Struggling in Silence. Refugees need help with trauma brought on by war and disaster

Take a minute to imagine this scenario…

You wake up in the morning, your country has declared war overnight to detract attention from its failing political situation. It has been too unstable over the last few months for your children to go to school, and you have not been able to work enough hours to pay the bills.

Perhaps you work in a government job, and because of that your house and family will be targeted, making you homeless. In this mess NGOs cannot get enough aid into the region, or they are being persecuted by government forces – the precise circumstances do not matter – over time food will become more expensive and scarcer, increasing the likelihood of a long path to starvation. Your children cannot play outside because of snipers and missile attacks. They go to bed to the sound of explosions and wake up crying because of nightmares. That is of course, if they are still with you and do not have to stay with family for safety.

Your uncle emigrated to the UK over a decade ago and said he would take you in, but only on the condition of if you could get there. For your family’s sake it is the best thing to do, but you will likely be in debt to a smuggler for years afterwards.

Now, that it before you even reach the safety of a new life and complete the asylum process, which could take years. And given the complexity of the UK’s asylum process all of your previous trauma and stress adds up and can cause serious mental health struggles which need treatment.

Watch this video for an illustrated refugee story:

The refugee experience, while individual, shares a collective sense of suffering. They leave home and everything familiar in order to escape war, violence, and death. Every story is unique, as is the trauma that is left. And as the child of someone who deals everyday with PTSD, anxiety, and panic attacks I understand how difficult it is to watch your parents struggling, and I cannot begin to imagine the added trauma of being forced to leave your entire life behind on top of this.

‘61% asylum seekers experience serious mental distress, and refugees are 5x more likely to have mental health needs than the UK population.’

– The Refugee Council

Stages of migration and associated stress factors –

Pre-Migration

Migration

Post-migration / Integration

Firstly, the myriad of reasons that led to having to leave your home:

Destruction of war
Starvation
Bombing
Threat of death
Targeted killing of your family
Etc.

The trauma of these individual experiences is too vast and varied to convey, but having to leave your home and community is a decision too heart-breaking to have to consider in our comfortable, convenient daily lives. And little separates the potential for disaster to happen to us, because refugees also had a normal life once too.

Secondly, on the journey to what you hope will be your new home:

Food security
Having a safe place to sleep
The safety and security of your family
The safety of the journey

The most important and overarching question is whether you will be granted asylum at all when you reach your final destination.

These are just some of the things you have to consider daily as a refugee before even reaching your new life, where you may not speak the same language or be accustomed to their new lifestyle.

Thirdly, all the circumstances surrounding the previous migration factors, and your new life.

Language barriers (making it difficult to express yourself)
Change of culture
Feeling lost / disconnected from the community
Worry about loved ones left behind
Etc.

It is the simple things that improve and ease the integration process, like employment opportunities, overcoming language and culture barriers, finding friends, and feeling part of the community after losing everything.

Effectively the result is a perfect storm for mental health conditions to develop and further complicate an already difficult set of circumstances. And where prolonged starvation or famine have been experienced before migration, it increases the likelihood of eating disorders which are extremely complex to treat. Unemployment, poor socioeconomic conditions, and lack of social integration are major risk factors for adults.

In comparison for children, the factors are socioeconomic deprivation, discrimination, racism, low family cohesion, and frequent school changes. Of course, children are famously adaptable, but they also need help to make sure they feel safe and happy in their new life. It is often easier for them to learn a new language than adults, so making friends is easier, but bullying particularly in schools may still occur.

A 2021 paper for the International Journal of Mental Health Systems gives an insight into the asylum situation in the UK…

Out of 34,354 asylum applications in 2019, 11,596 were granted, and 5,606 were granted protection through resettlement schemes (~50%)
PTSD is common, with around 31% experiencing prolonged illness for years afterwards
Occurrences of depression around 31%, and anxiety around 11% (particularly evident soon after migration)
In terms of unemployment – asylum seekers receive cash support of £35.39 per person per week for all expenses (while not being allowed to work), compared to £73.10 per week for British citizens job-seekers allowance
NHS England invests £1.4 billion in mental health services, but no specific funding allocation or guidelines for refugee mental health

The impact that would be added to the underfunded and overtaxed mental health services could be avoided by improving access to employment and services, social support, proficiency in host language, and family reunification. Migrants and refugees have shown they can contribute positively to society, but they cannot reach their full potential unless they are in good physical and mental health.

