Refugees deliver mental health services to locked down camps

Ayat Al Huseein: refugee community psychosocial worker helps other refugees tackle mental health issues

“In some ways, this job has helped me rebuild my own life. I can now help others heal and develop mental health resilience, too,” says Ayat Al Huseein, a thirty-year-old refugee from Syria, who left with her family by boat for Greece about three years ago and is now working as a psychosocial worker. She is part of a project offering refugees and asylum seekers psychosocial assistance.

“I meet people who are very diverse, as are their psychosocial needs, which means I need to adapt my response accordingly. When I visit a person who has requested assistance or has been referred to us, I use the competencies acquired during my training and rely on my personal skills. Before leaving Syria, I worked as a teacher and my ability to communicate, actively listen and empathize serve me well.

“Refugees’ psychosocial needs vary depending on lived experiences, age, gender and background, but I strive to help them all find hope again for what the future might bring.”

Impactful multidisciplinary collaborations

“Psychosocial support can come in various forms – some refugees require emotional comfort, others need to be motivated to join activities that can help them establish ties with local communities, and yet others need practical support in carrying out day-to-day tasks.

“I help refugees by listening to their stories and identifying organizations or actors that offer the services they need to get better, like language classes or assistance in accessing health care, legal counsel or finding a job. Mental health issues require a comprehensive, multisectoral response.

“When refugees face severe mental health issues, I turn to my team leader and other health care professionals. This collaboration is essential to ensure a holistic and multidisciplinary approach to refugees’ mental health, and we continuously emphasize the importance of coordination among all actors on the ground, to help refugees become autonomous again.”

Ayat and her colleagues refer to various WHO-issued manuals for mental health field workers, such as Psychological first aid: Facilitator’s manual for orienting field workers, Psychological first aid: Guide for field workers, and Problem Management Plus Individual psychological help for adults impaired by distress in communities exposed to adversity.

Sharing similar stories helps make meaningful connections

“One of the best features of this project is that the community psychosocial workers are refugees themselves. As we often share similar stories, culture and language, refugees have an easier time confiding in us because they know we can truly relate to their experiences. This makes it easier to build a relationship and a meaningful connection.

“I once met a woman who was dealing with anxiety and depression. She was listless, had no friends, and would even forget to pick up her children from school. We began to meet regularly and, over time, she made substantial progress. We managed to help her sign up for language classes, find a job, and attend cultural events, where she found friends. She was able to change her life.

“It is these experiences that keep me motivated at work. I want to help people and see them improve. I wish for this project to continue and reach everyone who needs it across all countries.”

The COVID-19 pandemic has altered but not stopped psychosocial workers’ efforts

The current COVID-19 pandemic may further exacerbate refugee mental health conditions, as public health measures, social isolation, food and medicine insecurity, and quarantine may act as triggers of past traumas. The lives of asylum seekers and refugees in countries of arrival, even before the pandemic, are also often fraught with social, cultural, linguistic and legal barriers which may exacerbate or cause psychological challenges.

Asylum seekers and refugees may experience intense feelings of depression, anxiety and loneliness due to past traumatic experiences, which may be a consequence of various stress factors related to hardships experienced in their country of origin, migration journey or living conditions in the European Region.

“Since the pandemic began, we have not been able to visit persons of concern in their homes and must instead meet online or over digital tools. We make use of all possible services, ranging from regular phone calls to video chats and social media channels,” Ayat explains.

“Some have been reluctant to resort to technological tools to communicate, and many required some time to adapt, just like we, psychosocial workers, also had to adjust to the new circumstances. However, I really believe that despite these challenges, we have been successful in continuing to offer the care and support refugees need.”

Ayat has worked at EPAPSY – the Association for Regional Development and Mental Health – since November 2019, providing psychosocial support to adult refugees and asylum seekers who live in the urban areas of Attica in Greece. From January to September 2020, the Community Psychosocial Workforce project has provided its services to 92 beneficiaries, including people experiencing homelessness, self-accommodated individuals and persons of concern identified in the Emergency Support to Integration and Accommodation programme implemented by the United Nations High Commissioner for Refugees in collaboration with local authorities and nongovernmental organizations, and funded by the European Union’s Civil Protection and Humanitarian Aid Operations.