a problem with her feeding tube, Sophie could choke. Most populous nation: Should India rejoice or panic? 12 (2005): 345, doi:10.1080/08035250510036778. Culture-Bound? She cried, shouted "Please go and find my dad! Study for free with our range of university lectures! The real issue hasn't been dealt with - it's limbo," says Dagson.