Refugees and mental health.

• Author: Mollica, Richard
• Position: Old Stereotypes, New Realities

International research and relief organizations estimate that there are between 10 million and 11 million refugees, and 20 million and 25 million internally displaced persons (IDPs) worldwide. Scientific studies underscore the impact that horrific events--characteristic of the refugee experience--have on the mental health of an individual and society. An article published in Scientific American [Mollica, Richard F., "Invisible Wounds". Scientific American, June 2000] discusses a number of discoveries revealing the varying nature and the long-term and debilitating impact of traumatic events experienced by refugees. The following illustrates the serious consequences of psychological trauma on the health of an individual and his or her society.

First, the prevalence of psychiatric disorders among survivors of war is considerable. In a study of Cambodian refugees, the prevalence rates of acute levels of depression and post-traumatic stress disorder (PTSD) were 68 per cent and 37 per cent, respectively--significantly higher than those found among the general population of 10 per cent and 3 per cent for depression and PTSD, respectively. Second, studies have also revealed the serious physical and neurological impact of trauma, showing that some potent events can indeed cause permanent organic changes in the brain. Third, research has shown that depression can lead to disability and even premature death.

Furthermore, survivors of trauma suffer from chronic fatigue and mental exhaustion. They feel as if "they are no longer capable of achieving the same level of competence in their work that they had prior to the violence". Their claims are grounded in scientific evidence showing that "intellectual performance, especially deterioration in memory and the ability to learn new tasks and ideas, is associated with head injury (beatings to the head), starvation and the secondary cognitive sequelae of PTSD and depression". Moreover, psychological trauma also manifests itself in physical pain through the process of somatization, whereby an individual feels pain, but examination reveals no underlying physical aetiology--a condition commonly reported among war-affected individuals. This research also underscores that the consequences of trauma leave people increasingly vulnerable to unemployment and poverty.

The unabated "trauma of war" ultimately and needlessly jeopardizes the human, economic, political and social development--each is requisite to the...