Refugee Mental Health Challenges And How You Can Help
The number of people living as refugees worldwide has now risen to over 108 million people, which represents a significant increase from previous years. Due to various societal, political, and environmental crises around the globe, more and more individuals and families are being forced to seek refuge from unrest and danger in their home countries. It can be vital for refugees and people who have faced displacement to receive mental health care and treatment. There are actions that both refugees and people in host countries can take to help.
Stressors refugees may face
Refugee mental health challenges are generally related to stressors at each step of the relocation process. The World Health Organization (WHO) divides the refugee experience into four stages: pre-migration, migration, post-migration, and resettlement. Each of these can involve different types of stressors that may impact mental health.
Premigration
The pre-migration period, sometimes called "pre-flight," refers to the period of life before moving to a new area or country. The challenges faced in this stage typically include the trauma or adversity the person or family is fleeing from, including persecution, armed conflict, human rights violations, violence, or other physical or mental exposure to traumatic experiences.
Migration
The time spent traveling from a country or locale of origin to a new home is often called the migration or “flight” period. It may involve uncertainty, familial separation, time spent in detention centers, and insufficient access to necessary services and care. A single one of these stressors can affect mental well being, so facing several at once can present an even greater likelihood of developing mental health challenges.
Postmigration
Post-migration refers to the initial time spent in a new location before permanent or long-term settlement. Again, asylum seekers in this stage may face situations like separation from family members, inadequate living conditions, and time in detention centers. Necessary care and social services are often unavailable or difficult for refugees to access during this time.
Resettlement
Adjusting to their new home or living arrangements in the resettlement phase can come with its own set of stressors and potential mental health challenges. Families and individuals might experience employment concerns, poor living conditions, and/or lack of access to psychosocial support and physical care and services. Cultural changes, language barriers, prejudice from their new communities, and isolation may also be part of this phase. Since these stressors can be difficult to solve and may persist long-term, it can be especially difficult for refugees to maintain their mental health over time and prevent mental disorders from occurring.
Types of mental health challenges refugees may experience
As a result of the stressors listed above, people experiencing displacement are generally at higher risk of developing certain mental health problems, specifically post-traumatic stress disorder (PTSD), anxiety, depression, and panic disorders. According to the Refugee Health Technical Assistance Center, studies have found that rates of these mental health conditions among refugees vary in range depending on age and specific experiences. Some research estimates that PTSD affects as many as 10–40% of refugee adults and 50–90% of refugee children. Depression is estimated to affect 5–15% of adults and 6–40% of children in these populations. These rates listed here are notably higher than those typically seen in the general population, especially regarding children’s mental health, reflecting the reality that the refugee experience tends to be fraught with unique mental health stressors and challenges.
Treatment for mental health conditions faced by refugees
The mental health treatment options for these individuals can vary depending on severity and their unique situations. In the general population, mental disorders such as depression, anxiety, and PTSD can often be effectively treated or managed through options like therapy, medication, and training in strategies such as mindfulness-based relaxation techniques. However, it depends on the person and their needs. Speaking with mental health professionals about their options is generally a recommended first step in seeking treatment.
Common barriers to mental health care for asylum seekers
A lack of access to mental health services throughout the stages of resettlement—even upon long-term settlement in a new home—may be a substantial roadblock for many families and individuals seeking resources or treatment. Even when services exist or are offered, they are not always accessible due to language or cultural barriers, lack of continuity or stability, or cost. In addition, situational challenges refugees may face can hinder progress toward improved mental health. Issues like unemployment, isolation, prejudice in their new city or country, and unsafe or unstable living conditions can present additional barriers to effective, lasting treatment.
How to address and support mental health in refugees
As research and public awareness of the importance of mental health and psychosocial support have expanded, some helpful policies have been introduced to help advocate for refugees in this way. Non-refugees and the governments of host countries may support mental well-being in refugee populations through policy change in national health systems as well as community and individual interactions. WHO prepares a helpful outline for the necessary changes on its website. In addition to advocating for helpful policies to be implemented, people may also push for the elimination of other policies that experts describe as detrimental (like family separation). Advocacy in day-to-day situations, like speaking up against prejudice, can be important as well.
Last, those who wish to support the mental health of refugees may also advocate for the improvement of mental health services and education on both a local and a policy level.
Health care program requirements for refugee mental health
Research suggests that, to be effective, these public health programs should be:
- Available: Mental health services are often not included in the physical healthcare options refugees have access to in their new locations. However, overall health includes both physical health and mental health.
- Accessible: Educational and outreach programs (including opportunities for financial assistance) may help displaced people know that help is available and accessible to them.
- Culturally informed: To be inclusive to refugees from different countries and cultures, resources and treatment options should be available in a variety of languages, or interpreters should be offered.
- Paired with a focus on psychosocial wellbeing: Providing opportunities for social events and connection—especially with peers of the same cultural background or refugee community—may be another key part of a successful, holistic approach.
Non-refugees who are interested in contributing to the improvement of mental healthcare for displaced people in their area may get involved with their local government or with local branches of organizations like the International Rescue Committee. Providing social support is another way to advocate for the mental health and psychosocial well-being of refugees.
The United Nations High Commissioner suggests that communities should consider preventive factors that can support vulnerable members and reduce mental health risk factors. These can include planning activities to reduce tension between refugees and surrounding communities, establishing child-friendly spaces, and helping to provide adolescents with access to computer and literacy classes.
