In a new UNHCR programme, trained refugee volunteers are protecting and promoting the mental health and psychosocial well-being of camp residents.
By Morgane Roussel-Hemery
San Lin is a mother of two who lives in Thailand’s Umpiem refugee camp, 12 kilometers from the Myanmar border. Her daughter has severe autism and her son suffers from polio. She is stressed and worried about her children and suffers from insomnia as a result.
Thailand currently hosts over 90,000 refugees in nine refugee camps along the Thailand-Myanmar border. Many refugees – who are mainly ethnic Karen, Karenni and Burmese – have lived in these camps since the mid-1980s after fleeing conflict between ethnic armed groups and the Myanmar army.
Like San Lin, many refugees face daily stressors that inevitably complicate and affect their mental health. Additionally, with widespread misconceptions and a general lack of knowledge about mental health issues, only 2 percent of camp residents registered to seek Mental Health and Psychosocial Support (MHPSS) services this year.
In response, UNHCR, the UN Refugee Agency through its implementing partner, Humanity & Inclusion, launched a new program dedicated to MHPSS. The objectives of the program are to raise awareness and strengthen community support – allowing campers to not only have a better understanding of mental health, but also to be empowered with coping strategies.
Recently, San Lin was visited by Do Nu Ei, 25, a young mental health staff member based at the camp. She is part of eleven newly trained MHPSS refugee staff in five Thai refugee camps. Do Nu Ei was selected based on her educational background and her ability to work with people with disabilities. She listened carefully to San Lin’s problems, gave her advice and ended the session by teaching her some deep breathing techniques to manage her anxiety. For San Lin, regular home visits from Humanity & Inclusion staff provide her with “comfort and encouragement.”
Home visits are not the only activities organized by staff like Do Nu Ei. They also organize regular workshops for camp residents to raise their awareness of mental health issues, learn how to alleviate them and methods to help members of their community.
Tami Lu, 23, camp-based mental health staff at Mae La Camp – Thailand’s largest refugee camp – recently organized a workshop for ten participants. Participants in these workshops are selected based on a mental health assessment conducted by the Humanity & Inclusion team.
Even before enrolling in the MHPSS program, Tami Lu provided an attentive ear to his neighbors and siblings to relieve stress. Now, his skills serve the community at large.
During his workshop in Mae La, he started the session by asking participants how much they knew about mental health. They knew very little.
To allow them to understand, Tami Lu draws on their daily experiences as examples. “For example, we start with a situation and analyze their thinking, feeling and reaction – including physical reaction,” he explains. “The objective is to make participants aware that mental health illnesses can cause physical reactions such as pain or insomnia. The effect is physical, but the cause is mental.”
Physical activities are also used to better explain how mental health illnesses arise. During one of their stress management sessions, Do Nu Ei asked Umpiem workshop participants to stand on one leg while holding a book in one hand. She gradually gives participants more books and items to hold. Once they couldn’t pick up the load, all the items would eventually fall to the floor.
“Then, I repeat the same exercise, telling the participants that they can ask someone else for help,” Do Nu Ei said. “When they get support, they realize they can stand on one leg longer or carry more things. The purpose of this analogy is for them to understand that negative thinking is like a pile of books. If they are already in a fragile position and continue, the stress accumulates and you may collapse over time. But if you ask for help, someone can take the burden off your hands – literally and figuratively.”
“In the past, when I was overcome by negative feelings, I would sometimes stay at home doing nothing, not moving, not eating and not sleeping,” said a young refugee who participated in the activity. “By joining the workshop, I realize that these coping mechanisms are toxic, but other people feel the same way I do. We learned that we can support each other.”
Art therapy workshops are also held to help campers channel their energy and frustrations. Making art, as many studies have found, can be very therapeutic. The act of drawing, painting, and other forms of creativity can significantly lower levels of cortisol, or the “stress hormone.”
Do Nu Ei asked Umpiem camp residents to create “hapa-zome” – or leaf color art. Participants were handed empty bags and flowers and leaves on top. Next, they smash the flowers and leaves onto the fabric with a hammer, transferring their natural pigment to the fabric. To further release, they were encouraged to shout “trouble, get out” as they smashed their bags. With easily found tools and materials, participants were empowered to manage their stress and create art.
Considering the challenges and stressors that refugees in the camps face every day, community-based psychosocial support is essential. The strategies that Tami Lu and Do Nu Ei use are simple, but they empower refugees – giving them the tools and knowledge to manage and improve their own mental well-being, and to be able to help other community members in need .
At the end of the home visit, San Lin’s breathing slowed and she felt calmer. “The breathing exercise helps me control my thoughts,” she says. “When I overthink, can’t sleep and feel anxious, I do exercise and it helps me calm down, lower my heart rate and relieve anxiety.”
