Do not ignore the mental health of refugees

The emotional aspects of refugees need to be looked after. Photo: Reuters

The haunting image of little Aylan Kurdi’s body lying face down on a beach in Turkey tore into the world’s collective conscience and sparked an outpouring of sympathy for refugees fleeing the bloodbath of war-torn Syria.

The three-year-old unwittingly left an unfortunate legacy of the current troubles in Syria, with the mass migration of Syrian refugees the worst exodus since the Rwandan genocide two decades ago.

There are now four million Syrians scattered throughout the region, making them the world’s largest refugee population.

Television stations across the world show mass movement of thousands of migrants towards Europe.

Unfortunately, like Aylan, not all of them will make it there alive.

Syrian refugees are now housed in settlements in countries like Turkey, Lebanon, Jordan and Egypt, and are waiting in hopes of achieving their dreams of living in any of the more prosperous countries on the continent.

It is also gratifying to learn that Prime Minister Datuk Seri Najib Tun Razak, during his impassioned speech at the 70th session of the United Nations General Assembly, announced to the world that Malay-sia will open its doors to 3,000 Syrian migrants over the next three years to help alleviate the refugee crisis.

Hunger, thirst, lack of hygiene and lack of medical care are not the only problems for Syrian refugees in many of the temporary settlements in intermediate host countries.

Enveloped in the problems of resettlement, the mental health needs of refugees are often ignored. Many of them would suffer from depression, anxiety and stress, due not only to their displacement, but also to their precarious existence, breakdown of social support, and lack of educational and livelihood opportunities.

The psychological and social stresses often experienced by refugees during migration can double the prevalence of severe disorders like psychosis, severe depression and disabling anxiety.

This does not mean that refugees are psychologically weak. The doubling in prevalence rates of mental disorders is a testimony to the cumulative impact of extraordinarily difficult experiences.

Having lost everything, and without a clear future to look forward to, they are at higher risk of developing mental health problems due to the stress of migration and resettlement, in addition to the experience of war, poverty and acculturalisation.

Even after resettlement, refugees are prone to exploitation and fear, facing a constant psychological battle to get back on their feet.

Many continue to struggle with profound grief, anxiety, suicidal thoughts and post-traumatic stress.

Children often bear the brunt of conflicts, the Syrian refugees being no exception. Their children have been used in combat, abducted, tortured and abused.

The provision of support for the psychological and social well-being and recovery of children in the resettlement camps has been minimal, if not entirely overlooked.

The stigma of mental illness is especially pervasive among immigrant and refugee communities where being mentally ill translates to being “crazy”.

Individuals with mental health issues are often isolated and ostracised by their own community, especially when symptoms are severe.

Men in particular are expected to be strong, and it is unacceptable for them to be “mentally weak”.

Also, information about someone’s mental health issues can spread quickly in close-knit refugee communities, potentially damaging a family’s reputation.

When the 3,000 refugees arrive on the shores of our country some time in the future, perhaps the most important thing is to treat them with respect and dignity, while preserving and strengthening their autonomy and self-efficacy.

Their mental health and psychosocial needs should not be ignored. Untreated mental health conditions can be detrimental, not only to the wellbeing of the individual, but also to the physical health, parental functioning and wellbeing of children and the larger community.

The poignant statement by the Prime Minister sums it all up: “For it is only when we transcend the silos of race and faith, only when we look at images of desperate migrants, the victims of extremists, and those whose lives are degraded by hunger and poverty ... and see not strangers, but our brothers and sisters, and it is only when we see that dreadful picture of three-year-old Aylan Kurdi washed ashore – and recognise our own children in that tragic boy’s innocent face – that we will act as our better selves.”

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