Overview of content:
“Born into an inhumane system”: Elizabeth
The Undermined Right
Trauma caused by separation
Further reading and articles
Download the manual
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Dear friends and colleagues,
The latest events in Afghanistan have caused an immediate urge for humanitarian aid and wide-ranging help, including bringing together the thousands of family members separated during the evacuation that took place when the US withdrew in September 2021. The deteriorating situation in Afghanistan, as well as the situation in other war-torn countries, have again sparked a debate about family reunification. It highlights the acute need for discussion and action in countries receiving refugees, in order to ensure that family reunification is made possible.
In October, the UN refugee agency, UNHCR, urged countries to step up reunification for Afghans whose families remain in the country or who are displaced across the region, as the humanitarian crisis in their homeland worsens.
The question we are raising in this newsletter is, what are the rights of families to reunify after separation? What are the obligations of the receiving countries to ensure that family reunification can take place? What kind of support and help do reunified families need to deal with the trauma of separation, often following trauma of war and danger? What do we know about the reunited families, and of the families that do not obtain reunification? And finally, what do we know about good practices in relation to family reunification? These are some of the questions raised in the following reports, and more information on this issue will be posted on our webpage soon!
“Born into an inhumane system”: Elizabeth
“I was literally born into a system that has been criticized by human rights organizations as illegal, inhumane and degrading, says 18 years old Irish-born Elizabeth Zion from Nigeria. In this TED Talk back in November 2021, she shares her own personal story about the long wait for a reunification with a father she never has been able to meet. It is a harsh reminder of why we so desperately need to continue to highlight the importance of family unity.

The Undermined Right
The right to family reunification is inherent in the right to family life, a human right that applies to all people and is set out in and protected in international law, international human rights, humanitarian law and international refugee law. But for years there has been a major change with profound consequences, separating families for years, or in worst case- for decades. One, but not the only reason for establishing restrictions on this matter, came very quickly after the influx of refugees in 2015, when millions of refugees headed to Europe.
Challenges: restrictions and domestic laws
It was an immediate push for putting national interests and domestic laws before international human rights and the lack of political consensus that resulted in the implementation of legislative tightening of national immigration rules in many European countries. This has challenged immensely the former obligations that the receiving countries had for decades, and has because of its impact even been taken to court after violating human rights law.
Some years ago, Norway received a report and a clear message from the UN High Commissioner for Refugees (UNHCR) who came forward and recommended that the Government of Norway should refrain from further restricting the existent family reunification legislation. UNHCR said that:
“There are insurmountable obstacles and barriers that a refugee encounters in an application process for family reunification in Norway (2016)”.
With the latest events taken place in different EU-countries, such as the court ruling of a case in Denmark last year and now Great Britain’s try to push through a new Nationality and Borders Bill, confirms the sad fact that there seems to not be any common ground at national, international and European levels in regard to the waiting period given for family reunification. This restrictive attitude towards refugees’ rights is undermining a fundamental and essential human right. Instead of protecting, is now in danger of putting families at an even greater risk, not knowing if their loved ones will gain the protection they are entitled to under flight or under migration after war or conflict.
Working for years with the mental health of refugees and among them, with people who is or will be waiting for a family reunification, MHHRI knows too well that the psychological effects of forced separation can cause great traumas- and that it needs to be treated for a long time even after reunification.

Trauma caused by separation
Being separated from your loved ones causes grave psychological traumas that need to be treated immediately, and will persist a long time after reunification takes place, studies have shown. The type of support and help that the reunified families receive in each country after years of separation differs and, in some cases, is almost non-existent.
The reports in the further reading below thematize this, offering the helpers access to studies that investigate the conditions of families affected by the politics of family unity in different countries.
Prevention through family conversations
Nora Sveaass, founder and chair of the board in MHHRI is among several psychologists in Norway who for many years have experienced and investigated how the process of reunification for refugee families best can be fulfilled, implementing methods that might facilitate the challenges, firstly through conversation and therapy for the whole family (Sveaass et al, 2016).
