By Morgen Makombo Sikwila
According to the World Health Organization (WHO), mental health is, a state of well-being in which the individual realises his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community.
Mental health conditions are considered a leading cause for disability globally, accounting for around 13% of the global burden of diseasesa, and 33% of total years lived with disability. It is estimated that people who have severe mental health disorders, for example, severe depression, bipolar disorder and schizophrenial are more likely to die prematurely than those who have not been affected. The problems of mental health are highly prevalent globally, affecting people across all regions of the world. They are expected to affect at least 1 out of 3 people across their life-time.
The world is currently witnessing an unprecedented wave of displacement, with countless individuals and families forcibly uprooted from their homes for many reasons, including conflict, natural disasters, and socioeconomic circumstances. This article explores the impact of displacement on health, especially on mental health.
Displacement refers to the forced movement of people from their homes and the areas where they usually live. It is a complex issue that entails various forms, including internal displacement, external displacement (or refugeeism), development-induced displacement, and more.
According to the United Nations High Commissioner for Refugees (UNHCR), millions of people are forcibly displaced worldwide as a result of conflicts, violence, fear of persecution and human rights violations. Those who are forced to leave their home countries often live in overcrowded reception facilities while waiting for resettlement or asylum decisions. These facilities have, in effect, turned into long-term detention centres and have poor health and safety conditions. All these factors create medical challenges and an increased need for displaced persons to utilise health services.
In analyzing the wide-ranging impact of displacement on health, it’s crucial to understand how displacement can drastically influence a person’s mental and physical health. This interplay is multifaceted, often intertwined with the traumatic events that commonly precede and coincide with displacement, the loss of social networks and supports, and the struggle to secure basic necessities, in addition to the challenges of integrating into a new and frequently unwelcoming environment.
The journey of many displaced individuals often begins with distressing events—such as war, violence, or natural disasters. These traumatic incidents can trigger severe psychological distress and mental health disorders, creating a haunting echo of the events that caused their displacement. This trauma often manifests as acute stress reactions and grief, but can escalate to more severe issues such as post-traumatic stress disorder (PTSD), anxiety, and depression.
Children and adolescents are particularly vulnerable to the negative mental health effects of displacement. The loss of their homes, routine, friends, and sometimes family members can result in severe emotional distress, affecting their development and psychological well-being.
Migrants can be exposed to various stress factors which affect their mental health and well-being before and during their migration journey and during their settlement and integration. While most migrants do not experience mental health problems, people displaced as a result of conflicts, violence, fear of persecution and human rights violations can lead to at increased risk of mental health problems. This is particularly true for persons who have experienced violence and trauma, including exploitation, torture or sexual and gender-based violence. Issues can range from low to moderate levels of anxiety and depression through to more severe mental disorders. Currently, the responsibility of mental health support for displaced persons is shared by a wide network of organisations depending on where the displaced person is based. These organisations include: the World Health Organization (WHO), the United Nations High Commissioner for Refugees (UNHCR), Governments and Non‐Governmental Organisations.
When individuals and families seek safety by leaving their homes, cultures, and communities because of the threat of violence and persecution, emotional distress can be heightened. About one third of displaced persons will experience high rates of depression, anxiety, and post-traumatic stress disorders (PTSD) as a result of the circumstances they faced during their migration, which can significantly affect the quality of their life.
While most displaced persons with PTSD and depression show a reduction in symptoms over time, particularly if there are low resettlement stressors, others may experience years of symptoms, particularly those with PTSD. Because of this, early access to mental health care should be prioritised, as post-migration stressors such as prolonged detention, insecure immigration status, and limitations on work and education, can worsen mental health.
When something traumatic happens in your life it rocks you to the core. The world is no longer a safe place. It becomes somewhere that bad things can and do happen.
According to the American Psychiatric Association (APA) and the DSM-5, Post Traumatic Stress Disorder is defined as a “psychiatric disorder in which patients have experienced or witnessed a significant traumatic event. Examples of such events include natural disasters, serious accidents, terrorist acts, war, combat, rape, or other violent personal assaults. PTSD presents with persistent, recurrent and disturbing memories or flashbacks of a witnessed or experienced trauma, avoidance of reminders of the traumatic event along with other symptoms such as negative thoughts and feelings, difficulty with concentration and sleep, feeling detached from people and current experiences, as well as exaggerated startle responses and arousal or reactive symptoms such as irritability, and angry outbursts. Reactions like fear, horror, and helplessness may be portrayed as the person’s physical integrity is being threatened. Difficulties in emotional regulation, cognitive functioning, self-perception, relationships, somatisation and hopelessness may occur due to severe stress as a result of overwhelming circumstances and disturbing experiences. The prevalence of traumatic experiences is common.
Once displaced, individuals face multiple adversities in their new environments. Difficulties in accessing essential services such as healthcare, housing, education, and employment are frequent. These hurdles can exacerbate existing mental health problems and also give rise to new ones, thereby further escalating stress, anxiety, and other mental health issues.
The stress of navigating an unfamiliar system, territories, language barriers, social isolation, and sometimes prejudice, stigma and discrimination can also pose significant challenges. These factors contribute to complex interaction between displacement and mental health, often leading to chronic states of mental health disorders.
The long-term consequences of displacement on mental health are complex, multifaceted, and can last for years or even decades. This is not a static situation but rather a dynamic process, with the potential for mental health issues to evolve over time.
We saw this in the Democratic Republic of Congo (DRC), as millions of citizens have been displaced due to the civil war and are in need of mental health support in order to cope with their experiences now and into the future. The longer the conflict continues, the more risk there is of individuals experiencing negative mental health effects.
The persisting trauma, chronic uncertainty, and loss of hope associated with long-term displacement can lead to serious mental health issues. Over time, this can potentially result in a shift from acute mental health symptoms to more chronic mental health conditions, emphasizing the necessity of accessible and effective mental health care for the vulnerable population.
Understanding the significant effects of displacement on mental health is not just a matter of academic interest, but a humanitarian imperative. It’s vital that these issues be part of any conversation about displacement, informing policy decisions and intervention strategies designed to support displaced people around the world. The DRC people desperately need help from individuals, agencies, organizations, and countries in order to find refuge and safety and gain access to critical mental health services. Since the beginning of the war, different organizations should have set up several projects to support displaced BaCongos. These could include providing emergency food and medicine, supporting the salaries of psychologists, social workers and other multidisciplinary workers assisting internally displaced citizens and trainings to identify individuals suffering from trauma and refer them to qualified mental health specialists.
The burden of depression, anxiety and other mental disorders call for concerted, intersectoral responses. The aim is not only to raise public awareness, but also to provide treatment and prevention strategies that can reduce this large and growing health problem and its associated economic cost. The correlations between poor mental health and an increased prevalence of musculoskeletal conditions, multiple areas of pain, chronic and preventable diseases emphasise the need for an effective and holistic multidisciplinary approach to managing these conditions.
Person-centred rehabilitation services for mental health should be implemented in many different health and mental health settings. High attention to mental well-being and coping strategies must be incorporated while evaluating basic needs, even in temporary settings.
Morgen Makombo Sikwila
MSc in Peace and Governance
BSc Counselling
Diploma in Environmental Health
Certificate in Marketing Management
Email address: morgensikwilam@gmail.com
Phone Number: 0772823282
