Reaching new land is just first step for Syrian refugees
Post-migration support crucial to mental health of newcomers, say those who help immigrants
A former refugee from Syria, Hussam Majbour is no stranger to feelings of hopelessness and helplessness.
Although the 34-year-old man fled Damascus for Toronto in 2008 — years before his homeland plunged into turmoil, sparking the worst humanitarian crisis since the Second World War — he understands that reaching a land of safety is just the beginning for the 25,000 Syrian refugees starting to arrive in Canada.
Soon, Majbour said, the new, stressful reality of securing housing, jobs, schools and a social support network will sink in — and that’s when the newcomers’ mental health will be most vulnerable.
“They have lost everything and left behind repression and poor conditions back home. It is important they have housing, jobs and social support,” said Majbour, who has a degree in English literature and has found support by volunteering as an interpreter at the Canadian Centre for Victims of Torture.
“They need to feel included and welcomed and be connected with their new community. Mental health could be an issue if they are isolated without the social support they need.”
While many who will be arriving in Canada in the coming months will have experienced first-hand the horrors of war and perhaps have lost loved ones, experts say worries over the resettled Syrians’ psychiatric needs are overblown.
In fact, the World Health Organization estimates that less than 4 per cent of the adult Syrian refugee population suffers severe mental disorder such as psychosis, severe depression or anxiety that cripples their functioning.
Rachel Kronick, a psychiatrist with Toronto’s Centre for Addiction and Mental Health, said resettled Syrians arrive in Canada as permanent residents, “a huge stepped-up advantage” over asylum seekers like Majbour, who must live in limbo and face deportation if their claims are rejected.
“These families have been through suffering and exposure to violence, but only a minority of them would have psychiatric disorders as a result,” said Kronick, who also teaches at the University of Toronto.
“What we should look at are the social determinants of mental health. If they are well taken care of, can find housing, don’t live in poverty and are embraced in school and do not face racism and discrimination, there is no question our health system can handle it.”
While health professionals only play a small part, mostly in cases involving severe psychiatric problems, frontline immigrant settlement workers are really the ones tasked with the newcomers’ overall well-being, including their mental health.
Debra Stein, who co-heads the migration team at the Hincks-Dellcrest Centre mental health service in Toronto, said many cases she has seen are the outcome of unmet settlement needs.
“They came out of war, conflicts and atrocities. We need to promote their resilience and offer them proper post-migration support. The big message here is resilience, not pathology,” said Stein.
Research has shown that how young children are able to adapt vastly depends on how well their parents cope with postmigration stress. But Toronto psychotherapist Pearl Goodman said trauma experienced by adults can transmit to their kids in overt ways.
Goodman, herself the daughter of Holocaust survivors, said the way adults react to their own trauma often interferes with their everyday routines. Although she was born in Canada, her parents’ experience always cast a shadow on her outlook.
“You pick up from the way your parents react to the world. Growing up, I was anxious and afraid that being Jewish was a liability and not an asset. I was wary of what people would think of me as a Jew,” said Goodman, author of When Their Memories Became Mine, a book on her experience.
“They need to feel included and welcomed and be connected with their new community. Mental health could be an issue if they are isolated without the social support they need.” HUSSAM MAJBOUR FORMER REFUGEE
Recognizing that children are less articulate in expressing their emotions, the group Windsor Women Working with Immigrant Women runs a project that helps youth between 14 and 25 who have experienced war trauma express their emotions through art.
The daily after-school program helps young people with their school work, but also, through its multi-media arts component, gives them a chance to recognize and embrace their past experience and new reality. A similar program will be launched next year for adults who experienced trauma.
The agency also offers mental health training to community partners such as hospitals, children’s aid societies, police and fire departments in dealing with clients from different parts of the world.
“There is a lot of learning, unlearning and relearning needed,” said the agency’s executive director, Sudip Minhas.
Aseefa Sarang of Across Boundaries, a Toronto health agency, agrees.
“We often position refugees as lacking, as a burden. Instead of recognizing their resilience, we are assuming their deficiencies and that we are doing them a favour,” said Sarang, whose organization offers mental health and addiction support to migrants and racial minorities.
“We need to throw out these assumptions and stereotypes and help these refugees see their values and strengths, so they won’t internalize these feelings and can move forward.”