The first reception system for irregular migrants taking the Mediterranean route into the European Union (EU) is dictated almost solely by border control and security concerns. There is no recognition of the role of nongovernmental organizations (NGOs) as human rights monitors in first reception, and access is limited, controlled, and dependent on local authorities. Newly arriving migrants are at their most vulnerable during first reception. Traumatization and retraumatization brought by violations of human rights, or alternatively, care and welcome within the first reception system will pave the way for subsequent integration processes, by ensuring migrants’ well-being, decreasing hostility, diffidence and subjugation, and peaceful relations with European host communities. By critically assessing the current system, backed by the author’s long-term ethnographic fieldwork, this article explores the links between policy, practice, and mental health consequences for migrants. It shows that there are multiple risks of human rights violations of a vulnerable group of people. The article is critical of the absence of an official role for NGOs as human rights monitors arguing that NGOs have a unique role to play. The article suggests that the dignified conduction of first reception could have a positive influence on integration processes, and concludes that first reception should not be designed within a security framework but within a reception one.