The Need of Golden Hours in Tragic Times: Mental Health initiatives to support the Refugees

Vandita Bajaj

Remedial Blog Post for Mid Term Exam

The ongoing refugee crisis has been the subject of immense debate across the world. Millions of people have been displaced as a result of extreme violence. And while there are countries who have given them asylum, and organizations that have sanctioned aid, the mental health issues faced by refugees have rarely been given the attention they deserve. Especially, children, who grow up in extreme-conflict zones, which means all they have known in their formative years is violence and instability. More often than not, they have no semblance of a routine of any kind since schools aren’t operational and neither can they freely play in the streets for there is always the fear of an impending attack. If at all they make it to the safety of refugee camps in other countries, the journey which they are forced to undertake is a dangerous one. Essam Daod, the founder of Humanity Crew, in his TED Talk, highlighted the need for immediate psychological intervention for children entering refugee camps.

He shared a personal anecdote, about his interaction with a young 5-year old boy, Omar, who was a Syrian Refugee. He saw him at the shore of Lesbos, Greece when Omar had just arrived in a rubber boat. Omar looked frightened, he was crying and wasn’t able to make sense of the flurry of activity around him, the uniformed guards with their guns only scared him further. Essam Daod knew he had to help Omar immediately, before, what he describes as, “the golden hour” passed away. According to Daod “the golden hour” consists of the few moments following the arrival of the refugees to campsites. It is in these moments that children’s memories can be reframed. In their 15-minute chat, he told Omar that the noisy police helicopter hovering over them was there to take pictures of him because he was a brave hero. The idea behind having such a conversation is that it reframes the emotional memories that are stored in the amygdala. According to Daod, this little intervention can decrease the chances of development of Post-Traumatic Stress Disorder and other mental health problems such as depression and anxiety, in the future. In the example of Omar, “the smell of the sea will not just remind him of his traumatic journey from Syria. Because to Omar, this story is now a story of bravery” exclaimed Daod.

But not every child is as fortunate as Omar, the lack of immediate psychological aid means that a lot of children have difficulties in overcoming their trauma and as a consequence, they experience difficulties in adjusting to the new environment. With the conflict being far from over, the number of refugees is going to increase substantially in the foreseeable future. If the right kind of mental health services are not made accessible to them, the challenges they face are only going to multiply. But the fight isn’t theirs alone. Very often the inadequate adjustment results in maladaptive behaviours. The lack of access to education and jobs, among other exclusionary policies, forces many to turn to pickpocketing or small-time jobs where there is rarely any scope for social upliftment. Often children see the mistreatment faced by their parents and internalize the feelings of hate and jealousy towards the out-group. Surely, they question where the “better life” promised to them is to be found.

Refugee Mental Health could result in a public mental health crisis. Stopping that from happening, requires not only policy efforts and psychological first aid but also a change in the way the general public perceives them. It is imperative to create supportive environments to aid their adjustment and inclusion. According to Silove, Ventevogel, and Rees (2017) “interventions aimed at creating a supportive environment which facilitates the capacity of refugees to restore their lost resources will advance the overall aim of promoting resilience and mental health.” This means sensitizing people about the impact that conflict has had on them and the role that they can play in their aid.

It is also important for clinicians to understand that refugees come from a different cultural context and the popular therapies used in the West won’t be of much help. Due to their prolonged exposure to volatile environments, they lack a sense of safety, are sceptical about intuitional frameworks since they have only been at the receiving end of hostility from them justice, they often have a negative conception of the self and experience great difficulties is forming interpersonal bonds. For many “the golden hour” passes and their road to recovery is slow, but hopefully, with increased awareness and recognition about the problem many more refugees can have that 15-minute chat that could make things a little better…

References:-

Daod, E. (2018). How we can bring Mental Health support to Refugees [Video File]. http://www.ted.com/talks/essam_daod_how_we_can_bring_mental_health_support_to_refugees

Silove, D., Ventevogel, P., & Rees, S. (2017). The contemporary refugee crisis: an overview of mental health challenges. World psychiatry : official journal of the World Psychiatric Association (WPA), 16(2), 130-139.