Fighting Stigma and Providing Mental Health Care to Syrian RefugeesBeyond Conflict
Yasmeen is a 28-year-old woman with an effortless smile, a mother of three boys and a little girl, living in Za’atri Refugee Camp in Jordan, one of the world’s largest refugee camps — and where two of her children were born. Yasmeen is one of over 10 million Syrians displaced by war, many of whom experience post-traumatic stress symptoms just like she does.
In the past seven years living in Za’atri, an urban settlement of tents and shipping containers, Yasmeen has been constantly looking for a way to cope with frequent nightmares and intrusive reminders of the war in Syria.
Displaced populations like Yasmeen’s face a higher risk of experiencing mental illness, while also dealing with a strong stigma associated with discussing their symptoms and seeking care. Though the physical, social, and economic toll of mental illness is great, the international assistance dedicated to mental health accounts for just 0.3% of all development assistance for health. This has left many refugees with scarce resources to address the crippling emotional and psychological burden associated with forced displacement, trauma and violence.
Yasmeen was the last person to be recruited for a new psychosocial support program in Za’atri, the Field Guide for Barefoot Psychologists. The Field Guide was born in Jordan, as a result of a collaboration between a local network of Syrian refugees, and experts in the fields of neuroscience, clinical psychology, and community development. The Guide tells the story of two displaced Syrian siblings, Isra’ and Ahmad, in order to explain the science behind how the brain and body react to the trauma and stress of forced displacement. The book, which will soon be available as a mobile application, also incorporates exercises for self-care and stress management.
As part of the first group of participants in the Field Guide, Yasmeen went through 18 group sessions over the course of 10 weeks. The sessions were led by community facilitators — refugees living in Za’atri, women just like her who had received Field Guide training. As Yasmeen read about the journey of Isra’ and Ahmad, she learned tactics to control her nightmares and intrusive thoughts, and also that the way she felt was not uncommon, but experienced by many members of her community.
Yasmeen talks about herself as “Yasmeen before” and “Yasmeen after” the Field Guide. Before, she felt constantly nervous and anxious, while experiencing permanent pressure on her chest. After the sessions, she described herself as a courageous woman who is able to face herself and her children in a better way. She has become a pillar of support to other women in her neighborhood, guiding them through breathing exercises and encouraging them to get more in touch with their bodies and talk about their emotions.
In addition to the lack of mental health resources, stigma remains a major barrier to mental health care in the Middle East and North Africa (MENA) region. Through storytelling and group sessions, the Field Guide is able to encourage the discussion of mental health symptoms, normalize common reactions, and directly target stigma.
More than 250 people have participated in Field Guide activities, in Jordan, Syria, and Lebanon. The Field Guide’s impact study was completed in 2019, and initial results suggest that structured use of the Field Guide plays a positive role in encouraging the use of mental health services, normalizing trauma symptoms, increasing resilience, and improving psychological symptoms of trauma.
Mike Niconchuk, Project Lead and Beyond Conflict Senior Researcher, is optimistic about the future of the program.
“The Field Guide is a non-clinical, community-based model for psychosocial support that has the potential to fill a large existing gap in global programing with displaced communities in training those working with displaced individuals.”
Niconchuk believes in the program’s potential for scalability as it is cost-efficient and does not require the sustained presence of trained mental health or clinical professionals. The Field Guide can also be implemented by a small team under limited supervision. With additional support, Niconchuk hopes to apply the Guide to emerging psychosocial crises around the world, including Venezuela/Colombia, Central America, and communities in the United States.
Yasmeen credits the Guide with a “transformation” in her life, that it filled a need she had been searching for with various professional services in the camp. She now wants to reach as many people as possible with what she learned.