Forced migration and mental health: prolonged internal displacement, return migration and resilience

Abstract

Forced internal displacement has been rising steadily, mainly due to conflict. Many internally displaced people (IDP) experience prolonged displacement. Global research evidence suggests that many of these IDP are at high risk for developing mental disorders, adding weight to the global burden of disease. However, individual and community resilience may act as protective factors. Return migration may be an option for some IDP populations, especially when conflicts end, although return migration may itself be associated with worse mental health. Limited evidence is available on effects of resettlement or return migration following prolonged forced internal displacement on mental health. Also, the role of resilience factors remains to be clarified following situations of prolonged displacement. The public health impact of internal displacement is not clearly understood. Epidemiological and interventional research in IDP mental health needs to look beyond medicalised models and encompass broader social and cultural aspects. The resilience factor should be integrated and explored more in mental health research among IDP and a clearly focused multidisciplinary approach is advocated.

A systematic review of resilience and mental health outcomes of conflict-driven adult forced migrants

“…Factors such as individual and/or community resilience and social support have been highlighted as key potential mediators between forced migration experience and subsequent mental health impact [11]. Individual resilience has been described as the ability of a person to successfully adapt to or recover from stressful and traumatic experiences [12].…”

Estigma y salud mental en personas víctimas del conflicto armado interno colombiano en situación de desplazamiento forzado

“…Aunque en otros contextos se observa alta prevalencia de trastornos mentales en personas en situación de desplazamiento tras un conflicto armado [41][42][43][44]9,[45][46][47] , en Colombia es alta la frecuencia de síntomas en este grupo de personas; no obstante, los pocos estudios indican que con el uso de evaluaciones estructuradas la frecuencia de trastornos mentales se reduce de manera importante 10 , de tal suerte que los profesionales de la psiquiatría deben tener presente que se abre la posibilidad de revictimización a través de la medicalización de las emociones de la vida cotidiana y el sufrimiento de las VCAISD sin que cumplan formalmente criterios de trastorno mental 7,17,48 . Esto implica que en las VCAISD la evaluación de síntomas debe ser extremadamente rigurosa y el cumplimiento de cada criterio debe ser total para evitar el sobrediagnóstico [49][50][51] , en particular de los relacionados con el complejo estigma-discriminación en salud mental 43,44,9,[45][46][47][48][49][50][51][52][53][54] .…”

“…Esto implica que en las VCAISD la evaluación de síntomas debe ser extremadamente rigurosa y el cumplimiento de cada criterio debe ser total para evitar el sobrediagnóstico [49][50][51] , en particular de los relacionados con el complejo estigma-discriminación en salud mental 43,44,9,[45][46][47][48][49][50][51][52][53][54] .…”

Methodological Challenges in the Study of Forced Displacement and Mental Health in Turkey

“…Indeed, internal displacement is a psychologically traumatic process for those who are displaced, and is determined by the pre-and post-displacement characteristics, as well as the displacement history of the individuals in question (Siriwardhana & Stewart, 2012). More importantly, forced migration cannot be regarded as a single traumatic event, even if this presumption is widespread.…”