Refugees and asylum seekers are some of the most vulnerable members of society, often having highly complex needs. Thousands of people arrive in the UK to seek refuge every year, and at the end of 2015, there were 123,000 asylum seekers and refugees in the UK. Often they are trying to escape persecution, disruptions and wars, the majority of them having experienced torture, trauma and loss.
Many refugees have been victims of violence and rape, or have seen their family and friends being tortured or killed. They leave their whole life behind, for a new and sometimes hostile place to live, with poor language skills and little or no knowledge of their human rights and entitlements. It’s no wonder then, that a high percentage of them experience Post Traumatic Stress Disorder (PTSD).
Studies have shown that upward of 40% of refugees, and as many as 90% of refugee children, suffer from post-traumatic stress disorder, but getting them help can be difficult.
What are the causes of PTSD amongst refugees?
The majority of refugees and asylum seekers are suffering from PTSD and other mental health conditions due to their past and current experiences, including:
- Language and cultural difficulties
- Financial difficulties and poverty
- Homelessness or poor accommodation
- Lack of employment opportunities
Often, it’s multiple, cumulative traumas that leads to PTSD or major depression, adjustment disorder or anxiety.
It’s also been noted that “PTSD in refugees seems to cluster in families. It is not clear whether this is due to shared experience, compromised parenting resulting from earlier trauma, or a genetic susceptibility to trauma”.
What can be done to help?
Researchers say “there’s still a stigma around receiving treatment and medication for these issues, and getting help can be further complicated by a lack of therapists who understand the language and culture of their home country.
Recognising PTSD in refugees and asylum seekers can also be challenging. “The nature of PTSD and the fact that it often appears in both parents and children can create assessment challenges.
Children are very sensitive to their parents’ reactions – both to an event itself and when talking about it later. It is not uncommon for children to avoid discussing a traumatic event and its consequences as they soon recognize that doing so upsets their parent(s). Children and youth may not be forthcoming about their feelings, particularly if they don’t feel safe.”
The opportunity of mental health support might not be known to many refugees, however, psycho-social activities proved to be the best framework to support refugees with their mental wellbeing.
Psycho-social support usually refers to approaches to support survivors of disasters, violence and other adverse situations by helping them to cope with certain situations and to develop resilience as both communities and individuals. Psycho-social support aims at enabling people to restore normal life and empower affected people.
What to do if you’re concerned about someone
If you work with refugees and asylum seekers and are concerned about PTSD, the Canadian Pediatric Society has some great resources about how to help including tips on how to discuss it such as keeping the discussion family centered, encouraging parents to create a safe environment for children, communicating the importance of confidentiality, and developing a trusting therapeutic relationship.
If you feel that you or a loved one may require PTSD support, please visit your GP who can refer you for diagnosis and treatment as required.
NICE guidance from 2005 and 2011 recommends the use of trauma focused psychological treatments for Post Traumatic Stress Disorder in adults, specifically the use of Eye Movement Desensitisation Reprocessing (EMDR) and trauma focused cognitive behavioural therapy (CBT).