International, as well as national research is decisive for the work and for the choices that helpers and people working daily with refugees need to take a stand on. To make it easier for you, we have therefore divided the literature list into different focus groups so that you will be able to select and prioritize the specific area that is most relevant and applicable to the work or interest that you have.
Further reading, articles, publications and websites that highlight different aspects of family reunification
This next part contains a literature list with several guidelines, studies, and reports- addressing the same questions further. There is undoubtedly a lot of research done on this important matter, and especially more throughout the years with also another important perspective: mental health and other serious health impacts.
Focus groups:
- Guidelines and recommendations given to countries
- Family reunification and therapy: methods and guidelines
- Side effects of waiting for family reunification
- Overview of the latest legal principles relevant to family reunification
FOCUS GROUP 1: Guidelines and recommendations given to countries
The main principles and guidelines for countries that enable family reunification
Guidelines UNHCR made in 1983 on how and when to make the reunification of refugee families possible, based on the essential principles the member countries must follow from certain covenants and again, are obliged to follow. This note restates the position of the Office concerning the types of family reunification promoted by UNHCR, the categories of persons eligible for assistance, and the action to be taken by UNHCR Headquarters, by the Field Offices, and by refugees themselves to achieve the reunification of refugee families under various circumstances (UNHCR 1983). UNHCR recommendations to Norway for strengthened refugee protection in Norway, Europe and globally.
Amongst their recommendations addressed to the Norwegian Government, UNHCR has given comments and solutions for improvement of the policies regarding family reunification in Norway.
Realising the right to family reunification of refugees in Europe
Council of Europe 2017
For refugees, the right to family reunification is crucial because separation from their family members causes significant anxiety and is widely recognised as a barrier to successful integration in host countries. Well-designed family reunification policies also help create the safe and legal routes that are necessary to prevent dangerous, irregular journeys to and within Europe. Based on this analysis, the Council of Europe Commissioner for Human Rights sets out a number of recommendations to member states intended to assist national authorities in re-examining their laws, policies and practices in order to give full effect to the right to family reunification, for the benefit of both refugees and their host communities.
FOCUS GROUP 2: Family reunification and therapy: methods and guidelines
How can family reunification be more successful?
As mentioned above, in 2016 a group of psychologists implemented a set of guidelines and tools to help those working closely with refugee families. To integrate the aspect of family therapy as an integral part of help offered to refugee families who are reunited in Norway (Sveaass et al. 2016)
Working with Refugee Families
L. de Haene and C. Rousseau (eds) 2020
In the field of a refugee family, research and intervention form a growing field of scientific study, focusing on the refugee family as the central niche of coping with, and giving meaning to, trauma, cultural uprooting, and exile. This important new book develops an understanding of the role of refugee family relationships in post-trauma healing and provides an in-depth analysis of central clinical-therapeutic themes in refugee family psychosocial interventions. Expert contributions from across transcultural psychiatry, psychology, psychotherapy, and social work have provided chapters on post-trauma reconstruction in refugee family relationships, trauma care for refugee families, and intersectoral psychosocial interventions with refugee families. This exploration of refugee family systems in both research and clinical practice aims to promote a systemic perspective in health and social services working with families in refugee mental health care.
Supporting Refugee Family Reunification in Exile
Nora Sveaass and Sissel Reichelt 2020
Family reunions in exile may be a complex and challenging experience. Refugee families are often reunited in the host countries after having lived through long periods of separation, insecurity, and violence. Assisting families in the process of reunification is discussed as an issue of priority, both from a psychological and a human rights point of view. Based on clinical experiences, the authors suggest that accompanying families in this process of transition is meaningful and useful. The chapter argues that work with refugees should be seen through a family lens and that mental health professionals have the knowledge and background regarding families and systems that enable them to offer good assistance to families in reunification processes (chapter 13 in Working with Refugee Families, not open access).
