Problems faced by Syrian refugees and asylum seekers in Switzerland

Abstract

BACKGROUND Refugees and asylum seekers are susceptible to developing common mental disorders due to their exposure to stressful experiences before, during and after their flight. The Syrian Civil War, which started in 2011, has led to a massive number of Syrians seeking refuge and asylum in European countries, including Switzerland. Currently, Syrians are the second-largest refugee and asylum-seeking population in Switzerland. However, very little is known about the problems faced by this new population in Switzerland and their needs relating to mental health services. Identifying the problems faced by this community is crucial to providing adapted and tailored mental health services to Syrian refugees in Switzerland. AIM OF THE STUDY The current study aimed to identify problems that Syrian refugees and asylum seekers face daily while living in Switzerland in order to inform the adaptation of a brief psychological intervention. METHODS We used a cross-sectional, qualitative design and collected data according to The Manual for Design, Implementation, Monitoring and Evaluation of Mental Health and Psychosocial Assistance Programs for Trauma Survivors in order to identify problems perceived by the target population. Free-listing, open-ended interviews were conducted with 30 adult Syrian refugees and asylum seekers and analyzed using thematic analysis. RESULTS The results show that besides physical health problems, Syrians experience primarily two types of problems: practical and psychological (emotional) problems. These two types of problems are closely interrelated. The most common practical problems (problems with government and authorities, problems related to residence permits, problems with integration, cultural differences, language problems, problems related to education, problems related to employment, and problems with housing) were reported by almost half of all participants. Symptoms of mental disorders and feelings of uncertainty, frustration and injustice were the most common psychological problems and were mentioned by more than one third of the participants. The finding that almost half of the participants reported typical symptoms of mental health disorders suggests that a considerable number of Syrian refugees and asylum seekers might need mental healthcare. CONCLUSIONS Authorities, practitioners and researchers should recognize that Syrian refugees and asylum seekers are strongly affected by a broad range of problems. Besides practical problems, they suffer a multitude of psychological problems, and a significant number of them report, among other issues, symptoms of mental health disorders. Officials working with this population should be aware of this vulnerability and be prepared to refer clients in need of mental healthcare to mental healthcare providers. Moreover, the significant variety and number of problems experienced by this population should be taken into consideration when developing solutions tailored to their needs.

Problems after flight: understanding and comparing Syrians’ perspectives in the Middle East and Europe

“…Overall, the results show the prevalence of psychological problems and the importance of social network and local displacement-related factors on psychological wellbeing, and illustrate psychological problems as the common consequence of a range of stressors. Psychological 27 [44] 15 [33] 23 [40] 65 [40] Interpersonal 15 [25] 14 [30] 15 [26] 44 [27] Physical/psychosomatic health 13 [21] 13 [28] 10 [18] 36 [22] Separation from family members 11 [18] 8 [17] 13 [23] 32 [20] Related to war/home country 7 [11] 6 [14] 7 [12] 20 [12] Related to family duties 10 [16] 5 [13] 2 [4] 17 [10] Personal development/unmet personal needs 0 [0] 3 [7] 7 [12] 10 [6] Note: N J number of participants in Jordan, N T number of participants in Turkey, N S number of participants in Switzerland, n/a not applicable Finances 11 [18] 17 [37] 6 [11] 34 [21] Camp related issues 26 [43] n/a n/a 26 [16] Government regulations 3 [5] 4 [9] 12 [21] 19 [12] Housing 2 [3] 5 [11] 11 [19] 18 [11] Medical treatment 6 [10] 6 [13] 3…”

“…'N' permit holders have serious restrictions in accessing the labour market, governmental subsidies, leaving the country and no right to family reunion [17]. It applies to both country that the temporary protection status leads to feelings of uncertainty and fears of being sent home [8,18]. Concerning employment in Turkey, since the "Regulation on Work Permit on Refugees under Temporary Protection" in January 2016, access to formal employment has been established [19].…”

“…Unsurprisingly, employment problems and poverty are reported as most salient problems among Syrians in Istanbul, Turkey [8]. Work permit challenges based on the legal status were also significant problems for Syrians in Switzerland [18]. In Turkey, Syrians have established their own neighbourhoods and communities in Istanbul and cities along the border due to the vast influx.…”

“…Despite commonalities between Syria and Turkey such as cultural and geographical proximity, increased discrimination towards Syrians due to their nationality, culture, and language has been reported in Turkey [14]. Discrimination, feelings of marginalisation and language difficulties related to entitlements based on legal status such as language courses have been reported by previous research in Switzerland [18]. Stressors and mental health of SRAs have been predominantly assessed through nomothetic measurements -often developed and validated in western contexts [20].…”

Problems After Flight: Understanding and Comparing Syrians’ Perspectives in the Middle East and Europe

“…Table 2 Overview Categories of self-reported problems of the three study populations. [44] 15 [33] 23 [40] 65 [40] Interpersonal 15 [25] 14 [30] 15 [26] 44 [27] Physical/psychosomatic health 13 [21] 13 [28] 10 [18] 36 [22] Separation from family members 11 [18] 8 [17] 13 [23] 32 [20] Related to war/home country 7 [11] 6 [14] 7 [12] 20 [12] Related to family duties…”