Into the Mind of the Refugee: Unpacking Modern Refugee Mental Health

Syrian Refugees strike in front of Budapest Keleti railway station. Photo accessed via Wikimedia Commons, CC BY-SA 3.0.

The story of the refugee is not new. From the times of the Roman Empire to the ongoing Syrian Civil War, civilians in conflict zones have historically been uprooted and forced to seek refuge. In these stories, the world struggles to make sense of the senseless brutality that people inflict upon one another. We feel outrage, expressing it through sanctions, foreign aid, and even military intervention—not realizing that we neglect a critically important refugee issue in the process.

The increased attention to refugees does bring numerous advantages, a fact that should not be understated. With more media coverage of these atrocities, people see refugee crises as more compelling, increasing pressure on countries to provide assistance. However, in the midst of the media frenzy, the mental health of these refugees is often forgotten. People sign checks and feel satisfied, knowing that they have provided food, water, and perhaps shelter for a refugee. However, refugees are often left in a new environment, haunted by past terrors, searching for family, and isolated, reinforcing the need for mental health assistance.

Refugees are streaming into Europe at unprecedented levels to escape war and persecution at home, leading to backlash in many countries. For instance, Poland has seen a rise in right-wing populist groups that employ anti-immigrant rhetoric as they fight to keep out refugees. While supporting refugees may be popular when they are far removed from citizens’ personal lives, some refugees are shunned once they enter the country.

Given the populist rhetoric against refugees, many refugees may feel hesitant to come forward about problems. A report by the United Nations High Commissioner for Refugees noted that 21.6 percent of patients in a Jordan refugee camp were diagnosed with anxiety disorders and 8.5 percent were diagnosed with post-traumatic stress disorder (PTSD). To put this into perspective, the US Department of Veterans Affairs found that 12 percent of Gulf War veterans had PTSD—demonstrating how refugees, like soldiers, face serious mental health issues. Cultural and language barriers between mental health specialists and refugees create serious obstacles for refugees seeking the care they need.

Compounding this problem is the stigma that surrounds mental health. Many people in countries around the world hold the view that mental disorders can be “worked through” without outside help. Indeed, Psychology Today writes that the social distancing and isolation that accompany those labeled as mentally ill are among the largest contributing factors to mental illness. . Mental health warrants attention just like any other need, whether it be shelter, food, or water. The international community and NGOs responsible for refugee aid need to better account for this need in their operations.

Refugee Populations Most Impacted

Children are particularly vulnerable members of the refugee population. In Germany, for example, one out of every five refugee children suffers from PTSD, yet only 4 of people in refugee centers receive mental health support. Moreover, 40 percent of the children had witnessed violence, along with 26 percent who saw their families attacked. Refugee children are at formative stages in life, and these moments of trauma can have an enormous impact on their mental futures. PTSD is never something that children grow out of, but it can be improved through treatment and nurturing.

Refugee Children from Syria at a Clinic in Ramtha, Northern Jordan. Photo accessed via Wikimedia Commons, CC BY-SA 3.0.

Refugee Children from Syria at a Clinic in Ramtha, Northern Jordan. Photo accessed via Wikimedia Commons, CC BY-SA 3.0.

Refugee women are especially susceptible during times of war or persecution. The Women Under Siege Project documents the staggering sexual violence that women face in Syria. While the project was able to analyze 226 separate incidents reported by sources like the BBC, the United Nations, and Human Rights Watch, many of these incidents remain unverified since it is very difficult to confirm any stories with the victims.

Indeed, rape is a weapon of war that multiple groups within the Syrian conflict are employing. In times of conflict, it is often used as a tool of “control, intimidation, and humiliation,” leaving survivors devastated. Indeed, rape has been described by the UN guidelines on torture as akin to other forms of torture for the lasting scars it leaves on a person’s mental state. Moreover, the effects of rape are not limited to the victims, but also their family members, friends, and communities, which also have to shoulder the burden of the memory. In many cases, soldiers will tie men and brothers up and force them to watch as their mothers, wives, and sisters are raped, to leave them feeling absolutely helpless.

