Refugee crises and mental health are key challenges of our time. We spoke with the Refugee Council to get some expert advice for our blog about studying and working with refugees and mental health.
Refugee mental health is a complex and multi-stranded issue. In this blog we will explore the background and current issues involved.
We’ll also tell you about FutureLearn courses, created with our expert university partners, that can train you in the therapeutic side of mental health work, and courses that teach you about the fundamentals of working in refugee support and humanitarian aid.
We also highlight FutureLearn’s online courses that refugees and displaced people can access for free. For many refugees, finding activities to keep the mind stimulated is a key part of combatting mental health issues that stem from a lack of social, professional and academic opportunities in their adopted countries.
To get some expert knowledge we spoke to Kama Petruczenko, Policy and Research Officer at the UK’s Refugee Council.
She started by giving us the stark facts.
“Two-thirds of people seeking asylum experience serious mental distress and are five times more likely than the UK population to have mental health needs,” says Petruczenko.
“The extremely traumatised women and children who arrive from Ukraine will need significant professional support to come to terms with all they have endured. And those who host refugees need training to support Ukrainian families who have lost so much.”
For those crossing the Channel, she says, the tough asylum system in the UK can lead to more stress and anxiety.
“We are seeing the devastating impact these policies have on people’s health and well-being. Our clients often tell us that all they want is for someone to listen to them and believe them.”
If you are interested in studying towards a career helping displaced people, take our Volunteering with Refugees course taught by Cambridge University Press, or Working Supportively with Refugees, with the University of Glasgow.
What causes displacement?
Perhaps the most common cause of displacement is violence – whether in the form of war, civil war between religious or ethnic groups, political violence and torture, or gang violence and crime.
Recent conflicts in Syria, Ukraine and South Sudan – and the mass displacement of people fleeing the violence – have received widespread media coverage. There are many more conflict situations all over the world that receive less news coverage – war in the Tigray region of Ethiopia, for example – but whose impacts are just as severe.
Elsewhere, persecution, inter-communal violence and economic crises have caused huge upheaval in places like Myanmar, the Democratic Republic of Congo and Venezuela.
There are also protracted situations – such as Afghanistan where decades of conflict and hardship mean that 2.7m people are long-term displaced.
Other causes of displacement and fleeing include hunger, the effects of climate change, and discrimination towards LGBT people.
All of these kinds of situations cause people to uproot their lives, leave their homes, jobs, schools and loved ones, to find a place of safety, whether somewhere else in their own country or in other countries.
The United Nations High Commission for Refugees (UNHCR)’s most recent Global Trends report, published in June 2022 showed that at the end of 2021 there were more than 89 million forcibly displaced people in the world.
Breaking down that figure, the statistics reveal that over 53 million are internally displaced (people displaced within their own country), 27.1 million are refugees (people who have been verified as in need of international protection) and 4.6 million are asylum-seekers (people who have been granted asylum in a host country but whose status as refugees has not yet been determined).
Among displaced populations we routinely find unaccompanied children and minors.
There are also millions of stateless people all over the world, who have been denied citizenship of a country and live in an ongoing limbo without access to essential basic needs and services, such as healthcare and employment because of their status.
Astonishingly, between the end of 2021 and May 2022 – in large part due to the war in Ukraine and situations in Africa and Afghanistan – the global displacement figure rose to more than 100 million people.
If you are interested in learning more about the movement of populations, you can develop critical thinking skills around the concepts by taking our Migration, Mobilities and Citizenship course with the University of Bristol or International Migration Law with the University of Kent.
You might also be interested in our fascinating courses, Global Health, Conflict and Violence led by the University of Bergen, and Planning for Success in a Conflict Zone, taught by international security expert Dr Aisha Ahmad.
What happens when people are forced to flee?
