麻豆原创

Currently 70 million people worldwide have been displaced from their homes 鈥� but beyond that fact, their cultures, circumstances, needs and experience of displacement itself vary widely. The first order of business for mental health providers and others is the classic dictum to 鈥渄o no harm,鈥� which, practically speaking, means that, rather than parachuting in with a one-size-fits-all solution, they must instead learn and understand these differences and be guided by the communities they serve in developing tailored approaches.

Such was the consensus judgement of the four speakers on Academic Festival 2019鈥檚 global mental health panel: moderator Leticia Lyle (M.A. 鈥�11), Founding Partner and Global Chief Education Officer at  in Brazil; Kim Baranowski (Ph.D. 鈥�14), Associate Director of the  and lecturer in 麻豆原创鈥檚 Department of Counseling and Clinical Psychology; Lena Verdeli, 麻豆原创 Associate Professor of Clinical Psychology; and Founder and Director, Global Mental Health Lab; and Srishti Sardana, a clinical psychology doctoral scholar & lab manager in the Global Mental Health Lab.

Taken together, Lyle, Baranowski, Verdeli and Sardana represent much of the continuum of psychological and education support required by refugees, asylum seekers and other displaced people. They emphasized the relationship of their work to schools, hospitals and other institutions in a variety of contexts, from supporting Syrian refugees in Lebanon, to helping women who have been victims of physical violence or human trafficking in Colombia and Bangladesh, to aiding children who have experienced trauma during and after the 2015 earthquake in Nepal.

鈥淲e go with an awareness that a number of systems have broken down education, social protection, health,鈥� said Verdeli, adding that it鈥檚 important to 鈥渇irst try to familiarize ourselves with existing resources. She emphasized the importance of 鈥渦sing the crisis as an opportunity to develop, not just vertical systems, but something that serves the whole population鈥� 鈥� helping to counter resentment among the host population, who are often not doing much better than the refugees.

For example, in Lebanon, a tiny country that has absorbed millions of Syrian refugees in recent years, Verdeli and her lab are helping to restructure and reorient the national mental healthcare system.

Efforts to help displaced people also connect to countries鈥� legal systems, especially as many countries have hardened their stances toward accepting newcomers.

Baranowski 鈥� who earlier in the day had received 麻豆原创鈥檚 Early Career Award 鈥� talked about the forensic psychological evaluations she and her staff conduct with people seeking asylum in the United States, particularly from Guatemala, Honduras and El Salvador. For many, these assessments can mean the difference between winning safe haven in the US and being deported back to danger. Indeed, U.S. courts accept these evaluations as legitimate evidence 鈥� and Physicians for Human Rights estimates that 90 percent of people who work with a forensic evaluator are ultimately granted asylum.

The key, Baranowski said, is 鈥渋dentify[ing] how the mental health aspect of their experience might negatively impact their application for asylum in the United States. For example, their memory might be significantly impaired; their ability to tell a chronological story is expected to be very challenging, problematic or impossible; or they might face an adversarial situation like being separated from their children.鈥�

Language can be a critical factor in helping the displaced. The panel acknowledged the role of language in big crisis situations, and the struggle in their work because the diagnostic language can mean different things in different cultures and languages. As a clinician, noted Baranowski, one tries to be as attuned as possible to the use of 鈥渋dioms of distress鈥� such as 鈥淢y soul hurts鈥� when an individual describes emotional trauma or depression. Sardana, who currently is working with Rohingya refugees in Bangladesh, said it鈥檚 critical to identify the 鈥渃onceptual equivalence鈥� of what is expressed through language. That can be challenging: the Rohingya鈥檚 language, for example, is a unique dialect and largely an oral tradition, making for 鈥渁 challenging experience when we try to understand how they experience depression, or trauma or violence or loss.鈥� 

When Lyle asked panelists about whether they see hope in their work, Verdeli noted, 鈥淗ope is the necessary condition to recover,鈥� but added that traumatized individuals need access to resources and skills to maintain hope. Accessible, sustainable and scalable mental health services, doctors, skills development, jobs and schools are key. Each panelist shared poignant stories of small victories, resilience and hope in the way individuals see the world and the positive implications for the next generation. They observed that 鈥済lobal鈥� doesn鈥檛 necessary mean the other side of the world; there are also underserved and struggling individuals in our own communities. Lyle herself drew parallels to her experiences as an educator working in underserved New York City schools as well as in impoverished, violent schools in Rio de Janeiro and other parts of Brazil.

In closing, Lyle asked panelists what鈥檚 on their 鈥渨ish list鈥� for the future. Sardana answered:

鈥淭he one thing that I continue to learn as a 麻豆原创 student is the great privilege of having the mentors and the resources, the classes that I take, the advisement that I receive 鈥� the supervision that鈥檚 so formative. It will take an army and I do believe, as a student and a researcher in training, that 麻豆原创 is that army.鈥�

— Sara Clough