Manchester Calling

The Humanitarian and Conflict Response Institute

We all have mental health, but not everyone has access to mental health support or is aware of how mental health conditions impact people’s lives.

In reference to World Mental Health Day, the President of the World Federation of Mental Health (WFMH) said: “Mental health is affected by many factors and circumstances. It touches on everything ̶ poverty, equality, and development  ̶  which is why we need to ensure greater investment and greater access to mental health for all.”

Did you know refugees are more than five times more likely to have mental health needs than the UK population? *  But what barriers do refugees have in accessing mental health support? And how does war affect one’s mental health?

We sought to address these questions at HCRI by asking two academic researchers to raise awareness of global mental health for today’s World Mental Health Day.

From Rutgers University, Dr Omar Dewachi, who is also speaking at our upcoming Landmark Lecture, When Wounds Travel, tells us how trauma manifests in those struck by war and displacement.

Omar Dewachi

What impact does war and displacement have on one’s mental health?’

“Over the past two decades, I have been documenting the physical, mental, and social impacts of war and displacement in various settings in the Middle East. One of the challenging tasks of doing this work has been attention to the complexities of war experience and survival in these settings; how the impacts on mental health are part of a more complex assault on individual and collective psyche and livelihood.

With the limits of Western frameworks of “trauma” and “resilience” to address these complexities, there is a need to ground our understanding of mental health in everyday life experiences and communities’ survival strategies impacted by war and displacement. It is only through an intimate understanding of the social and cultural dimensions of war that we begin to fathom the deep wounds of war and their lingering intergenerational consequences.”

Learn more about Omar’s research in our upcoming event-  HCRI Landmark Lecture: When Wounds Travel– on 22 October 2020. 

Dr Rubina Jasani, from HCRI, talks about the cultural and funding barriers refugees experience when accessing mental health support.

Rubina Jasani

How can we consider cultural differences in providing mental healthcare worldwide? 

“The most common cultural factor is at the level of insight.  Some of my earlier research has shown that not every culture understands mental illness so that the medical model understands it. There is also a difference in attribution; if you do not think your problem is medical, your help-seeking will be affected by it. Most cultures interpret mental illnesses through a supernatural or religious lens. There is also a problem of language, or the registers for deciphering symptoms and causality differ and cause major delays in accessing the right kind of care.”

What are the barriers for refugees and asylum-seekers accessing mental health support?

“Research has shown that refugees and asylum seekers struggle with accessing primary care, have no access to secondary care, and mental health care is classed as secondary care. Research has also shown that not all professionals understand what asylum seekers and refugees are entitled to. Mental health care is provided by the voluntary sector and organisations in the city that provide support to refugees and asylum seekers. Austerity has affected the funding for these organisations, and hence mental health becomes a neglected area for asylum seekers and refugees.”

Is there a solution to overcome these barriers?

“With regard to asylum seekers and refugees, it is purely political will and making   secondary care available to all asylum seekers. Transcultural Psychiatry and Psychology are emerging as disciplines that are working with some of these tensions in terms of culture and mental health. There is a lot of ethnographic evidence emerging from the ‘developing world’ on the challenges of internationalising the medical. James Millwater, one of our intercalating medics on our HCRI Masters, has just written a fantastic dissertation outlining some of these issues.”

Find out more about Rubina’s research in her research profile.

If you have been affected by any of the issues raised, you can contact the Refugee Council to access support. If you need to talk to someone, you can call the Samaritans for free on any phone by dialling 116 123. Call 999 if you are in an emergency.

* https://www.refugeecouncil.org.uk/our-work/mental-health-support-for-refugees-and-asylum-seekers/