The important role of therapy in the mental health of refugees
Online therapy can provide support for those who are experiencing symptoms of a mental health condition or other mental health challenges. Found to be as effective as in-person therapy for a variety of mental health needs, virtual counseling may be an accessible and practical option for people of different backgrounds and experiences. Online counseling may help people navigate traumatic experiences and mental health conditions and can support them in reaching goals in their careers and relationships in their new cities or countries. Therapy has also been shown to be effective specifically for refugees facing depression, anxiety, and PTSD.
Those who are interested can get started with online therapy through BetterHelp and be matched with a licensed, professional counselor to begin their mental health journey. Each individual’s unique needs and preferences (based on their answers to a questionnaire) will be considered in the matching process. A different match can be requested at any time, and a BetterHelp subscription can be canceled at any time, too.
Takeaway
What are the mental health challenges of refugees?
Refugees face a number of mental health challenges, including anxiety, depression, trauma, and other conditions. The World Health Organization notes that some of the most common mental health concerns experienced by refugees include sadness, hopelessness, irritability, and anger. They also note physical symptoms, including difficulty sleeping, fatigue, and aches and pains.
What are the problems faced by most refugees?
The American Psychiatric Association defines a refugee as someone who has left their home country, either voluntarily or by force, due to a reasonable threat of persecution. Refugees may seek asylum from persecution in other countries. The APA estimates that more than 70.8 million people worldwide are forcibly displaced, with about 41.3 million people qualifying as internally displaced persons and roughly 25.9 million of these people qualifying as refugees.
When it comes to mental health, refugee life can be incredibly difficult. Most refugees live in constant fear and uncertainty for extended periods of time. They may be forced to live in refugee camps, where not only are there threats to their physical and mental health in the form of overcrowding and inadequate food and shelter, but there is also limited or no access to health care services.
Even if a refugee finds themselves in a more permanent housing situation, most refugees do not immediately have legal standing as citizens or legal visitors in their asylum country. This can mean that they cannot access most health care providers due to bureaucratic barriers, leaving them without health and psychosocial support. This is especially true of immigrant and refugee children who travel alone.
What are the risk factors for refugee mental health?
According to some reports, the risk factors for refugee mental health include exposure to war and violence, exposure to or experiencing torture and systemic abuse, forced migration and exile, uncertain status in asylum countries, and stress related to disconnection from family, friends, and all familiar surroundings.
What are the mental health issues of refugee youth?
Refugee youth face many of the same mental health symptoms that adult refugees do, including anxiety, depression, and common mental disorders associated with trauma such as PTSD and C-PTSD. On top of this, immigrant youth may face difficulty with socializing due to differences in culture and lived experiences from their peers, which can make acclimatizing to a new country even more difficult. They may also face more significant challenges in terms of financial support and accessing appropriate health care services due to their inexperience and youth.
That being said, there are many programs designed specifically for young refugees. Programs like the UN Refugee Agency and the Refugee Women’s Alliance can help youths maintain their physical and mental health. These programs can introduce resources for mental health including treatments like narrative exposure therapy and CBT.
What are the problems with refugee health?
Refugees face health concerns like exposure to the elements, physical danger from threatening forces such as soldiers in their home country and wild animals, a lack of steady access to food and water, and a lack of regular and restful sleep, among other factors. This can cause physical symptoms including fatigue, illness, sleep deprivation, and malnutrition. They may also face poor mental health or even mental illness as a result of their situation.
How do refugees affect health in my community?
Displacement and forced migration are considered a public health crisis as they can cause massive amounts of people to lose access to necessary support quickly. In communities in asylum countries, an influx of refugees can mean that existing systems for supporting those with mental and physical symptoms from displacement are stretched. It is recommended that those who can volunteer their time and resources do so, to support these systems and ease the strain.
What barriers can prevent refugees from seeking help?
Beyond physical barriers like geographic blocks and distance, many mental health clinicians are unable to attend to refugees due to bureaucratic tie-ups or a lack of resources to accommodate a large influx of new patients. Additionally, many of the common mental disorders refugees experience have avoidant symptoms that may prevent them from seeking care.
Why is mental health a risk?
Poor mental health can cause a person to act in ways that are contrary to their best interests, resulting in an overall damaging effect on their mental, emotional, and physical health that can have long-lasting results.
What is the main cause of refugees?
There are many reasons a person might become a refugee including natural disasters, war, and extreme prejudice (including religious, ethnic, and cultural prejudice).
What is the negative impact of refugees?
An influx of refugees can increase strain on a community’s resources and economy. More people means more competition for work and available goods, which can lead to a rise in unemployment and shortages.
Is depression the most prevalent mental health condition among refugees?
No, studies show that post-traumatic stress disorder (PTSD) is more prevalent among refugees than depression. However, these conditions often coexist, making the mental health needs of refugees complex and requiring comprehensive care that addresses the various aspects of their trauma and resettlement experiences.
What is post-traumatic stress disorder?
Refugees often experience extreme stress, trauma, and loss during their displacement, including exposure to violence, persecution, and the difficulties of adapting to a new environment. This makes PTSD particularly common.
Depression among refugees
Many refugees experience depression due to the loss of loved ones, homes, and their previous way of life, as well as the uncertainty about their future.
Other common mental health conditions among asylum seekers
- Anxiety disorders: High levels of anxiety are common, often stemming from fear of deportation, uncertainty about legal status, and ongoing stressors related to resettlement and integration.
- Adjustment disorders: The stress of adapting to a new culture, language, and social system can lead to adjustment disorders.
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