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From: IRIN <[email protected]>
Date: Thu, Aug 11, 2011 at 5:50 PM
Subject: GLOBAL-KENYA: Refugee children at "high risk" of mental-health
problems
To: Jean-Francois Darcq <[email protected]>
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*GLOBAL-KENYA: Refugee children at "high risk" of mental-health
problems <http://www.irinnews.org/report.aspx?reportid=93484>*
[image: lead photo]LONDON, 11 August 2011 (IRIN) - An estimated 18 million
children worldwide have been forcibly displaced from their homes because of
conflict; a third of those are refugees whose families have fled across
international borders, research shows.
To explain the consequences on their mental health, the UK journal, The
Lancet<http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2811%2960050-0/fulltext>,
undertook a review of all the work on this subject, to see what lessons can
be learned for the best way to support refugee and displaced children and
their families.
One of the co-authors of the review, released on 10 August, Mina Fazal, told
IRIN: "This is important because of the vast numbers affected, mostly in
resource-poor countries, and we know that they are at high risk of
mental-health problems because they are likely to have been exposed to
violence, which is the strongest predictor of poor mental-health outcomes."
The Oxford-based researchers found one major information gap. The vast
majority of existing work had been done with refugee children in high-income
countries, and yet the typical refugee child probably lives in a camp,
somewhere close to their country of origin, in a low or middle-income
country with very limited resources to spend on mental-health issues.
This brings specific problems. In Sudan's Darfur region and in Chad, both
boys and girls reported having been raped, usually while collecting
firewood. At least 75 percent of children interviewed in internally
displaced persons (IDP) camps in Darfur met the diagnostic criteria for post
traumatic stress disorder and 38 percent had depression.
Local people, poor themselves, can be hostile and threatening towards
newcomers competing for scarce resources. And just being close to home does
not always diminish the culture shock. The report says, "Evidence suggests
that adaptation to apparently similar settings is not necessarily easy, and
refugees themselves draw attention to cultural dissimilarity in settings
that western researchers judge to be similar on the basis of religion and
language."
One positive factor was the retention of community structures in the new
setting. When non-Arabs were chased out of Mauritania in 1989, whole
villages fled together across the river that marked the border. Entire
schools, children and teachers moved together and reconstituted themselves
on the Senegalese side. That kind of continuity and community support helps
children to be more resilient to the shocks of exile.
* <http://www.irinnews.org/photo/Details.aspx?ImageId=201107250753530574>
Photo: Tom Maruko/IRIN <http://www.irinnews.org/photo/> Local people can be
hostile and threatening towards newcomers competing for scarce
resources Integrated
approach *
The authors call for more research in poorer refugee-receiving countries,
and for an integrated approach that, as well as providing basic food and
shelter, will support the development of community structures and activities
that promote mental health. And they suggest that richer countries should
help pay for this, since it is their increasingly restrictive asylum
policies that have left poorer countries to carry most of the burden.
For younger children, who are with their families, whichever country they
end up in perhaps matters less. But refugee children carry their memories of
past events and live with the continuing consequences. One aspect that
emerged from the review was that exposure to violence, particularly
continued exposure, carried the strongest risk of subsequent psychological
disturbance. And worst of all is violence that disrupts the integrity of
family or home. It may not be the violence of political conflict; high rates
of domestic violence in the stressful environment of refugee camps cause
great distress to children.
Children are very sensitive to the anxieties of their parents. Even
traumatic family events that happened before a child was born can raise his
or her risk of mental-health problems.
For refugee children in rich countries more resources are available, but
there are specific problems. Another issue that emerged from the review of
research was that post-migration detention, where children are held as part
of the immigration process, seems to be particularly detrimental to their
mental health.
Aoife O'Higgins, who works with young refugees on behalf of the Children's
Society, says this matches her experience. She told IRIN: "I think it is
very shocking for young people who have travelled so far, and had very
difficult journeys, and then they are detained on arrival."
O'Higgins said she had direct evidence of the effect of detention on one of
the women and girls she works with, a young Iraqi woman, who was sexually
abused during her journey to the UK, and has severe mental-health problems,
self-harming, scratching and cutting herself and pulling out her hair.
"Because her immigration status is unresolved, she has to go and sign on
[for social security] every week," O'Higgins said, "and every time she is
terrified of being detained again. She was detained for two days last year
by mistake, and her condition deteriorated significantly."
Fazal hopes her work and that of her colleagues will help prevent this kind
of extra stress. "What we highlight is that even if they have been exposed
to these pre-disposing risk factors, you can try to moderate any future risk
factors, because it is cumulative adversity which is the worst thing for
these young people," she told IRIN.
"So the important thing is not being forced to move too many times, not
being placed in detention, not being separated from family - all these cause
greater risk."
eb/js/mw
Read report online <http://www.irinnews.org/report.aspx?reportid=93484>
------------------------------
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