Mental Health Assessment
Estimating the prevalence of mental health disorders among Syrian refugees in Jordan in order to provide EMPHNET and its partners with evidence for addressing mental health and psychosocial support (MHPSS) problems as part of both the emergency response for Syrian refugees in Jordan and the longer-term development initiatives for vulnerable Jordanians and refugees.
Conflict situations, such as wars and displacement, are known to have a negative impact on the mental health and psychosocial well-being of those involved. Populations affected by situations of unrest, violence, loss, separation, and drastic changes in social and living conditions, are likely to experience a number of distressing psychological reactions such as hopelessness, helplessness, and anxiety, as well as behavioral and social problems. These are common and normal reactions to abnormal events, and experience and research indicate that the majority of people will exhibit resiliency, and recover over time using natural coping mechanisms which can be fostered by supportive environments. A minority of people will develop more enduring mental health problems such as depression or anxiety, while others may suffer from pre-existing mental health problems and would need more specialized care. Addressing the mental health and psychosocial support (MHPSS) needs of displaced populations is of utmost importance in any adequate humanitarian response.
Specific definitions of the terms “mental health” and “psychosocial support” differ between and within aid organizations, disciplines, and countries. The following definitions were used as the underlying conceptual principles to guide this study:
- Mental Health: defined by the World Health Organization as “a state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community”.
- Mental Health and Psychosocial Support: defined by the Inter-Agency Standing Committee (IASC) Guidelines as two complementary approaches that include “any type of local or outside support that aims to protect or promote psychosocial wellbeing, and prevent or treat mental disorder”. The term “psychosocial” is used to indicate the close connection between psychological characteristics of experiences in life (our thoughts, emotions, and behaviors), and broader social experience with the environment (our relationships, traditions, spirituality, interpersonal relationships in the family or community, culture, and life tasks such as school or work). Use of the term “psychosocial” incorporates the family and community in assessing problems and needs.
The ‘Arab Spring’—a period of civil unrest, revolts, and uprisings—has affected millions of people across the Arab world. Beginning with a Tunisian uprising in December 2010, followed by similar revolts in Egypt, Libya, Yemen, Syria, Bahrain, and other Arab nations, these events led to the collapse of several regimes and called for the establishment of democratic governments. What started as peaceful demonstrations quickly turned to national unrest in many countries, including in Syria, where, by June 2011, armed clashes erupted in many locations. By September 2013, the Syrian conflicted had resulted in over 100,000 deaths, over 2 million refugees in neighboring countries, and another 4 million displaced persons within Syria.
Jordan has witnessed a considerably large influx of Syrian refugees since the beginning of the conflict. As of October 2013, the number of Syrian refugees reported by the United Nations High Commissioner for Refugees (UNHCR) reached 2,374,331 (of which 2,325,346 are officially UNHCR registered). More than a quarter of these refugees (27%) reside in Jordan (576,354). The UNHCR estimates the number of Syrian refugees in Jordan to exceed 800,000 by the end of 2014, which will comprise about 16% of Jordan’s total population.
This assessment revealed that many displaced Syrians in Jordan experience a variety of mental health and psychosocial support (MHPSS) problems that disrupt their daily ability to function normally. Common MHPSS issues include distress, sadness, fear, anger, nervousness, disinterest and hopelessness, and many suffer from behavioral and social difficulties resulting in a decreased ability to care for self and others. The incidence of nocturnal enuresis in children is of great concern, as well. While some Syrians have adopted positive coping strategies such as socialization and engaging in religious practices, others are using negative strategies such as anger and fighting, or passive behavior such as sleeping and crying.
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The Eastern Mediterranean Public Health Network (EMPHNET) published the report, “Assessment of Mental Health and Psychosocial Support Needs of Displaced Syrians in Jordan,” in February 2014. Supported by the World Health Organization (WHO) and the International Medical Corps (IMC), in collaboration with the Jordan Ministry of Health (MOH), EMPHNET carried out the assessment using quantitative and qualitative tools adapted from the WHO-UNHCR Toolkit for Assessing MHPSS Needs and Resources in Humanitarian Settings.
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