In 20 years of activity, some 531 people from 61 countries have received assistance from Ferite Invisibili ("Invisible Wounds"), a service offered by the Rome branch of the Catholic charity Caritas that focuses on treating migrant survivors of torture, intentional violence, and extreme trauma.

The average age of those assisted was 26, and many had no family members with them. They had suffered persecution, war, detention, and exploitation. Among them were 157 minors -- many unaccompanied -- who bore deep wounds that were not always visible.

The Invisible Wounds service has been supported by the Rome branch of Caritas since 2005. It has been recognised by the UN Office of the High Commissioner for Human Rights as part of a supranational network providing support and care for victims of torture.

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Most patients seeking international protection

The report providing these details of the service was presented on December 5 during a basic course to recognise signs of victims of violence entitled 'When Wounds Are Invisible'. A total of 70 people working in the social sector took part.

Most of the patients arriving at the service were seeking international protection, 44.3 percent, while 26.8 percent came to the service after already obtaining it (including 11.7 percent who had received refugee status and 6.3 percent with subsidiary protection).

A total of 16.3 percent of patients had not had any formal schooling whatsoever and, at the time of the initial examination, 17.1 percent did not speak Italian, while 56.8 spoke not enough to communicate sufficiently and 3.3 percent spoke it very well.

While 26.8 percent of the cases did not have a formal diagnosis recorded in their medical records, the most common diagnosis by far was that of PTSD (79.7 percent), followed by depression (10.4 percent).

A total of 6,877 psychotherapy sessions were conducted, with an average of almost 13 per patient, underscoring the complexity and delicacy of the therapeutic approach. In 28.3 percent of the cases, it was considered useful to bring in a psychiatrist for pharmacological treatment as well.

In 71.8 percent of the cases, cultural-linguistic mediation was made use of, while 234 certificates of the psycho-physical condition of the patient were issued, attesting to the violence suffered.

In most of the cases, these certificates were used by those seeking international protection as support and evidence of their right to it.

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Focus of latest issue of 'Sguardi'

The latest issue of the 'Sguardi' collection of publications supported by the Rome branch of Caritas is entitled 'Accogliere E' Già Curare' ('Welcoming Is Already Treating').

It tells the story of the service and its evolution, starting from the international conference One Billion held by the Rome branch of Caritas with health ministers of countries at war, to its recognition within the UN network for support to victims of torture.

It goes on to detail the clinical, cultural, and pastoral intuition that led to creating a place where treatment goes beyond psychotherapy and includes an environment able to make those in it feel safe: a door that is always open, a doorbell designed like a leaf as a symbol of service, hot tea offered with simplicity, and the time needed to build trust.

The publication was created as a pathway of training shared by the multidisciplinary team of Invisible Wounds -- psychologists, psychotherapists, psychiatrists, linguistic-cultural mediators, and social workers -- and reflects on the complexity of taking care of people whose suffering is not always visible but nonetheless deeply affects their present and future lives.

The publication deals with key issues such as the therapeutic value of reception, the quality of relations with victims of trauma, the role of somatisation as a language of pain, trans-generational trauma affecting minors and families that migrated, and the importance of a 'life plan' as an integral part of the healing process.

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