When refugees flee their homes it is often an emergency situation with little time to pre-plan. In Myanmar, for example, when Rohingya villages were attacked, villagers killed and injured, and their houses burned, families had no choice but to grab a few possessions and escape. The displacement in Myanmar led to hundreds of thousands of Rohingya walking on foot for days, across the border into Bangladesh where they sought safety in some of the world’s largest refugee settlements.
In the Rohingya situation and in most humanitarian crises caused by conflict or natural disaster, the immediate concerns are survival. Humanitarian agencies – like UNHCR, UNICEF, the Red Cross – dispatch emergency aid including food, shelter, water and medical supplies.
Aid workers – including international agencies or national organisations from the countries receiving refugees – mobilise to register refugees and record any specific needs they may have. For example, there may be elderly people, very young children and babies, pregnant women, and possible victims of violence and sexual or gender-based violence. Where possible, mental health assessments may also be carried out to ascertain who may be in need of specialist help as a result of trauma.
In some situations, refugees are hosted by local communities. In other situations, refugee camps must be constructed with tents, sleeping mats and blankets distributed. In dire situations, refugees have no choice but to find shelter under trees, in abandoned buildings, in makeshift shelters they construct themselves, or in the open air sleeping on the ground.
For many displaced people their ultimate refuge will be in towns and cities. For example, of the 6.6 million people who have fled Syria because of the war that began in 2011, many live in towns and cities in Turkey, Lebanon and Jordan where they have had to find accommodation to rent – often living in overcrowded apartments, sleeping many to a room.
Others travelled much longer distances, seeking asylum in European countries like Germany, where they hoped to find shelter in temporary housing such as hostels and refugee shelters.
What mental health challenges do refugees face?
Refugees can experience multiple mental health issues – often overlapping or simultaneously – including anxiety, depression, PTSD (post traumatic stress disorder), suicidal thoughts and other issues.
The situations they fled from, the experiences of what happened to them or their friends and families, their experiences in flight and in their place of refuge, all have a huge bearing on mental health.
“Because of the experience of fleeing war, discrimination, persecution and torture, many people seeking asylum present with complex mental health needs,” says Petruczenko.
“People seeking safety are often deeply traumatised, having lived through dreadful experiences and faced devastating losses.”
Many refugees and asylum-seekers witness violence. Some are themselves victims of violence. Women and girls can be victims of sexual and gender-based violence. Others may be escaping poverty, or have been persecuted or discriminated against based on their politics, religion, ethnicity or sexuality.
“Many have lost their homes, livelihoods and been separated from loved ones,” Petruczenko says.
“Some are tortured or face other forms of inhumane and degrading treatment. Many make very difficult journeys.”
In transit, refugees may have been forced to walk for days, covering huge distances on foot and over difficult terrain and weather conditions – in freezing temperatures or sweltering heat, over mountains or through rainforests. Others make perilous journeys across the sea on unsafe boats in a desperate attempt to reach a better life.
Many refugees are often exploited by people smugglers demanding extortionate sums of money for safe passage, threatening their family members back home, and even detaining refugees illegally and subjecting them to severe mistreatment.
And even when asylum-seekers reach a new country in hope of a warm welcome they can encounter rejection, racism, social marginalisation, exploitation, and a lack of livelihood opportunities, schooling and even housing.
“Refugees suffer acute anxiety, with concerns about loved ones left behind, the situation in their home country, and the stress of building new lives,” Petruczenko says.
“Many refugees worry about the asylum process which is very complex to navigate, accommodation, money, education, and accessing legal advice.
“They fear detention, deportation, destitution and homelessness. All this takes a heavy toll on people’s emotional and psychological wellbeing.”
FutureLearn has well over a hundred psychology and mental health online courses available to join, from short courses lasting a few weeks, to more intense ExpertTracks, to fully certified online Masters degrees.
What support is available?
Because of their legal status, displaced people are often unable to access the same levels of treatment and support from national healthcare systems that citizens are afforded.
“One of the biggest challenges is the ability to refer our clients to specialist mental health services,” says Petruczenko.
