Refugee experience is essentially an experience involving a loss. Loss of what is obvious, tangible and external such as possessions i.e. a house, a work role, a status, a language, beloved members of the family or other closed relationships; also a loss which is less obvious, internal and subjective: loss of trust in oneself and others, loss of self-esteem, self-respect and personal identity. You are suddenly stripped off things which link you with your community. The absence of all these links brings on stress, anxiety, depression and disorientation.
The long waiting time to process an asylum application is very harmful for mental health. Refugees think they have gained freedom and then they realize that they still have to wait for it. They become passive, they lose their self-esteem, especially in cultures where the family welfare depends on the man.
Living in a center for a long time increases social isolation and inactivity.In the UK asylum seekers have limited privileges, however after 6 months they are allowed to work while waiting for their application to be processed by the Home Office. They are also aware that the length of time spent on waiting for the application has no bearing on the ultimate decision. Unfavorable decision can result into deportation at any time. Therefore they live in a dilemma which causes concern and insecurity.
Roles change within the family: in the country of origin men are bread-winner, meanwhile in the host country women could find it easier to get a job (e.g. as housecleaner). The balance within the family cracks.
Split up of families: separation of families makes people nervous and paranoid.
Men come first to Europe leaving their families behind. But family reunion is a long-lasting procedure. So women left back home complain about men who did not do enough to bring them to Europe. This causes mental health problems to men.
Sometimes, when family members arrive, they have been many years without seeing each other; they no longer understand each other and even the cultural unit of the family breaks up.
The cultural shock is very severe from one country to another: the lifestyle changes, asylum seekers are not allowed to work. They remain isolated for a long time, passively waiting for a decision which will affect deeply their life. Their standard of living too decreases.
Minimizing mental health problems, even if minor ones, could be very harmful. There are long waiting list to be treated in specialized medical centers, sometimes up to two years. What is going to happen meanwhile?
Refugees frequently present symptoms such as headaches and tiredness which may be related to stress, financial pressures, language barriers, leading also to isolation and anxiety. Overcrowded council flats hide lone parenthood, especially for women who have lost or are separated from their husbands. Depression and loss of economic status for men make them feel powerless.
Refugee adult and children have specific experiences related to persecution, imprisonment, separation from their family and friends, uncertainty about their future. This causes anxiety and mental stress. There is a high level of psychological, post-traumatic stress disorder and psychiatric illness among refugees.
Cultural factors inhibit refugees from seeking help and treatment for fear of being labeled as mentally ill.
Doctors do not always know the different ways a trauma can be released (i.e. when people cannot sleep, are nervous, have high/low blood pressure, feel pain in their stomach etc). Therefore difficulties over diagnosis may occur if issues relating to traumatic experiences and cultural background are not fully recognized and investigated.
Doctors do not take these patients seriously, they do not want to go into deep as for the psychological area. They do not recognize stress. A holistic approach to health is missing.
Sometimes people are no longer able to speak: there is a wall of silence between them and doctors. Then medical doctors tend to minimize or even deny what happened to their patients, thus not providing them with the right treatment.
Care Link West Midlands under this programme tries to bridge the above gaps through a range of militancy and advocacy activities like:
+ Offering immediate psychotherapeutic help to traumatized refugees
+ Setting up rehabilitation centers to help traumatized refugees to overcome their traumas
+ Alleviate the cultural shock (i.e. organizing camps, festivals together with local people)
+ Faster and more fair decision on the asylum application
+ Making the reunion with family members possible + Providing health education to refugees
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