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Refugee volunteers trained in a new UNHCR program are protecting and promoting the mental health and psychosocial well-being of camp residents.
By Morgan Russell-Hemery
San Lin is a mother of two who lives in Thailand’s Umphim refugee camp, 12 kilometers from the Myanmar border. Her daughter has severe autism, and her son suffers from polio. She worries and worries about her children, and suffers from insomnia as a result.
Thailand currently hosts more than 90,000 refugees in nine refugee camps along the Thailand-Myanmar border. Many refugees—mainly from the Karen, Karenni, and Burmese ethnic groups—have lived in these camps since the mid-1980s, fleeing conflict between ethnic armed groups and the Myanmar military.
Like San Lin, many refugees face daily situations that cause stress and damage their mental health. In addition to widespread misconceptions and a general lack of knowledge about mental health issues, only 2 percent of campers registered for mental health and psychological support (MHPSS) services this year.
In response, UNHCR, the UN refugee agency through its implementing partner, Humanitarian and Inclusion, has launched a new special program on MHPSS. The program’s goals are to raise awareness and strengthen community support – not only to help campers better understand mental health, but also to encourage coping strategies.
Recently, San Lin was visited by Do Nu Yi, 25, a new camp-based mental health worker. She is part of eleven newly trained MHPSS refugees in five refugee camps in Thailand. Do Nu Yi was selected based on her educational background and her expertise in working 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 by Humanity and Inclusion staff give her “comfort and encouragement.”
Home visits aren’t just organized by staff like Do Nu E. In addition, campers organize regular workshops to increase their awareness of mental health issues, learn how to alleviate them, and learn ways to help members of their own community.
Tammy Lu, 23, a mental health worker at Mae La Camp – Thailand’s largest refugee camp – recently organized a workshop for ten participants. Participants in these workshops are selected through a mental health assessment conducted by the Humanities and Inclusion Team.
Even before enrolling in the MHPSS program, Tammy Lou was attentive to his neighbors and siblings to relieve stress. Now the talent serves the community at large.
In a workshop at Me La, he started the session by asking participants how much they knew about mental health. They knew very little.
To allow them to understand, Tammy Lou draws on their everyday experiences as examples. “For example, we start with one situation and vary their thoughts, feelings and reactions – including physical reactions,” he explains. The aim is to make participants aware that mental health conditions can cause physical reactions such as pain or insomnia. The effect is physical, but the cause is mental.
Physical activity is used to better explain how mental health disorders arise. In one of their stress management sessions, Do Nu E asked participants to stand on one foot with a book in one hand at the Umpim workshop. She gradually gives participants more books and items to hold. Once he can’t take the load, all the items will eventually fall to the floor.
“After that, I start the same exercise by telling the participants that they can ask for help from someone else,” Do Nu E said. “When they get support, they find they can stand longer on one leg or carry more objects. The purpose of this comparison is to help you understand that negative thinking is like a pile of books. If they are already in a vulnerable position and continue, the stress will accumulate and they may eventually collapse. But if you ask for help, someone can take the load off your hands—literally and figuratively.
“Before, when I was overwhelmed by negative emotions, I would sometimes stay at home without doing anything, without moving, without eating or sleeping,” said a young migrant who participated in the movement. “By joining the workshop, I realized 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 held to help campers channel their energy and frustrations. Many studies have shown that creating art can be highly therapeutic. The act of drawing, painting and other creative activities significantly reduces cortisol or “stress hormone” levels.
Du Nu E has Umpim camp residents create “Hapa-Zome” – or leaf-paint art. Participants were given empty bags with flowers and leaves on them. Then smash the flowers and leaves on the fabric with a hammer. To release more, they were encouraged to smash their bags and shout, “Troubles, go!” With readily available tools and materials, participants are empowered to both manage their anxiety and create art.
Community-based psychological support is essential given the challenges and stressful situations that refugees in the camps face on a daily basis. The strategies, Tami Lu and Do Nu Ei say, are simple, but they empower refugees – they can manage and improve their tools and knowledge, and help community members in need.
As the home tour ended, San Lin’s breathing slowed and she became more calm. “Breathing practice helps me control my thoughts,” she says. “When I’m overthinking, sleepy, and stressed, I do the exercise and it calms me down, lowers my heart rate, and relieves stress.”
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