MENTAL HEALTH INTERVENTIONS FOR REFUGEE CHILDREN

What are the major mental health care challenges for Syrian refugees?

Language Barriers

Lack of Arabic-speaking health providers and interpreters inhibits access [1]; inability to communicate complicates treatment and assessment.

Belief Systems

Culture is a major determinant of how individuals evaluate and and react to distress [2]. Ex. many refugees use religion, prayer, family, and social relationships as coping strategies.

Cultural Stigma

Mental health is considered a taboo topic; this affects whether refugees accept mental health diagnoses and the subsequent treatment [1,3].

Access to Specialists

Shortage of mental health specialists for refugees: in Germany, only 5% of refugees in need of mental health services received treatment in 2015 [12].

Establishing Trust

After decades of widespread corruption and oppression in Syria, many refugees do not easily trust formal services and establishments and therefore do not seek out mental health resources when they need it [8].

Community-based approaches

In many cases, Syrian refugees have been isolated from family, friends, support groups, and communities that they normally turn to in order to cope with traumatic experiences. Mental health support therefore needs to go beyond clinical treatment and enhance community support networks [4].

A community-based approach that touches on multiple access points in schools, community, centers, and health clinics, offers stronger support for refugee children than individual-centered approaches in typical therapy methods [5]. Given that the mental health of caregivers has been shown to influence the mental health of children [15], family-level considerations are also important.

Syria Bright Future: A Model for Mental Health Interventions

Founded by Syrian refugee Mohammad Abo-Hilal, a psychiatrist, Syria Bright Future (SBF) address the mental health, social, and educational needs of refugee children in Jordan. The organization consists of a team of mental health professionals and trained community volunteers that teaches kids how to cope with PTSD, offers creative educational activities, and provides counseling and support to caregivers. The teams also visit individual families for interviews with each member to thoroughly assess their specific mental, physical, social, and educational needs [7, 8]. Syrian cultural norms are also taken into account with the inclusion of traditional spiritual healers [7]. 

Thus, SBF improves access to trusted, mental health care services that are individualized, multifaceted, culturally-sensitive, and rooted within the immediate refugee community [7] as well as serves as a model for other countries or organizations to integrate many areas of health services for children and families. 

Policy-level considerations

  • Better integration of mental health strategies for refugee children into schools.
    • Mental health programs developed and delivered through schools, which refugee children tend to prefer over traditional services [9].
    • More language acquisition opportunities in schools would enhance children’s ability to reach out to health services and improve social interactions within host culture [10].
  • Include mental health care into basic refugee health services upon arrival in host country [1, 11].
  • Implement more training programs for mental health professionals to promote better understanding of and more culturally-appropriate treatment methods for refugee groups [1].
[13]
Samira, 5, (in red) is learning to count in English and Arabic [14].

With interventions oriented around family and community, policies and healthcare practitioners in host countries should aim to instill a greater sense of stability, belonging, and hope in displaced Syrian refugee children.

By uniting communities and healing Syria’s next generation, we can offer refugee children and their families a path out of the relentless horror and violence of the Syrian conflict and into a brighter future.

References:

  1. Giacco, D., & Priebe, S. (2015). WHO Europe policy brief on migration and health: mental health care for refugees. World Health Organization Regional Office for Europe. Retrieved from http://www. euro. who. int/__data/assets/pdf_file/0006/293271/Policy-Brief-Migration-Health-Mental-Health-Care-Refugees.pdf.
  2. Cetrez, Ö., & Balkir, N. (2017). Resilience and Mental Health Risks among Syrian Refugees in Europe: A Cultural Perspective. ACTA PSYCHOPATHOLOGICA, 5(5), 1-4.
  3. Abo-Hilal, M., & Hoogstad, M. (2013). Syrian mental health professionals as refugees in Jordan: establishing mental health services for fellow refugees. Intervention, 11(1), 89-93.
  4. Abou-Saleh, M. T., & Hughes, P. (2015). Mental health of Syrian refugees: looking backwards and forwards. The Lancet Psychiatry, 2(10), 870-871.
  5. Fondacaro, K. M., & Harder, V. S. (2014). Connecting cultures: A training model promoting evidence-based psychological services for refugees. Training and education in professional psychology, 8(4), 320.
  6. Abou-Saleh, M. T., & Hughes, P. (2015). Mental health of Syrian refugees: looking backwards and forwards. The Lancet Psychiatry, 2(10), 870-871.
  7. Sirin, S. R., & Rogers-Sirin, L. (2015). The educational and mental health needs of Syrian refugee children. Washington, DC: Migration Policy Institute.
  8. Abo-Hilal, M., & Hoogstad, M. (2013). Syrian mental health professionals as refugees in Jordan: establishing mental health services for fellow refugees. Intervention, 11(1), 89-93.
  9. Fazel, M., Garcia, J., & Stein, A. (2016). The right location? Experiences of refugee adolescents seen by school-based mental health services. Clinical Child Psychology and Psychiatry, 21, 368–380.
  10. Fazel, M., & Betancourt, T. S. (2018). Preventive mental health interventions for refugee children and adolescents in high-income settings. The Lancet Child & Adolescent Health, 2(2), 121-132.
  11. Hodes, M., & Vostanis, P. (2018). Practitioner Review: Mental health problems of refugee children and adolescents and their management. Journal of child psychology and psychiatry.
  12. Sleijpen M., Boeije H. R., Kleber R. J., & Mooren T. (2015). Between power and powerlessness: a meta-ethnography of sources of resilience in young refugees. Ethnicity & Health, 21, 158-180.
  13. (2018). [Photograph]. Retrieved from https://www.georgetownjournalofinternationalaffairs.org/online-edition/2018/4/20/europes-great-challenge-integrating-syrian-refugees.
  14. Warren, J. (2016). Samira, 5, (in red) is learning to count in English and Arabic.[Photograph]. Retrieved from https://www.worldvision.org/refugees-news-stories/photos-syrian-refugee-children.
  15. Panter‐Brick, C., Grimon, M. P., & Eggerman, M. (2014). Caregiver—Child mental health: A prospective study in conflict and refugee settings. Journal of Child Psychology and Psychiatry, 55(4), 313-327.

Biology of Global Health Final Project