Mr. SJ, a Bangladeshi national, left his country at age 16. For many years he lived in Iran, where he wanted to study but was unable to legalize his stay. He decided to move on to Greece in 2003. He was working in Greece to support his family; the income he generated was especially important after his father passed away at home. He came to Hungary in 2013 and submitted an asylum claim, which Hungarian authorities rejected and ruled that he be expelled from Hungary. He was moved to administrative detention; authorities however did not enforce and execute the expulsion order. He wanted to move on to Western Europe, but his health started to deteriorate and his body weakened. He gave up his plans in the past years and has lived in homeless shelters, while his health is going from bad to worse. Mr. SJ currently lives in a homeless shelter run by the Hungarian Baptist Aid. He converted to Christianity a year ago. He does not have a family, is not in a relationship, and lacks a supportive environment.
He exhibits several somatic symptoms. He has gastroesophageal reflux disease (GERD), chronic inflammation of the stomach and the duodenum, and an ulcer.
The Cordelia Foundation first met Mr. SJ in March 2016 and has received medical treatment. Since then, he has not received state provided medical care as he does not have social security coverage.
His condition started to deteriorate further in November 2017. The social worker signaled that his behavior had changed. Mr. SJ became psychotic and delusional. He felt that people unknown to him, and others living with him in the homeless shelter, force him to utter swear words and commit blasphemy. He also felt that external forces grab his neck and strangle him, and he cannot breathe. He also had acoustic hallucinations, hearing swearing and fragmentary words of prayer. As a consequence of this psychotic state, Mr. SJ became isolated. He cut his ties to his family for he felt ashamed of his condition.
Mr. SJ has since been given antipsychotic and anti-anxiety medication. His psychotic symptoms can be relieved by continuous medication, but severe anxiety lies in the background, with panic attacks, fears for his health, and sleeping disorders. Part of his anxiety is caused by real problems related to his grim existential outlook. His stay in Hungary is never guaranteed for more than a few months, therefore he does not receive medical care and is unable to put his existential, social and health issues back on track due to not having a work permit.
Mr. SJ suffers from sleeping disorders; he has problems falling asleep or sleeping through the night, and does not get more than 3-4 hours of sleep daily. During the day he suffers from increased anxiety and worries for his family. At the same time, he often loses realistic judgement. He exhibits panic-like symptoms once or twice a day in congested areas and other public places, and the symptoms reach the severity of a panic attack once or twice a week (including palpitations, fainting, sweating, dizziness, fear of death, and hyperventilation). He is depressed and does not have an appetite; he has lost 10 kgs in the past years, and he feels hopeless. His coping skills and resilience are weakened. He is lonely and socially isolated, and this adds to his feeling of being threatened as he is not entitled to any provisions and is unable to do anything for a better future.
Mr. SJ exhibits both the subjective and somatic symptoms of anxiety. He has tremors, he hyperventilates, and also has abdominal discomfort. His assessment of his situation is constantly deteriorating.
This existential insecurity has profoundly contributed to the worsening of the psychotic symptoms Mr. SJ already had. He needs continuous medical supervision and medical and psychological treatment for his condition to improve and his symptoms to be alleviated.
The constant state of insecurity, the lack of integration possibilities, and the constant uncertainty surrounding his legal status seriously contribute to his condition deteriorating. If these issues were solved once and for all, his stay in Hungary was legalized, and he received social security coverage, his condition would improve and he could regain control over his life.