International Framework in Responding to Refugees

The major issue, according to University of Michigan Law School Professor Alexander Aleinikoff, is how governments are currently set up in the international system. Governments follow principles very similarly to the “social contract” that Jean-Jacques Rousseau proposed, in which people give up certain levels of freedom to gain rights and protection from their governments. However, in the international community where some governments are corrupt or weak, refugees are left in a strange position where they are offered neither freedom nor protection. These refugees are not a part of any state, and when they try to assimilate into another country, they are often treated as problems that need to be taken care of rather than constituents in the state’s social contract.

In the modern era, this disconnect in the social contract for refugees seems especially problematic, given how technology and transportation have brought people from different countries together. While it is important to have cultural and national pride, if such pride comes at the cost of stigmatizing people fleeing war-torn regions of the world, it is a pride that ought to be tempered with empathy.

Possible Solutions

There are different paths that countries can take moving forward. One path, outlined in The Atlantic, was provocatively titled “Let Syrian Refugees In—All of Them.” Though this path runs counter to our traditional sense of how governments should operate, the arguments of this path are persuasive. Morally speaking, if we believe that individuals deserve rights by being human, and if these rights ought to be indiscriminate, then governments risk their own legitimacy by turning away refugees. In addition, governments value their security. When crises happen around the world, governments usually do not intervene from a purely altruistic standpoint, but rather, they try to maintain some economic or political stability. Thus, when civil war breaks out or terrorists wreak havoc on civilians, international governments intervene because they are afraid of violence spilling over.

Syrian refugees and migrants pass through Slovenia. Photo accessed via Wikimedia Commons, CC BY-SA 3.0.

Syrian refugees and migrants pass through Slovenia. Photo accessed via Wikimedia Commons, CC BY-SA 3.0.

Simply taking in as many refugees as possible is a compelling moral and practical alternative to military intervention alone. Though resources are spent in resettlement processes, the human and economic costs are far less in comparison to military interventions. Broader and more effective resettlement would not only reduce mental health issues, violence, and instability in other regions and give people an opportunity to work, but less restricted refugee resettlement policies would also reduce radicalization by helping refugees escape from the powerful terrorist groups that operate in and sometimes control many refugees’ home countries.

While the rationale behind this policy seems convincing, there are complex politics behind such a change. There are legitimate fears that allowing such an influx of refugees would be too great of a strain on host countries’ economies. Due to these fears, it would be unlikely that a government would choose to immediately accept all refugees who are fleeing from their home countries. However, it is important that gradual, intentional steps are taken to create more inclusive environments for refugees and to change the hearts and minds of citizens.

Helping Refugees Resettle

One of the greatest factors that lead to refugee mental disorders stems from the realities that begin to sink in when refugees reach safe countries. Most of the time, these trips are fraught with threats of violence, sexual assault, and discrimination. Refugees risk everything to try to find a haven, but they realize that they have little support in doing so. Many countries view them as nuisances even though they send aid and make promises from afar. When these refugees try to find work, they are often discriminated against and cannot find jobs that match their skill level. More than 33 percent of female Palestinian refugees in Jordan are unemployed, which is more than double Jordan’s official unemployment rate. In addition to unemployment, refugee families often find it difficult to integrate in their new communities, which are unfamiliar and often hostile towards refugees. With all of these factors in play, refugees find themselves lost, disenchanted, and hopeless, leading to high rates of mental illness.

Refugees need to have more resources available to them when they resettle. Their children need to have better access to education that prevents them from falling between the cracks. Parents and other adults need to receive job training, if necessary, and they should create mentorship communities where people of similar cultures can communicate with and work alongside them. They also, very critically, need to have better access to mental health services.

The culture surrounding mental health needs to change as a whole. Beyond the topic of refugees, mental health is stigmatized and misunderstood by a majority of the people around the world. International, non-governmental organizations like the United Nations should heavily promote the importance of mental health in their countries of operation. As societies’ views on mental health improve, these views will hopefully trickle down to their treatment of refugees.

The work involved in providing mental health services is multifaceted. Importantly, it is work that will take time. There are many attitudes, from policymakers’ to those of the public itself, that need to change. Attitudes need to change regarding mental health, the treatment of refugees, and the international community’s role in solving these issues. All of these changes require time, but most importantly, they will require a hard look at ourselves and what we stand for. If we truly believe in the rights of people, everywhere, regardless of who they are, we will look at the refugee’s story and listen.

About Author

Ryan Sim
Ryan Sim

Ryan Sim is an Associate Editor for the Features section of the Harvard International Review.