"Migrants used to fit into society: they weren't persecuted and didn't have to hide."

BarcelonaJoseba Achotegui (Durango, 1954) experienced firsthand what a migrant might hear in a foreign country, with an unfamiliar language and a hostile environment. The La Caixa Foundation bused around 100 professionals into a square in Girona and transported them to a farm as it was getting dark. "We were greeted by a group of Africans carrying flashlights and speaking in Mandinga, calling for us to move quickly and enter some barracks," explains this Basque psychiatrist, who thirty years ago convinced the Pere Claver Foundation in Barcelona to open a clinic to treat the migrant population left out of medical services. Years later, he still remembers that scene with "impression" and asserts that it's a good way to increase society's empathy for the lives of its residents from abroad.

Achotegui's relationship with migrants and refugees dates back to the 1980s when, with a group of doctors, they formed GASIR, a project that in 1994 was transformed into the SAPPIR, the acronym for the Psychopathological and Psychosocial Care Service for Immigrants and RefugeesFrom there, he witnessed the social and immigration changes and was able to confirm "the direct impact of immigration laws on the physical and mental health" of the community.

The turn of the millennium

In those years, migration was primarily Moroccan and Latin American, and Pakistanis were beginning to arrive. Despite the post-Olympic crisis, they "fit into the host society" without major problems because migrant networks were functioning and "there wasn't much immigration control," he recalls. The turning point came at the turn of the century, when the intensity of arrivals coincided with pressure from the European Union to close borders. This strategy changed "the circumstances of migrants and created problems" that they had been able to overcome until then. The migrant's grief and unrest became even more pronounced. In fact, Leaving home out of necessity is a shock to the migrant's life., which goes through seven duels (seven losses), lists the professional: family, language, culture, land, group belonging, social status and physical risks. The hardening of borders has meant that People have to risk their lives at sea or crossing continents and that the risks of abuse, violations and infringements of rights increase.

It is then that Achotegui detects in the consultation an emotional discomfort caused by the tightening of the laws for migrants to obtain residency in order to be able to work legally or to start the procedures for claim family reunification of children or parents who have stayed in their country of origin. Patients describe the difficulties in finding a job, a place to live, the feeling of loneliness, and from these stories Achotegui describes a repeated pattern that reminds him – he says – of the adventures described in The Odyssey. And in 2022, he coined the term Ulysses syndrome.

"It's not an illness, but rather a crisis, stress, and mourning," he clarifies, and for that very reason, it requires social treatment rather than medication. It manifests itself in nervousness, insomnia, headaches, crying, and sadness, which, although they can be confused with depression, are not. "A depressed person becomes apathetic, without energy. They don't: they have projects, the desire to do things, but they can't, and that frustrates and saddens them," he says. Rather than antidepressants or anxiolytics, the recommended therapy for these cases is "psychosocial and psychoeducational support" to help them manage stress. Unlike grief over the death of a loved one, that of a migrant is "partial and recurrent" because they are mindful of their origins due to the "responsibility of helping the family left behind." Once in the host country, they also carry a "burden" and a feeling of "defeat" if they haven't met their own and their relatives' expectations.

Word of mouth

SAAPIR patients are referred by medical professionals, organizations that care for migrants, and also by word of mouth that there is a clinic in Poble-sec that listens and can provide the necessary support. In thirty years, they have treated approximately 5,000 people: adults and children, more men than women, who may be looking for other ways to soothe their emotional pain or, simply, life doesn't allow them time to find a place to rest. "It's an issue we need to study further," Achotegui notes.

Ulysses syndrome has always existed, although the psychiatrist asserts that current migration cannot be compared, for example, with that of the Spaniards who moved to Germany. "Now it's much worse, because back then they weren't persecuted and they didn't have to hide," he responds. It's estimated that 15% of migrants worldwide suffer from Ulysses syndrome—"a lot of people," he asserts—and even the UN has recognized it. The Ulysses Syndrome Institute has been created in London. The symptoms disappear. When the person stabilizes, has papers, a job, a roof over his head, and he can see his family again. "As a society, we must improve our approach to immigration, which does so much for the country and dehumanizes them."