Chloe Hall, Author at Poverty Child

Self-help Strategies for Young Refugees’ Mental Wellbeing

UNHCR presents some sobering statistics on the numbers of people around the globe forced to leave their homes. By mid-2022 there were estimated to be 103 million refugees. That is approximately one and a half times the total population of the UK, and about one and a half percent of the world’s population. Of that unimaginably huge number, over a third – or 36.5 million – were under the age of eighteen. Strikingly it is calculated that a thousand children every day are born with refugee status.

The challenges facing these young people and their families are bewildering. Everyday facilities, resources, and community benefits which people in the UK take for granted, amount to little more than pipe dreams. Basic shelter, sanitation, education, health care, nutrition, and earning a living appear dauntingly out of reach, while language barriers and cultural differences in host nations may provoke and embed prejudice and hostility.

Anxiety is commonplace among refugee children

As my previous blog explained, for migrant children anxiety is a prevalent condition for which there is limited scope for formal treatment in many host countries. Nor, regrettably, is there much prospect of that situation immediately improving for the vast majority of the 103 million people presently forced into migration. Resources and services in host nations like Uganda (one and a half million refugees), Columbia (two and a half million refugees) and Turkey (over three and a half million refugees) are critically overstretched and underfunded, despite these nations’ best humanitarian initiatives. It is issues such as the impact of personal and political crises on people’s mental health which leads to conditions like anxiety and depression becoming long term and widespread.

A place for self-help strategies

While there is no substitute for professional advice and help, experts do recommend a series of self-help strategies which can prove beneficial in addressing symptoms of anxiety. Raising awareness about the importance and fragility of mental wellbeing is vitally important for everyone, especially for the most vulnerable people in global communities. Mental health first aiders are trained to promote these self-help strategies to empower people of all ages to attempt to regain some sense of control over their emotional wellbeing. By informing young refugees about practical steps endorsed by specialists they are likely to feel more positive in their outlook on their lives. That would amount to a significant start in appreciating and countering symptoms of anxiety, although there is no denying the uphill struggle which they will continue to face without professional treatment.

What self-help strategies are accessible for young migrant people?

Sports and exercise

Experts suggest that taking regular exercise is beneficial in addressing mental health conditions like anxiety. This could be as simple as going for a short walk. For a lot of young people, linking the issue with physical wellbeing is a natural place to begin. Regular exercise is acknowledged to be affirming for mental wellbeing. It improves fitness and can inspire a positive mood. This is a first step on the way to a broader and more positive outlook, which in turn can start to create a sense of self-esteem.

So if, for example, a group of migrant children were given a second-hand football, they would have the potential to improve their physical and mental wellbeing. Of course, unsupervised they might risk physical injuries, but potential benefits could reach comfortably beyond the children’s wellbeing into the heart of their community, if local people became involved in organising some basic training or informal games.

Thanks to organisations like Fairplay For All Foundation, operating in Payatas, young football players who grow up facing extreme poverty have been selected to participate in the Street Child World Cup, representing the Philippines. This is truly aspirational for others in the community. Imagine the liberating sense of fulfilment galvanised by this opportunity. For the majority of those invited to Doha to participate in this year’s global competition, it would have been their first time flying, just one beneficial aspect of such a broadening experience. Having ambitions like these is a powerful motivator and can certainly impact positively on mental wellbeing. By taking some daily exercise, however informally, young people may benefit from a host of other lifestyle improvements. For example, they are more likely to adopt better sleeping routines.

Building friendships

Moreover, social interaction certainly benefits mental health. This is especially vital as young children develop. Building friendships impacts positively on mental wellbeing, for instance by fostering self-confidence and a greater sense of self-esteem. Aberdeen-based charity, Befriend a Child reaches out to young people who face difficult personal circumstances. Volunteers regularly meet up with the children to help them increase their sense of self-worth, develop new skills, reduce isolation and promote positive wellbeing. Friendships can generate a feeling of belonging, together with a positive and purposeful outlook. This means that interaction with other young people can boost confidence and help to provide a broader perspective on other issues, whether through diversion or by changing a child’s dominant moods. Even something as simple as listening to jokes can help to improve outlook. Enjoying good friendships can also foster a common sense of purpose, which is potentially transformative for mental wellbeing.

