For years, refugees and asylum seekers have gone through intensely stressful situations due to religious or political oppression, resettlement, war, and migration. It’s not easy to define every kind of event they have experienced, as refugee trauma frequently precedes the stressful situations that push them to flee. But before this happens, they might go through torture, imprisonment, physical abuse, rape, unemployment, property loss, or malnutrition. What’s worse is that these refugees are often separated from their loved ones during their flight, or they are forced to kill or witness torture or withstand very cruel environmental circumstances. Possibly, the most relevant outcome from all the encounters that refugees withstand is being betrayed by either their friends or their enemies.
Indeed, refugees have had significant emotional and occasionally physical recovery encounters that should be meticulously evaluated and treated. Needless to say, the mental health of refugees is often at stake and must be discussed.
Refugees And Mental Illness
Studies have proven time and again that mental health disorder is the primary source of disability across the world. It comprises more than 10% of the global problem of disease and accounts for over 30% of the number of years survived with disability. It is projected that individuals who have serious mental disorders like bipolar disorder, severe depression, and schizophrenia have a higher likelihood of dying earlier than those who don’t suffer from them.
The issues concerning mental health are widespread, and it impacts people around the world. Additionally, there are significant economic outcomes of this widespread occurrence. The cost of mental illness-related evaluations and treatments was estimated to be about $16 trillion from 2011 until 2030.
The official definition of a refugee or an asylum seeker is someone “who is often afraid of being victimized because of race, nationality, religion, member of a political or social group, is outside his own country and is not able, unwilling to access protection of his country, or does not want to return to it because of fear or apprehension.”
Presently, the obligation of mental health support for refugees and asylum seekers is shared by a group of organizations such as the United Nations High Commissioner for Refugees, World Health Organization, and non-profit and government organizations. Most of the refugees are inflicted with PTSD because of the various devastating situations they are confronted with that inevitably affect their way of life.
Posttraumatic Stress Disorder (PTSD)
This mental health disorder is defined as enduring, distracting, and repeated flashbacks or memories of someone who has gone through trauma, including detachment symptoms, sleep disturbance and amplified startle response. PTSD is thought of as a single major mental disease that might have a clear cause. Responses such as horror, helplessness, and fear can be described as the individual’s integrity becoming vulnerable. Problems in cognitive function, relationships, emotional management, hopelessness, and somatization may happen because of extreme stress due to overwhelming situations and unpleasant experiences.
The presence of traumatic experiences is not uncommon. In fact, over two-thirds of individuals in the general populace can encounter a major traumatic situation at some point in their lives. Several studies on asylum seekers in the western part of the country revealed that almost 10% of refugees had PTSD, and about 5% suffered from depression. These pieces of evidence suggest that most of them require counseling. In other studies that delved into the biological impact of PTSD, the findings revealed:
- Decreasing volumes of the anterior cingulate cortex and hippocampus suggest the development of substance abuse and depression.
- Increased heart rate in response to unexpected loud tones, suggesting central sensitization.
- The dorsal anterior cingulate cortex and amygdala are hyperactive, while the ventral medial prefrontal cortex region is hypoactive in PTSD, suggesting attentional bias towards abnormal emotional regulation.
- Alterations in the brain, particularly brain volume, in PTSD.
The above information revealed that cognitive-behavioral therapy specific to trauma or eye movement desensitization and reprocessing must be considered in people with PTSD. One should also consider psychological evaluation and treatment to decrease PTSD symptoms. Finally, mental healthcare programs should be incorporated into policy planning like psychotherapy, counseling, psychosocial treatment, and pharmacotherapy.
Refugees And Healthcare Professionals
Psychiatrists, social workers, medical doctors, and other healthcare professionals must be aware of the important elements that influence refugees and asylum seekers’ mental health.
- The incidents they are exposed to in their own country or the evacuation camps have stayed in.
- The experiences they have on the way to their host country and their new life in the new country they are in.
- Their health is also impacted by neurological conditions, chronic diseases, cancer, and infectious conditions that could lead to polymorbidity.
- The consequence of starvation, which may include paresthesia, epilepsy, and ataxia.
- Psychological concerns.
- Communication, attention, and intercultural difficulties.
A clinical trial on mental health needs in a group of asylum seekers in Malaysia revealed that these asylum seekers and refugees stressed their worries about providing opportunities for permanent relocation and concerns about their capacity to survive financially. Service providers must pay attention to their mental well-being. Coping techniques and strategies should be integrated while assessing their basic needs, whether they are staying in temporary locations.