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Supporting the mental health of refugees: lessons from the UK's Afghan resettlement scheme

Expert Comment

Written by Rabia Nasimi

When the Taliban regained control of Afghanistan in 2021 two decades after being removed from power by a US-led military coalition, the UK Home Office announced its initial response: Operation Pitting kicked in.

Through this scheme, the UK Government evacuated around 15,000 people to safety. This included British nationals and their families, Afghans who loyally served the UK and others identified as particularly at risk such as campaigners for women’s rights, human rights defenders, Chevening scholars, journalists, judges and members of the LGBT+ community.

This was the largest and fastest emergency evacuation in recent UK history. Since the end of Operation Pitting, the government has continued to bring people to the UK. Unfortunately, in spite of this, many more Afghans continue to live in fear in Afghanistan and its neighbouring countries, awaiting news of their relocation.

It is important to acknowledge that the country's return to the oppressive and barbaric Taliban regime will have severe mental health consequences not only for those who remain in Afghanistan but also for those who have been evacuated and are now in a safe country. Twenty three years ago, my family fled war-zone Afghanistan and had to adjust to a new life and language in London. As well as first-hand experience, I have worked closely with Afghans at the Afghanistan and Central Asian Association (ACAA) and within the Civil Service when I was part of the Afghan resettlement team.

The mental health of Afghan migrants and refugees

It is common for people who have fled their country due to persecution or conflict to suffer from anxiety, PTSD, depression and other mental health conditions. The trauma that often acts as a catalyst for people to leave their home, or that happens along their migration journey, does not disappear post-migration. In fact, many people struggle severely with survivors’ guilt once they reach safety, which adds to the trauma experienced directly after the event itself. Many factors such as trauma experiences in the asylum system and the legal limbo, language and cultural barriers, isolation, and a loss of identity can trigger further mental health challenges.

Among the Afghan community, perceptions of mental health tend to be quite negative as there is little awareness of the meaning and importance of mental health. For some, the term mental health is quite new, and people are unaware of the equivalent words for depression, anxiety and isolation in their mother tongue. Some view mental health conditions from a religious perspective, believing it to be a punishment from God. As a result, they may turn to religion for answers, looking inwards at times of struggle and not seeking support from family, friends or professionals.

The taboo and stigmatisation of mental health in Afghan society and lack of culturally appropriate services means that there is generally a low uptake of support. It is unlikely, therefore, that for most of these individuals the underlying issues will have been successfully confronted and treated. A very considered, trauma-informed and holistic approach is needed to ensure that refugees talk about their needs and feel comfortable to seek help. Safeguarding and specialist, culturally sensitive support is required to ensure that the mental health for Afghan refugees and resettled persons is managed.

Mental health support and integration

Health, including mental health, is just one of the important markers and means to successful integration. Another is learning the language of the host society – in our case English. Mental health struggles tend to impact negatively on an individual's concentration and willingness to learn. It can impact one’s attention and memory as well as the ability to process information. This makes it really important for educational providers to take innovative approaches towards organising lessons, ensuring that refugees are interested in taking up classes and can engage effectively. Understanding the language is vital to integration and wellbeing, opening up many opportunities for refugees, whether to make friends and feel part of the community, volunteer and seek employment, navigate daily life, or take part in formal education.

Tips for refugees and asylum seekers:

  • Get involved locally. See if there are any services that you can access and attend. This will provide an opportunity to make friends and take your mind away from what causes you distress.
  • Connect with others. Meet people who are in a similar situation to you or those who have gone through similar journeys. You can learn from others on how they are coping.
  • Spend more time outside. Whether it’s at a local park, museum or just a walk. The more you stay at home, the less chance you have to put your thoughts aside.
  • Be active and look after yourself. Exercise has proven scientific benefits for mental health, stimulating the release of mood-boosting chemicals in the body. It also gives people the chance to work towards a goal and can boost self-esteem.

Tips for host community to welcome and support refugees:

  • Educate yourself. Learn the facts about refugees – and in this case specifically about Afghanistan. Do you know enough about the history and culture and current situation to know why they face particular mental health pressures?
  • Advocate for refugees. You can speak to your local councillors and MPs to let them know that you’re eager for refugees to be resettled in your community. You can also talk to them about the need for refugee services to support their mental health and overall integration.
  • Donate. You can support them by providing essential household goods or gadgets so they have the necessary essentials to begin a new life. Having access to a phone or tablet or laptop can enable them to stay in touch with friend and family and positively impact their mental health. Charities such as Screen Share UK are a good place to start!
  • Provide volunteering/ employment opportunities. Many refugees struggle to find work and giving them access to the world of work is one way to pave their journey to integration. Volunteering could give them the CV boost and reference that they need to get into paid employment. If you have a business and can bring in some refugees to help do, consider it– or speak to your managers to enable such opportunities.

Resources

Moments for Mindfulness. A self-help guide to managing stress and uncertainty by the Refugee Council.

City of Sanctuary’s Mental Health Resource Pack aimed towards professionals working with refugees and asylum seekers.
A trauma workbook developed by Good Thinking to help those who have experienced trauma to process their emotions and begin to heal.

ACAA’s Mental Health Resources information is specifically tailored towards refugees with limited English. Financial, cultural or language barriers to accessing mental health support mean many people have little option but to turn to self-help.