The Mental Health of Internally Displaced People and Refugees

Dr. Nemat Al-Zubair

The horrors that displaced persons endure—such as conflicts, persecution, and psychological and material stress, in addition to long and dangerous journeys and extended periods of waiting—negatively affect their mental health. Displaced individuals often experience disturbing episodes that may lead to psychological disorders related to trauma, stress, and low self-esteem. Particularly, those forced to flee unsafe areas suffer from issues like post-traumatic stress disorder (PTSD), depression, and anxiety.
Forcibly displaced individuals face severe stress before they flee their homes. The sense of alienation and exile exacerbates their emotional distress, doubling their mental and physical health challenges, especially for the elderly.
Additionally, displaced persons face post-displacement pressures related to the new lives imposed on them, such as accumulated stress, cultural assimilation, language barriers, and bias or discrimination from native populations. Sometimes, they are forced to live in overcrowded and congested spaces due to low costs. This situation often compels the elderly to live in the same household as the rest of the family, which limits their freedom and adds to their psychological stress due to tension and conflicts arising from the close quarters and differing personalities. This increases their sense of loss and detachment from everything they once knew and were emotionally attached to. Elderly people’s suffering is also due to cultural rigidity, adherence to traditions, language difficulties, and the lack of social support. As a result, the elderly among the forcibly displaced are among the most vulnerable to mental disorders (such as depression, anxiety, feelings of oppression, loss, and frustration), in addition to physical health issues (e.g., heart disease and diabetes).
Displaced children and youth are similarly vulnerable to mental disorders as adults. Still, these disorders pose a unique threat to their development, potentially leading them toward crime, moral deviance, identity disorders, and social disconnection, as well as exacerbating the mental health problems of their parents.
In refugee camps and displacement areas, the environment is often alienating and frightening, with people crowded into small spaces, nearly eliminating any sense of privacy and with limited or no access to necessities. This makes adaptation difficult, and psychological issues related to constant tension and anxiety begin to emerge, accompanied by feelings of resentment, sadness, pain, and helplessness, ultimately leading to a sense of complete powerlessness and loss of energy.
In reality, the focus on physical needs and challenges often overshadows concerns for mental health. In this article, I call for the enhancement of mental health care in countries of transit, destination, and displacement, as well as addressing the economic and social conditions, integrating psychological treatment with the public health programs offered to them, increasing donor funding for mental health initiatives and programs for displaced persons, and ensuring equal access to mental health services. Additionally, access to community support programs should be ensured, along with preserving family unity and providing culturally appropriate activities and educational and recreational programs to mitigate the psychological effects of war and displacement. There should be international pressure to focus on the health and mental health priorities and needs of displaced persons alongside other necessities, with adequate financial and social support.