Maintaining a balanced diet

It goes without saying that eating a well-balanced diet and keeping hydrated are also important to physical and mental wellbeing. It’s vital that information about these important aspects of everyday life are publicised, perhaps even by word of mouth, as a rudimentary element of any basic educational programme. Funding and resourcing a well-balanced diet for refugees is a huge economic and logistical challenge for host nations, but it is still fundamental to address awareness of these issues among young people.

The benefits of safeguarding mental wellbeing

There are of course other important self-help suggestions to safeguard and improve mental health. For example, mental health first aiders recommend deep breathing exercises, which can be performed almost anywhere and at any time. They can quickly bring a sense of calm to anyone feeling symptoms of depression, anxiety or stress. Young people are also encouraged to write an informal journal, if possible on a daily basis, briefly focussing on positive moments in their lives. These could be as simple as a good sleep, or fine weather. Mental health first aiders also commend mindfulness. While this may not immediately appeal to young people the benefits of calmly focussing on our surroundings and listening to our sensory responses are indisputable.

One important yet understated benefit of being part of a community is the potentially positive impact on children’s mental wellbeing. Bringing young people together, integrating them into informal activities offers a way ahead for migrants and refugees. The benefit of addressing mental wellbeing through self-help strategies may not appear to be as tangible as other fundamental improvements, but in a number of ways it is the most significant of all, helping to transform and empower some of the world’s poorest children.

Signposting help

Various organisations give advice on safeguarding mental wellbeing. For example, the NHS discusses the benefits of self-help tips for improving mental health. Moreover, in 2022 the Mental Health Foundation has produced a series of short, educational films to support refugee mental wellbeing. One tells the story of Mariam, who fled from Syria and now lives in Scotland. The video endorses the Mental Health Foundation’s support programme and promotes tips to improve and safeguard young refugees’ mental health. Hearteningly, in initiatives which the foundation runs in Wales and Scotland, asylum seekers and refugees are recruited and trained to serve as peer leaders. Their role is to foster empathy, understanding, and mental health literacy. By empowering people in this way, young refugees can derive an affirming sense of self-esteem, while appreciating the difference that can be made through constructive mediation.

In conclusion, young refugees can benefit a great deal from talking about mental health issues. Raising awareness and encouraging self-help through educational programmes, however informally, can make a marked difference to the mental wellbeing of young people, particularly when little or no expert medical treatment is available. Community initiatives, especially those which empower people from the refugee community, can prove to be advantageous in more ways than one. Naturally, young refugees benefit from improved knowledge of mental health, but they are also likely to look up to community role models. Anything which inspires young people, no matter what their circumstances across the world happen to be, can become transformational for them, providing them with a more purposeful outlook. This in turn will impact positively on their mental wellbeing.

Chloe Hall In Programmes

Mental health issues facing refugee children

In her recent blog for Poverty Child, Samantha Bunce discusses the detrimental impact of poverty on health. An overwhelming catalogue of challenges facing refugee children is documented in an all too sobering account by UNICEF. Displacement, loss and the complete breakdown of routine are only the beginning. Millions of refugee children, many unaccompanied, are confronted by terrible challenges while travelling before they reach their destination, often without any prospect of a return to their former homes and lives. They appear to have very few options to undertake safe migrations, risking unforeseen exploitation and dangers, for example being forced into child labour, marriage, trafficking, let alone the risk of violence and humiliation. It goes without saying that these children are deprived of an education, basic nutrition, organised medical care, as well as possessions, friends and relatives. As personal tragedies unfold and compound, daunting problems await further down the line. How challenging it must be to try fitting into a new community so different to anything previously experienced. Initially there is political bureaucracy to negotiate; inevitable prejudice; language barriers; cultural differences; and the lasting impact left by the pandemic. Organisations like UNHCR, UNICEF, and Save the Children present arrays of statistics to highlight the suffering and deprivation associated with the plight of refugee children, but it is a sad reality that long-term mental health issues can be all too easily overlooked by the new host community. The old notion that a broken leg is easier to treat than a mental health condition, because it is clearly tangible, remains totally applicable.

What forms of anxiety can refugee children experience?

