The people of our world are on the move, but their minds have a hard time processing their past

The world is moving, the United Nations estimated in 2016 that over 65.6 million people worldwide where displaced by war, armed conflict, or persecution. In 2021 this number of worldwide people who were forced to flee had already increased to 89.3 million people. This sharp increase in number of refugees is new in our modern world. It is the biggest refugee flow since the II World War. This global relocation comes with a lot of problems. Countries must deal with thousands of claims asking for asylum, but also other problems arise due to the global change of residence. A problem refugees face themselves are mental health problems, these people are entitled treatment. This is putting a lot of pressure on mental health care systems in the countries where people end up. This subject gets little attention. In recent years a lot of research has been conducted on mental disorders refugees have to deal with, and which treatments are desirable. These I will present to you in this blog.

Throughout history refugees have been welcomed in different ways by countries. Refugees have been taken in as heroes but also as intruders who threaten peace, integrity, cultural identity, and economic stability in the host countries. The way groups of refugees are welcomed also influence the mental health of that refugee population.

Mental health problems among refugees remains a big problem. Many of them have experienced trauma before their journey began or have experienced traumatizing events during their journey. In 2009 a large study was conducted on mental health, this study conducted 181 surveys among 81.866 refugees and other conflict affected populations from 40 countries. The results of this study showed that prevalence’s of PTSD and depression where approximating 30%. The prevalence of mental disorders is variable across studies, due to differences in studied groups and the type of factors the researched group has been exposed to. Nevertheless, if the real percentage is a little lower than 30% it is still a shocking number of refugees experiencing mental disorders. In addition, a lot of refugees face somatic problems such as pains or tiredness.

Trauma may cause the mental health of refugees to deteriorate but also the massive disruptions to family and social networks plays a role. Many refugees feel isolated or lost due to losing a fundamental sense of belonging. Which in the end can lead to refugees losing trust in authority structures or can cause anger.

To take on mental health problems among refugees’ protocols should be multidimensional. Firstly, they should focus on providing a supportive environment in which refugees can restore their personal, familial, social, and material resource base. Secondly, there should be conducted a thorough assessment of the losses refugees have made and there should be a possibility for them to talk about these losses. Thirdly stresses that can maintain mental health problems should be taken away, such stressors entail: food, water, shelter, and health care.

In addition to creating these fundamental conditions in which refugees with mental health problems can get better, people in need should get a fitting treatment. The research done by Silove et al., (2017) suggests three options for treatment: brief psychotherapies, pharmacotherapies, and psychosocial interventions.

The last of the three helps healing mental health problems and directly contributes to re-establish social networks and promote self-help activities.

Mental health problems do not only arise among adult refugees, but it also occurs among children who are displaced. A study conducted by Dangmann et al., (2022) presented the following numbers on mental health problems with refugee children: 23% of refugee children worldwide face PTSD, 14% of these children face a depression and 16% of them have anxiety problems. Studies also report high levels of somatic disorders. With children trauma-focused cognitive therapies are commonly used as treatment. In addition to cognitive therapy, creative expressive techniques are used. These techniques are applied to provide guidance in coping with the trauma these children have experienced.

Refugees facing mental health problems should receive tailored treatment for their mental disorders. Refugees must be able to regain their mental equilibrium after that they have lost this due to overwhelming circumstances.

How do you think countries can deal with refugees facing mental health problems, and which agency do you think is responsible to take care of this?

Sources:

- Dangmann, C., Solberg, Ø., & Dybdahl, R. (2022). Mental health in refugee children. Current opinion in psychology, 48, 101460. https://doi.org/10.1016/j.copsyc.2022.101460

- Global Trends, Forced displacement in 2016. (2017). In UNHCR, The UN refugee agency. UNHCR. Geraadpleegd op 15 maart 2023, van https://www.unhcr.org/5943e8a34.pdf

- Global Trends, Forced displacement in 2021. (2022). In UNHCR, The UN refugee agency. UNHCR. Geraadpleegd op 15 maart 2023, van https://www.unhcr.org/62a9d1494/global-trends-report-2021

- Silove, D., Ventevogel, P. and Rees, S. (2017), The contemporary refugee crisis: an overview of mental health challenges. World Psychiatry, 16: 130-139. https://doi.org/10.1002/wps.20438

- Steel, Z., Chey, T., Silove, D., Marnane, C., Bryant, R. A., & van Ommeren, M. (2009). Association of torture and other potentially traumatic events with mental health outcomes among populations exposed to mass conflict and displacement: a systematic review and meta-analysis. JAMA, 302(5), 537–549. https://doi.org/10.1001/jama.2009.1132