The urgency of addressing mental health for Syrian refugees

When Secretary of State John Kerry visited a vast camp for Syrian refugees in Jordan last month, refugees implored him to take action to stop the killing in their homeland. Their desperate pleas made news around the world, and illustrated the intense mental anguish that has accompanied physical atrocities in Syria’s civil war.

The secretary’s visit to the Za’atri camp came the same week that UN officials deemed Syria the worst refugee crisis since the Rwandan genocide. And in June, a UN Commission issued a dire warning: “War crimes and crimes against humanity have become a daily reality in Syria where the harrowing accounts of victims have seared themselves on our conscience.”

But amidst the collective horror and political debate, an important question looms: What are the psychosocial needs of those survivors whose “harrowing accounts” we read in the news and whose suffering we watch on YouTube? Who is caring for those refugees? Who is tending to their mental health and facilitating their recovery?

Millions of Syrian civilians – men, women and children – have been tortured, imprisoned, raped, and shot at while fleeing from the ever-escalating conflict. They’ve personally witnessed brutal treatment, including the massacre of entire families and the destruction of homes and neighborhoods. As the political and sectarian violence facing Syria becomes more pronounced, the need to address refugees’ psychological distress becomes more urgent.

In Jordan, home to about a third of the 1.5 million Syrian refugees, the Center for Victims of Torture has a team of therapists who provide mental health care and physical therapy to Iraqis and Syrians who fled the fighting in their countries. Although we haven’t publicized our services, we have a waiting list of of potential clients of more than 700, the vast majority coming from Syria.

Such a large response, especially without any public outreach, is unprecedented for us. After several past conflicts, including those in Sierra Leone, Liberia, and the Democratic Republic of Congo, our organization worked closely with community leaders. We conducted public education activities to explain the effects of violence and how mental health care can help individuals and communities regain control and resume basic functions.

By contrast, the Syrians who seek us out are not waiting for public outreach campaigns. Up to 50 Syrian refugees a day come to us with requests for psychosocial and mental health care for themselves, their children, and other severely distressed family members. They are distraught – sobbing uncontrollably, sharing stories of unimaginable terror, showing our counseling staff pictures of killings that happened in front of their eyes.

Their stories are heart-breaking. Parents are desperately worried about their children, who are wetting the bed, covering their ears and crying when airplanes pass overhead, clinging to their parents, and unable to concentrate at school. The parents want to help their children, while struggling with their own horrific experiences and feelings of failure that they could not protect their little ones from harm.

Children as young as four have been imprisoned and tortured. One young child was kidnapped, thrown in a dark jail cell, and left for several days before freed. The child is numb – no longer speaking or playing.

We are struck by the courage and resilience of Syrian refugees as they struggle with their daily lives. They, and all torture and war survivors, deserve better. And having provided care to nearly 24,000 survivors of torture and war since our inception, we at the Center for Victims of Torture know that mental health services can provide a ray of hope amidst the barbarities of conflict.

Therefore, last fall, the center made a Commitment to Action at the eighth Annual Meeting of the Clinton Global Initiative to provide mental health and physical therapy services to the traumatized Syrian refugee population in Jordan over the next three years. This commitment includes increasing treatment capacity at our existing clinic in Amman, and adding a mobile unit that travels daily to places in Jordan with large concentrations of Syrian refugees.

It is understandable that humanitarian aid during conflict is focused on basic needs: food, shelter, and medical care. For example, many Syrian refugees who fled to neighboring countries and the millions who are internally displaced live in sub-standard, make-shift housing. The UN and international agencies responding to the crisis remain severely under-funded.

But many will need skilled and appropriate mental health care to recover.

Some survivors may develop enduring mental health problems if they cannot access specialized mental health care. They will struggle with all the challenges any refugee must face but will do so while also feeling deep despair, anxiety, and psychological pain. For some, they will be unable to function and to provide for themselves or their children.

Wealthy nations must step up to the plate – and one way they can do so is by providing more robust contributions to the UN Voluntary Fund for Victims of Torture. Established in 1981, the fund awards grants that bring medical, psychological, legal aid, and financial support to torture survivors and their families. The United States has been a leader in this effort, but it could do more to encourage allies to make comparable contributions and prioritize mental health.

With more resources, the UN voluntary fund would be well-equipped to support torture survivor programs, including those in countries hosting large numbers of Syrian refugees, such as Turkey, Lebanon, and Jordan, and where resources have been exhausted.

Through our work and our Clinton Global Initiative commitment, we bear witness to the most horrific acts of humanity each day. But we also see the possibilities for resilience when people are empowered to rebuild their lives.

It’s urgent that the international community escalates its efforts to ensure that skilled, culturally appropriate care reaches displaced Syrians – care that addresses their internal suffering and recognizes their humanity.

Curt Goering is executive director of the Center for Victims of Torture, a Minnesota-based international nongovernmental organization dedicated to healing survivors of torture.