Engaging refugee families in therapy: exploring the benefits of including referring professionals in first family interviews (can make free download)
In this guide booklet, the possible benefits of including referring professionals in the first family interviews are being explored as a way of engaging refugee families in therapy. Families in exile confront several problems related both to premigration traumatic exposures and to present adaptation processes. Refugee clients and the referring professionals in the larger system frequently see the problems and their solutions quite differently. This situation may often result in unclear working alliances in the context of therapy. (Sveaass, N. & Reichelt, 2001, p. 212-231).
FOCUS GROUP 3: Side effects of waiting for a family reunification
Waiting for family reunification and the risk of mental disorders among refugee fathers.
This is the first large-scale cohort study to demonstrate that family separation is associated with an increased risk of psychological disorders among refugee fathers. The study found that the risk of being given a psychiatric diagnosis was twice as high for refugee fathers who are waiting for their families to arrive than for other refugee fathers, and this risk was found to increase the longer the family separation. More than 20% of the waiting fathers have been diagnosed with a psychological disorder, most commonly PTSD (Hvidtfeldt, Petersen. Nørredam 2021).
Trauma sustained by Asylum-seeking children and parents persists after reunification.
A new study analyzing the mental health impacts of family separation finds that children and parents seeking asylum at the U.S.-Mexico border experience severe psychological trauma even years after reunification. The Physicians for Human Rights (PHR) study provides the first-ever qualitative analysis of the mental health effects of the forced family separation policy and shows further evidence of the “zero tolerance” policy’s detrimental effects on the mental health of impacted families (The Physicians for Human Rights (PHR) 2021).
The challenges to family reunification in Norway, Sweden and Denmark.
The report, commissioned by UNHCR and made by NOAS (Norwegian Organisation for Asylum Seekers, is a comparative legal study of the legal framework, policies and practice pertaining to the family reunification procedure in Norway, Sweden and Denmark. It compares the politics and practice of family reunification for refugees in three Scandinavian countries. Policies regarding family reunification have become increasingly strict over the last few years, especially after the influx of asylum applications that all Scandinavian countries received in the summer and autumn of 2015. While the number of asylum applications rapidly decreased, the number of family reunification applications have continued to increase in recent years (UNHCR and NOAS 2019).
Family Migration and Integration: A Literature Review.
This report from Norway (in English) shows that there is very little evidence of that strict conditions for family immigration provide better integration. Stricter conditions, on the other hand, lead to more families being split up, which has very serious consequences for those concerned. Stricter conditions for family immigration read to fewer applicants and more people being rejected. The children experience anxiety, restlessness, behavioral problems and have serious negative consequences in the quality of life and possibility of integration (Eggebø and Brekke 2018).
Disrupted flight the realities of separated refugee families in the EU
This report gives an overview of the health impact a family separation can have, from poor mental and physical health, which again has an impact on peoples’ ability to learn a language, look for a job, re-train, or simply interact with others (including with officials and administrations). It goes through the consequences of what a long separation can also do with the family structure by causing conflict when the family is reunited again (Red Cross 2014).
FOCUS GROUP 4: Overview of the latest legal principles relevant to family unity
Family reunification for refugee and migrant children – standards and promising practices.
This handbook focuses on the reunification of families with children, with a particular focus on unaccompanied and separated refugee and migrant children. It presents an overview of legal principles of human rights, children’s rights, refugee law and EU law relevant to family reunification and then discusses key features of family reunification procedures, with promising examples of law and practice and relevant applicable standards (Boreil, Desmet, Dimitropoulou, Klaassen 2020).

All manuals can be downloaded from the MHHRI website
There are three different manuals, which respectively address working with women, with boys and men, and with children who have experienced sexual violence.
The manuals are translated into several languages. The page numbers in each manual remain the same across languages. This allows survivors and helpers to work from copies in their preferred language and read the same content on the same pages. It also makes it easier to teach participants when participants and trainers work in more than one language. The manuals include a toolbox. Survivors can use it individually to regulate their own emotions through grounding exercises or in collaboration with a helper. Helpers can also use grounding exercises to take care of themselves as helpers.
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Shima Harati-Shahriari, Mónica Orjuela and the MHHRI team
Mental Health and Human Rights Infopost@hhri.orgwww.hhri.org