The Effect of Displacement on Mental Health: Staying or Leaving?

Abstract

Editorial In the last three decades, war, famines, natural disasters, and political upheaval have led many to be forced to migrate worldwide. In the 1970's the number of refugees reached the estimate of 2.5 million, gradually increasing to 8.2 million within a decade, and by the 1990's the number of refugees had reached 17 million [1]. As reported by the UNHCR (2013), the number of displaced has reached 45.2 million people. Previous literature has indicated that refugees generally suffer from several mental health issues including depression, anxiety, and post-traumatic stress disorders (PTSD) [1-5]. Also, previous studies have reported that displaced individuals suffer from high rates of mental health symptoms as compared to their non-displaced counterparts. A methodical review of psychiatric surveys on unselected refugee populations of 6743 adults from seven countries indicated that 9% of adults were diagnosed with PTSD, 5% with major depression, and 4% with generalized anxiety disorder. These findings suggest that refugees are ten times more likely to have PTSD than their non-displaced counterparts [6]. Another study compared the mental health of Iranian refugees internally displaced and externally resettled in the Netherlands. Results indicated that externally displaced Iranians indicated higher rates of depression (77.6%) and anxiety (58.5%) as compared to the non-displaced Iranians reporting 21% depression rates and 20.08% anxiety rates. In other words those who were externally displaced showed higher prevalence of mental health issues than those who remained in the country [2]. Long term effects of external displacement have yet to be investigated extensively. However few studies have reported long lasting detrimental effects of displacement [4,7-9]. One study addressed the mental health of 490 Cambodian refugees 20 years after their resettlement in the United States. Results showed that that 62% of the population had PTSD and 51% suffered from major depression in the past year (2004) [10]. In conclusion, previous studies have suggested that displacement has long term effects on mental health and that staying and coping with the trauma could be less detrimental on mental health than migrating. When risk is too high displacement is imminent, therefore better understanding short and long term effects of displacement could provide better early intervention as related to long term effects of anxiety, depression, and PTSD. References 1. Pumariega AJ, Rothe E, Pumariega JB (2005) Mental health of immigrants and refugees. Community Ment Health J 41: 581-597. 2. Gerritsen A, Bramsen I, Deville W, Willigen L, Hovens J et al. (2006) Physical and mental health of afghan, iranian and somali asylum seekers and refugees living in the netherlands. Social Psychiatry and Psychiatric Epidemiology, 41: 18-26 3. Porter M, Haslam N (2005) Predisplacement and postdisplacement factors associated with mental health of refugees and internally displaced persons: a meta-analysis. JAMA 294: 602-612.