By Deirdre Finnerty
BBC News, Hamburg
22 December 2015
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"Some people see me crying on the road and they probably think I'm crazy. But I really want to cry it out, scream, get it out of my system."
Rafat Hazeema is a Syrian refugee who has been living in Germany for over a year. Originally from Damascus, he and his wife Ferial are glad of a warm of comfortable home for their son Anas.
But like many of the refugees arriving in Europe, the family need more than food and shelter.
The deaths of their two sons continue to haunt Rafat and Ferial Hazeema
The Hazeemas lost their two youngest sons, Ahmed and Mohammed, while making the dangerous journey from Libya to Malta just over two years ago.
The crammed smuggler's boat they were travelling on capsized, and the two boys - aged 12 and 9 at the time - have been missing ever since.
Rafat is finding it difficult to cope.
"It's beyond me to be in control of my emotions, my mental well-being... It's impossible, impossible for me to forget my boys," he says.
"My wife hides the photos so that we can forget... But I can't. If she puts them away, I take out my mobile to see Ahmed and Mohammed."
Ahmed and Mohammed disappeared when their boat capsized
Rafat has been diagnosed with post-traumatic stress disorder (PTSD) and is taking medication as a result of his ordeal.
He has had some counselling sessions and German lessons but finds it hard to concentrate.
He tells me he is struggling to find an appropriate job and says moving on is difficult when you have got nothing to help you take your mind off things.
Limited services
Rafat's experience, however sad, is not unusual.
A recent report by Germany's chamber of psychotherapists found that half of refugees are experiencing psychological distress and mental illness resulting from trauma.
One fifth of refugee children are also suffering from PTSD, according to the same report.
But as more and more migrants and refugees arrive, support services are becoming increasingly stretched.
Alexander Glisoski is a manager in the Schnackenburgallee camp on the outskirts of Hamburg.
Kind and soft-spoken, he explains that the camp's long rows of tents and containers are home to about 2,400 people facing their first winter in Germany.
Alexander Glisoski says its difficult to meet all the needs of everyone who comes into the camp
Thousands will spend their first winter in Germany in the Schnackenburgallee camp
But for those suffering from serious psychological problems, treatment often has to wait.
"Dealing with people who have trauma is about stabilisation first. At the moment that's just possible with medication.
"It's not possible to cover everything here… You'll always have people who you don't see."
Although migrants are provided with basic healthcare in the camps, in lots of cases, they cannot access full psychological services until their asylum claims have been processed.
'Quite optimistic'
But some psychiatrists are trying to help. Dr Manoshi Pakrasi oversees a weekly outpatients clinic in the camp, set up just a few months ago.
She tells me it is the first of its kind in the whole of Germany.
In her work with people living there, the most common symptoms she sees range from sleep and mood disorders, to depression and more serious issues.
Dr Pakrasi says there is reason to be hopeful
"I've seen one young man who has been hidden in a cave by the Taliban. He was tortured for three months without seeing any light."
Dr Pakrasi says that some have even attempted to take their own lives as they saw "no other solution" for their problems
With such challenges ahead for many of those who have reached Germany, how does she view their long-term future in the country?
"I am quite optimistic because a lot of them are quite young, there are a lot of children.
"And if the children are going to school, if the people are getting work, or something to do... I think it's necessary to give them something to do.
"But I think we can integrate them. Not all of them."
'Grateful'
Back with the Hazeema family, I ask 18-year-old Anas whether he feels he can be happy in Germany.
"We need to be grateful and not look back. I want to study. I'm studying at the moment and I hope to become an engineer."
Anas Hazeema sees a future for himself in Germany
But his parents have a different outlook.
"I can't see any good in my life in Germany because I've lost my boys," his mother Ferial says.
"All I want is to see my kids again."
Migrants in Germany
Map showing distribution of asylum seekers