It really is not any wonder why levels of anxiety, depression, and post traumatic stress disorder (PTSD) are high among asylum seekers and refugees. And given that access to mental health care in the UK relies on the NHS and a waiting list of approximately 7.47 million people that is famously years long, it does not promote a path to success.

All of the combined factors outlined above lead to symptoms including hopelessness, insomnia, fatigue, irritability and of course an increased suicide risk – as shown on the Bibby Stockholm barge in December 2023. These convoluted ideas of housing asylum seekers on barges or deporting them to a third country, instead of providing the best support available shows the disregard of the government to treat both mental health and refugees or asylum seekers.

Find out more here:https://www.independent.co.uk/news/uk/home-news/bibby-stockholm-asylum-seeker-death-b2462557.html

https://www.bbc.co.uk/news/explainers-61782866

Currently there is no provision for refugee specific mental health care in the UK, and it relies on the NHS availability leading to a lack of available help. In such cases, creating a specific organisation geared towards treating mental health conditions in refugees would be the best option. This would be particularly useful when very little money is allocated within an already stretched service to employ interpreters, who are also seen as a nuisance by health care professionals. It would provide an easier avenue of communication rather than having to try and express what you are feeling and recount previous trauma in a foreign language. And on a more down to Earth level, being able to talk to a mental health professional in their native language, it allows refugees and asylum seekers to regain some of the autonomy lost while losing their homeland.

‘If you talk to a man in a language he understands, that goes to his head. If you talk to him in his own language, that goes to his heart.’ – Nelson Mandela

To make the integration process into their host country easier there both needs to be a solid provision of health services and a welcoming environment. Refugees, migrants, and asylum seekers, unlike the narrative taken by the mainstream media, contribute positively to society when given the best opportunities and support.

In fact, given the UK Conservative government’s well documented stance towards migrants and refugees, constructing a scheme to ensure all refugees have the opportunity to share their skills with society would actually reduce many of the stress creating factors of the complex asylum process. Which would really reduce the financial burden, refugees can gain work easier and contribute to the UK economy, and the government would not have to waste copious amounts of money deporting them to Rwanda.

So, what can be done?

Overall, the main improvements that are needed are include but are not limited to:

Enabling the opportunity to achieve a better socioeconomic status, widening access to education, promoting a perceived sense of safety, securing contacts with family, and promoting living and socialising alongside other people of the same ethnic origin, in order to build stable and cohesive family structures and good parental mental health.

This can be done through initiatives and charities which promote things like:

Education programmes: for refugee women, so they have the best opportunity to gain employment and be empowered, for refugee children to make friends and integrate easier.
Conversation classes to increase confidence and ease the process of integration, but also allow refugees to gain extra language skills which improve employability.
Promoting community integration initiatives (for example Forth Valley Welcome and their ‘Have a cup of tea with a refugee’), it leads to both a greater community understanding of refugees and forges new bonds in the community.
Diaspora networks to make a connection with home, because while easing integration into new lives is beneficial, it is nice to have a little bit of home when you are away from it for so long.

These are just some of the actions at a community level to ensure asylum seekers and refugees are given the best chance to achieve their full potential after the hardships they have already gone through. That is why we as a nation should be calling on the government to take the step and begin giving refugees the decency and dignity, they deserve to succeed instead of treating them as an inconvenience. Nobody chooses to be scarred by the trauma of war and disaster. And since there seems to be no motivation to solve this issue at a government level, as there are more serious and important things to prioritise, small actions at a citizen level may well be a way to help refugees and asylum seekers with their mental health struggles.

So, take a second to think how you would feel in the scenario at the opening of this post, and then reflect on how you would like to be treated when you reach safety. If the answer is that you would like to be welcomed with open arms and given the best opportunities, perhaps think about how you could help with this. Have a look whether there are any initiatives near you that need volunteers, or how about you set up a scheme yourself?

‘A stranger is just a friend you haven’t met yet.’

ICC Study Trip Geneva 2024 Blog Site

Struggling in Silence. Refugees need help with trauma brought on by war and disaster

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