Article by Andrea Amato
Refugee communities, including asylum seekers and irregular migrants, comprise particular mental health concerns that merit international attention and support. At the end of 2021, there was an estimated total of 4.3 million individuals reported as stateless (UNHCR, 2022). Whilst these individuals are exposed to various threats and stressors, including for reasons of persecution, conflict, violence, human rights violations, among others, all of these contribute and affect their mental health and overall wellbeing.
Additionally, refugees experience diverse journeys, whereby their migration can bring about novel stressors as well. Albeit explained in this article later in further detail, refugees can experience stressors at the beginning of their migration journey and during their integration with communities and settlement. This diversity of refugee experiences encourages a deeper and more inclusive outlook on refugee mental health to appropriately address individual needs and provide long-term, effective support.
Perhaps one of the greatest challenges in addressing refugee mental health lies in healthcare accessibility. Due to their differing status in a foreign country, many migrants and refugees struggle to access mental health services and experience obstacles in receiving this altogether.
Organisations and leadership alike must address the mental health and wellbeing needs of refugee communities by developing inclusive and accessible mental health care, as well as promote relevant programs that include mental health as part of basic healthcare services. In so doing, refugee communities are able to receive diagnoses that are important for treatment outcomes and receive the appropriate short- and long-term care.
Understanding Refugee Communities
As indicated earlier in this article, millions of individuals are reportedly displaced from their home countries due to reasons such as war, violent conflict, and similar threats annually. Unfortunately, these numbers are rapidly increasing—necessitating the need to push for wellbeing support among similar interventions for refugee communities.
Whilst the term ‘refugees’ encapsulate the broad experiences of these individuals, it’s critical to understand what we mean by refugee communities and be inclusive of their unique experiences. This is important when providing accurate mental health diagnosis and care. In this article, we define the following terms:
- Refugees: defined as individuals who fear prosecution due to reasons such as race, religion, nationality, political affiliations, or similar social group memberships. Refugees are outside their home countries and are unable to return due to the above fears and depend on a foreign country to support their protection.
- Asylum seekers: similar to refugees, asylum seekers experience prosecution but have also crossed borders to attain safety and sanctuary. This difference is important when making a request for protection.
- Forcibly displaced youth: a more modern and representative term, the experiences of forcibly displaced individuals are increasingly varied and includes people who have uncertain futures or chronic, violent life experiences. This term also includes minors and youth who lost family members, for example, to war circumstances or similar conflict.
Whilst the above offers a simple explanation and a brief introduction to the differences among refugee experiences, it is by no means a detailed reference of these experiences. Instead, it provides readers with an understanding in which these groups require mental health support and depending on their circumstances, experience barriers to accessing healthcare altogether.
Many if not most refugees, asylum seekers, and forcibly displaced youth will not access basic mental health services due to pervasive stigma or underfunded services. As refugee communities are left to support themselves in foreign organisations and countries, it is even more invaluable that these individuals receive adequate support from respective country leaders to aid in the security of their life circumstances.
Prevalence of Mental Health Disorders
In order to appropriately support refugee communities and provide mental health care access to these groups, research is warranted to understand the diversity of refugees and migrants alike and their individual circumstances. Further, comprehending mental disorder prevalence necessitates studies that focus on diverse factors, such as age and similar demographic information, for effective prevention and intervention.
For example, a recent study conducted by Gadermann et al. (2022) focusing on the prevalence of mental disorders for immigrant, refugee, and nonimmigrant children and youth found a consistent pattern of conduct, attention deficit hyperactivity disorder (ADHD), and mood/anxiety disorders.
Further differences were illustrated depending on demographic variables such as age and migration categories, highlighting the need to understand the diversity of refugee communities and what their unique needs are when accessing mental health care.
Generally, research has consistently indicated that one in three asylum seekers and refugees experience significant rates of depression, anxiety, and post-traumatic stress disorder (PTSD). However, the prevalence and proportions of these disorders vary drastically according to specific refugee populations.
It’s therefore essential that mental health care and interventions are provided to these communities early-on, for early and accurate detection and ongoing support. We must also recognise the ongoing and deleterious effects of migration experiences, such that refugees may experience novel traumas and stressors throughout their migration, and these concerns must be adequately addressed too.
Specifically, as refugee communities experience increased exposure and vulnerabilities to mental health disorders, the nuances of these arise from pre-migration experiences (such as in the circumstances of war and similar conflict) and post-migration conditions (including prolonged separation from family and other uncertain events). Such circumstances continue to illustrate the complexities of mental health concerns among refugee communities that merit unique attention to these groups.
Challenges and Recommendations for Mental Health Access
This article so far demonstrates the varied experiences of refugees and their barriers to accessing mental health care, whereby even when they do receive these services, may not access the right treatment and care. Refugee communities undoubtedly face difficult and oftentimes complex situations that hinder their mental health and wellbeing. Whilst some individuals may showcase tremendous resilience, many refugees require additional support.
With the above in mind, it’s essential that organisations and leadership alike prioritise wellbeing interventions and similar programs to support mental health care for refugee communities. To engage these individuals and focus on their wellbeing and feel welcomed in the wider community. MOAS is just one example among other organisations consistently working to support refugees and asylum seekers in attaining better life experiences.
For certain countries with limited healthcare services, large organisations such as UNHCR provide assistance in offering volunteering programs that can help in developing the appropriate care facilities for refugees, alongside the provision of resources related to these initiatives. Namely, the following should be adopted to better support an action plan:
- The general inclusion of refugees in national health institutions and systems,
- The integration of mental health services within general healthcare,
- Psychosocial and psychological training to volunteers, nurses, and so forth, particularly in addressing refugee needs,
- Funding for current mental health services and clinical professionals,
- Inclusive services that do not discriminate based on ethnicity, religion, age, or other protected characteristics,
- Improvement of ongoing wellbeing initiatives such as sports activities,
- Particular attention and care for child protection, and
- Educational strategies that aim to support refugees and integrate additional support.
It’s worth noting that providing sufficient care for refugee communities requires particular attention on a case-by-case basis, in that every refugee, asylum seeker, and so forth receive the appropriate care depending on their individual circumstances and experiences. In this way, refugee communities can receive a tailored approach to case management and reach the accessible support needed to grow and develop as they continue to navigate their migration journeys.