view all campaigns

Campaign Stories
  Accompanying urban refugees in Ethiopia
  Entrepreneurial refugee in Kenya teaches computer skills
  Ethiopia: Helping refugees adapt
  Europe: a hope that knows no borders
  France: JRS 'Welcome Project' offers more than space for refugees to live
  Working with Urban Refugees: A Handbook
  Journeys of Hope postscript: Longing for Life
  Journeys of Hope: Breaking family ties
  Journeys of Hope: From life and death to asylum
  Journeys of Hope: If people are crying, no one hears
  Journeys of Hope: Listen to the story behind
  Journeys of Hope: My Last Chance
  Journeys of Hope: The people here are kind
  Journeys of Hope: The route through hell
  Kenya: building self-reliance among refugees and the host community
  Kenya: decades of refugee integration shaken
  Kenya: refugee parents cope with autism
  Kenya: xenophobia affects refugees in Nairobi
  New class provides path to self-sufficiency
  Panama: JRS program helps urban refugees
  Refugee from Iraq finds help from JRS in Romania
  Refugee Protection and Solutions in Urban Areas
  Serving urban refugees in South Africa
  South Africa: shining a light in xenophobia's darkness
  Southern Africa: the rise of urban refugees
  Spotlight on refugees from Iraq
  Thailand: helping survivors of sexual violence
  Thailand: Hmong refugees from Vietnam live with fear
  Thailand: marginalization in the metropolis
  The Refugee Voice: Hidden in Plain Sight
  Turkey: Deadly winter is coming for Afghan refugees
  Turkey: refugees from Iraq struggle
  Urban refugees in Turkey face daunting challenges
  Video: Advocacy in support of urban refugees
  Video: Global approach to urban refugee issues
  Video: JRS accompanies Urban Refugees
  Video: JRS and Urban Refugees
  Video: JRS focus on urban refugees
  Video: JRS services for Urban Refugees
Connect with us
On World Refugee Day last month, refugees and asylum seekers in the Bangkok Immigration Detention Centre wrote notes conveying the emotional and psychological stress placed on them as refugees. (Jesuit Refugee Service)

(Bangkok) July 19, 2013 — Depression, anxiety and post-traumatic stress disorder (PTSD), while frequently overlooked by the governments, continue to plague more than 50 percent of all refugees and asylum seekers worldwide, according to the World Health Organisation (WHO).          

"Refugees and asylum seekers tend to be more prone to suffering from mood disorders...because of the situation they are in, the journey they undertook, and the initial cause that made them flee," said Nawinda Limamapar, the Information Assistant for WHO Thailand.

The prolonged and difficult refugee status determination process (RSD)— which can take up to three years in some cases, according to The Search, a 2012 JRS publication on RSD challenges in Asia Pacific — can exacerbate the fragile psyche of people who have been forcibly uprooted from livelihoods, homes and loved ones.

Refugees’ reactions are "normal reactions to an abnormal situation," WHO points out.

"They could be under a great deal of stress due to the protection environment in the country of asylum, where they have no legal status and are subject to arrest and detention," said Vivian Tan, the public information officer for the UN Refugee Agency Regional Office in Bangkok.

Yet urban refugees in Asia Pacific do not have enough access to adequate psychosocial services that would help them to cope, leading to the frequent occurrence of psychosomatic health problems, chronic nightmares, and other stress-related sympsaid Junita Calder, the regional spokesperson for JRS Asia Pacific.toms, according to UNHCR, WHO, JRS, and the Asia Pacific Refugee Rights Network (APRRN).

Living in limbo exacerbates health risks

Asia Pacific is home to upwards of 9.5 million persons of concern — 30 percent of UNHCR's total global population of concern. 

Yet "policy makers frequently ignore the mental health needs of displaced persons. Public opinion should be directed towards recognizing the shared humanity between refugees and local communities, acknowledging and helping with refugees’ extraordinary struggles - rather than focusing on immigration status and cultural difference," said Junita Calder, the regional spokesperson for JRS Asia Pacific.

Urban asylum seekers or refugees awaiting a durable solution are the most vulnerable, as they often need to find work to survive — risking arrest in many countries without the legal rights to work.

"They worry about trying to make ends meet in a difficult protection environment where they cannot be legally employed," said Tan.

Psychologist Abraham Maslow's 1954 Hierarchy of Needs emphasizes physical health, safety, belonging and achievements as the fundamental basis for mental health.

But urban asylum seekers live "in a state of distress because they often live in poor physical conditions, cannot support themselves or integrate into the local community, and have little information about their future for long periods of time," said Zarah T. Alih, Psychosocial Counselor at the Jesuit Refugee Service Thailand Urban Refugee Programme in Bangkok. "It is impossible for them to establish a stabilizing routine," she added.

Suffering in silence

Urban refugees generally disperse into the population, living in obscurity to escape attention of the authorities. As such, they rarely have access to mental health care.

"There is a lack of adequate services across all sub-regions of Asia Pacific," said Julia Mayerhofer, the Communications Officer for APRRN.

The lack of qualified interpreters, lack of coordination between stakeholders such as UNHCR and humanitarian organizations, along with limited reach to vulnerable groups and scarce information held by authorities about the seriousness of mental health concerns of refugees, all lead to neglected mental health needs that interfere with the RSD process, according to Mayerhofer.

"The occurrence of traumatic events, stressful living situations, as well as difficulties in retelling a story may interfere with the outcomes of the RSD process. Trauma can interfere with memory and the ability to recall events," she explained.

If UNHCR and immigration officials — often the first people that refugees encounter in the asylum country — were trained to recognize mental health problems, issues could be identified and treated at an earlier stage to avoid interfering with RSD outcomes.

Currently medico-legal reports - reports detailing the medical condition of a refugee claimant - can be submitted to UNHCR offices, such as UNHCR Bangkok, to lighten the burden of proof on the client.

"This is a necessary pre-condition to ensuring a fair process," said Junita Calder, the advocacy spokesperson for JRS Asia Pacific.

The way forward

But providing access to mental health care alone will not provide a solution, as mental health is intrinsically connected to other issues such as safety, acceptance, and the right to work, according to NGOs.

"Urban refugees face security risks when traveling to access these services and have very little disposable income to spend on transport for follow-ups," said Tan.

States and service providers should adopt policies and practices that address the toll that deprivation of human rights takes on health, according to APRRN.

"Sending a refugee to a counsellor will not be enough if he or she continues to suffer under these conditions," said Mayerhofer.

by Dana MacLean
JRS Asia Pacific Communications Officer


While JRS' Urban Refugee Project in Bangkok targets up to 500 urban asylum seeker and refugees, to provide financial, legal, and psychosocial support services, due to the limited budget each family can only be supported for three months. Meanwhile, up to 80 percent of asylum seekers survive in Bangkok without any assistance or protection.


  Follow Me on Pinterest


Countries Related to this Region
Canada, United States of America