Psychological Challenges for IDPs and Refugees in the Middle East:
Internally displaced persons (IDPs) and refugees are among the most vulnerable populations in the world, facing multiple sources of stress and trauma.
In the Middle East, where conflicts and violence have displaced millions of people, the mental health needs of IDPs and refugees are often neglected or unmet, this article will explore some of the psychological challenges that IDPs and refugees face in the Middle East context, and suggest some ways to provide mental health support in humanitarian emergencies.
Sources of psychological distress IDPs and refugees experience psychological distress due to a variety of factors, such as:
• Exposure to violence, loss, and human rights violations in their home countries and during displacement.
• Living in precarious and insecure conditions, such as overcrowded camps, urban slums, or informal settlements.
• Facing discrimination, stigma, and harassment from host communities or authorities.
• Struggling with poverty, unemployment, lack of education, and limited access to basic services.
• Coping with acculturation stress, identity issues, and social isolation.
• Dealing with uncertainty about their legal status, protection, and future prospects.
These factors can affect the mental health and well-being of IDPs and refugees in different ways, depending on their individual characteristics, coping skills, social support, and resilience. However, some of the common mental health problems that IDPs and refugees may develop include:
• Depression: A mood disorder characterized by persistent sadness, hopelessness, loss of interest, low self-esteem and suicidal thoughts or behaviors. Depression can impair one's ability to function normally in daily life and may worsen physical health conditions. Depression is more prevalent among women, older adults, people with chronic diseases and people who have experienced multiple traumas.
• Anxiety: A general term for a group of disorders that cause excessive fear, nervousness, worry or panic. Anxiety can interfere with one's performance, relationships and quality of life. Anxiety disorders include generalized anxiety disorder (GAD), panic disorder, social anxiety disorder, obsessive-compulsive disorder (OCD) and phobias. Anxiety is more common among children, adolescents, women and people who have experienced violence or abuse.
• Post-traumatic stress disorder (PTSD): A condition that develops after exposure to a traumatic event that involved actual or threatened death, serious injury or sexual violence. PTSD can cause intrusive memories, nightmares, flashbacks, avoidance of reminders, negative changes in mood and cognition and increased arousal or reactivity. PTSD can impair one's functioning in various domains such as work, school, family and social life. PTSD is more likely to occur among people who have experienced multiple traumas, especially interpersonal violence.
• Psychosis: A severe mental disorder that affects one's perception of reality and ability to think clearly. Psychosis can cause hallucinations (seeing or hearing things that are not there), delusions (false beliefs that are not based on evidence) and disorganized speech or behavior. Psychosis can be triggered by stress, trauma, substance use or underlying medical conditions. Psychosis can affect one's safety, health and social functioning.
The mental health needs of IDPs and refugees are often neglected or unmet due to various barriers such as:
• Lack of awareness: Many IDPs and refugees may not recognize or acknowledge their mental health problems due to stigma, cultural beliefs or lack of knowledge. They may also not seek help due to fear of discrimination or persecution.
• Lack of resources: Many host countries or communities may not have sufficient resources to provide mental health care for IDPs and refugees. There may be a shortage of trained mental health professionals, especially those who are culturally competent and linguistically diverse. There may also be a lack of funding, infrastructure or coordination among different sectors.
• Lack of access: Many IDPs and refugees may not have access to adequate mental health services due to cost, distance, language or cultural barriers. They may also face challenges in navigating the health system or obtaining legal documentation.
• Stigma or shame associated with mental health problems or seeking help.
• Cultural or linguistic differences between IDPs or refugees and mental health providers.
• Lack of trust or confidence in the quality or effectiveness of mental health services.
• Fear of discrimination or persecution by authorities or host communities if they disclose their mental health problems or seek help.
To address the psychological challenges that IDPs and refugees face in the Middle East context, it is essential to provide mental health support that is culturally sensitive, trauma-informed, community-based, and integrated into primary health care and humanitarian response.
Some of the strategies that can help achieve this goal include:
• Conducting needs assessments of the mental health needs and resources of IDPs and refugees in host settings, we recommend here to do it on different levels: Individuals, Community, Key Informants, NGOs' staff, only by a comprehensive assessment we can get the full picture.
• Training and supervising Doctors (mhGAP), primary health care workers, community health workers, teachers, social workers, and other frontline staff to provide trauma informed services, identify and manage common mental health problems among IDPs and refugees.
• Providing psychological first aid (PFA) and regular Psychosocial support activities, to IDPs and refugees who have experienced acute stress or trauma.
• Implementing evidence-based psychological interventions, such as cognitive-behavioral therapy (CBT), interpersonal therapy (IPT), narrative exposure therapy (NET), eye movement desensitization and reprocessing (EMDR), or group psychotherapy for IDPs and refugees with moderate to severe mental health problems.
• Promoting psychosocial wellbeing not just as a part of some training, it should be an approach in all projects as the staff in working under high pressure: they are a part of the affected population, and they have to support other affected people.
Only by joint huge, structured and organized efforts, a real change can be done...
References:
who.int
apa.org
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