“We know that these services are operating under huge pressure. In the case of refugees, they require support from services which have a specialism in forced migration and understand the impact traumatic experiences have on refugees’ mental health.”
Because of the barriers to accessing specialist care from caregivers like the NHS, organisations like the Refugee Council and smaller charities, NGOs and local community volunteer schemes become key to helping restore the wellbeing of refugees.
“The Refugee Council provides specialist mental health support to help refugees rebuild their lives using the resilience, strength and skills acquired on their journeys,” says Petruczenko.
“Our experienced and highly qualified therapists apply a range of evidence-based and best practice approaches.”
The specific approaches to dealing with refugee mental offered by the Refugee Council include:
- One-to-one counselling – giving individuals intensive support to heal in a safe, private space
- Psycho-education – health and wellbeing workshops to help refugees better understand their own situations, promote long-term recovery, and support each other
- Psychosocial groups where refugees have opportunities to come together, explore their own experience, and share them with their peers
- Intensive casework and crisis intervention when they are at greatest risk of harm
Free online courses for refugees and displaced people
Refugees have the same basic needs as everybody else. They aspire to achieve academically and professionally. But their displacement, asylum status, and economic situations often mean they have limited access to education and work – two fundamental activities that keep people active and mentally stimulated.
FutureLearn, in partnership with King’s College London, has created and curated eight short courses designed for refugees, displaced people, and the communities supporting them, to learn new skills and boost their career opportunities with course certificates.
The courses can be taken on any device, including your mobile phone, and are flexibly-designed so you can study them in your own time and at your own pace.
Check out the free courses here:
- Basic English 1: Elementary
- Basic English 2: Pre-intermediate
- Introduction to Nursing: The role of nurses around the world
- English for Healthcare
- Introduction to business management
- Entrepreneurship: From business idea to action
- Digital skills: Embracing digital technology
- Principles of engineering
How can you help?
So what can you do if you want to volunteer to help support and improve the mental wellbeing of asylum-seekers? Or if you are already volunteering or working with refugees and you see that they are struggling with things like anxiety, depression or PTSD?
Kama Petruczenko says, “The most important thing is to offer them your time to listen to what they want to share. Creating a safe space and trust is vital.”
“Be mindful of not making promises you cannot fulfil. There are many organisations that support refugees and we would encourage professionals to engage with Refugee Council and other specialist NGOs to learn about the best way to work with and support refugees in a trauma-informed way.”
On a more social level, inviting and including refugees in the sorts of activities you do with friends and family – like singing in choirs or playing in five-a-side football teams – is a positive way of combatting the sorts of mental health issues brought on by a lack of social engagement and boredom.
I’m interested in working with refugees – how can I get involved?
Routes into working with refugees include technical roles like registration, support roles (sometimes known as protection) similar to the kind of work done by social workers, and more specialist careers such as youth work, working with vulnerable people, working with victims of violence or sexual assault, and of course mental health and psychosocial provision.
You could find yourself working in an office, dealing with the administrative sides of refugee work or out in the field, close to the frontline of conflict, helping to process and manage situations of massive displacement.
Refugee organisations always need creatives and people who are good at digital and social media. And most organisations rely on donations, so any skills associated with charity work – such as donor relations and fundraising and logistics are always useful.
Above all, you need to have a passion for helping refugees and to build your knowledge of the situations that affect them. Which you can do through FutureLearn and our expert-led courses.
“Working with refugees is very rewarding and we need more people to support their integration,” says Petruczenko.
“Despite suffering unimaginable horrors, refugees show unbelievable kindness and resilience in the face of adversity. They truly show that the strength of the human spirit, understanding and compassion are boundless.”
“We try to help them, give guidance and advice but we also learn so much from them, every day.”
So, while the work may be emotionally, mentally and even sometimes physically, challenging, it is also the kind of job that makes you feel good about the work you are doing, the people you are helping, and proud of the contribution you are making to a world going through challenging times.