Anxiety occurs in many forms. For example, Separation Anxiety which especially affects younger children. If refugee children are separated from a parent or relatives, then they are susceptible to powerfully specific feelings of being unsafe and unloved. New circumstances and contexts can make them feel bewilderingly upset, even if they are with people they know and love. While it is perfectly natural for children to miss their parents for a few hours or even a few days, imagine the emotional prospect of being separated on a seemingly permanent basis. They may be clinging to hopes of being reunited, as well as vividly recalling final goodbyes. Suddenly having to cope without the support of loved ones, in unfamiliar and dangerous situations would seem utterly daunting to refugee children. Some do take with them one or two personal possessions which they strongly associate with their homes and relatives. While these can prove to be affirmingly comforting they can also provoke poignantly sad memories. The NHS discusses Separation Anxiety here.

Generalised Anxiety Disorder (GAD) is a chronic condition. Anyone suffering from GAD is likely to be preoccupied about a past event or specific people a great deal of the time. It can have a hugely inhibiting impact on a child, to the point where it becomes difficult for them to concentrate or socialise. The condition is linked to Social Anxiety Disorder, where children become withdrawn because they feel convinced that they will be judged, mocked, and bullied by those around them. Experiences of child refugees mean that they are particularly susceptible to these mental health conditions. The NHS discusses Generalised Anxiety Disorder and Social Anxiety Disorder here.

Post-Traumatic Stress Disorder (PTSD)

Unsurprisingly, child refugees commonly suffer from PTSD. They have often witnessed terrible events and losses. They are prone to mental health aftershocks which include panic attacks, nightmares, flashbacks, and persistent preoccupation with what they have experienced. It is vital to understand that these episodes frequently occur when there is no present trigger for them. This can make it difficult for new hosts and communities to appreciate precisely what the child concerned is suffering. The incidents may be over, but the children are highly likely to experience these symptoms of PTSD until formal treatment can be administered, which may not be for a long time, depending on the new host society. And these symptoms can be terrifying, not simply upsetting. The NHS discusses PTSD here.

Mental health first aid approaches

Mental health first aid courses emphasise the importance of providing non-judgemental reassurance and space to young people who are suffering from forms of anxiety. Experts explain that intrusive probing is counterproductive and risks exacerbating anxiety issues, possibly even leading to self-harm. Supportive, sympathetic conversations may convey enough comfort to empower a young person to begin to open up about their feelings and concerns. Listening in a calm manner is an important approach, establishing a sincere sense of trust. It is important that the young person can feel reassured enough to take the lead and explain their feelings. In other words, thoughtful listening is central to reaching out to people with anxiety. Mental health first aiders are trained to avoid patronising approaches which can stifle opportunities for the young person to describe their feelings and reactions. Consequently, it is recommended practice to avoid assertive-sounding language, a simple phrase like ‘How may I help you?’ is far more likely to prove conducive to establishing trust than ‘You have to calm down’. Likewise, ‘You are welcome to come back to see us when you would like to’ would feel more empowering and respectful than ‘You are overthinking your situation’, which sounds judgementally dismissive. Reaching out to young refugees with anxiety conditions is all about building bridges and affording opportunities to talk openly in a safe and supportive context.

It is also important to validate the young person’s anxiety. The triggers and reflections which continue to prompt their anxiety remain consistently threatening for them. They do not seem irrelevant or irrational and must not be played down. Young refugees need to be assured that they are not alone, that people do care about their situation and that there will be help available. Above all, mental health first aiders are trained never to hold a young person accountable for their condition. Nor will they overwhelm anyone with too much information about specific forms of anxiety, but they will confirm that improvement and recovery are completely possible. Finally, if professional services are available mental health first aiders will recommend those when the time feels right.

Positive steps forward

The Refugee Council supports families and unaccompanied children arriving in the UK. They have developed a specialist mental wellbeing service for lone young refugees, My View. Their vision is encouragingly ambitious, to help children harness the extraordinary strength and resilience which they have demonstrated in their stories so far. Professional treatment includes one-to-one therapy and therapeutic group meetings. Young people are invited to discuss and express their feelings, for example, through creative arts. There have also been opportunities to participate in psychosocial activities, for instance, an outing to Kew Gardens, or joining an equine therapy workshop, or attending practical sessions at a community garden. Professionals consider the impact of such treatment and activities to be hugely beneficial to the young people concerned. Gratifyingly, approximately eighty percent of participants have acknowledged tangible improvements to their mental health.

In conclusion, child refugees face daunting challenges and displacement leaves them bewildered and susceptible to mental health issues like anxiety. This can manifest itself in various forms, like GAD, PTSD and separation anxiety. If professional treatment is unavailable, mental health first aid can provide support and offer a way ahead for these most vulnerable children.

Chloe Hall