It is no surprise that being a refugee puts many strains on one’s mental health. Difficult circumstances in one’s homeland and the challenges of a new country can be emotionally jarring and lead to long-term mental health consequences. As they prioritize other basic and urgent needs, getting help for mental health can sometimes seem like a matter of secondary importance.
This is what happened to Khaled*, a 37-year-old refugee in Lebanon. After arriving, he, his wife, and three children had to move from one place to another due to threats, evictions, and insecurity. Khaled experienced mental anguish but delayed in seeking treatment due to the daily grind of putting bread on the table for his family. He also had to grapple with the stigma of men showing emotions, acknowledging their weakness, and reaching out for help. Only when he was about to reach his breaking point JRS was able to make an intervention.
Khaled’s symptoms began at the onset of the Syrian crisis. He had headaches, stomach aches, dizziness, vomiting, and pain in his bones. Over time, his condition worsened. When he moved to Bourj Hammoud, a municipality northeast of Beirut, for work, Khaled was angry every day and taking it out on his wife and family. He isolated himself from his friends and neighbours. He realized that he needed help when he came home and saw his children cowering. “After a very long and exhausting day at work, the most frustrating thing was to see my children afraid of me.”
Fortunately, there is a JRS community centre in Bourj Hammoud, and Khaled met with Fatima, our clinical psychologist. She first referred him to the psychiatrist to check to see if he needed medical intervention. Then, she started to do sessions individually with Khaled and with the family on a weekly basis. Using cognitive behavioural therapy (CBT), Fatima helped Khaled to manage his stress through relaxing techniques. These exercises helped Khaled to identify his thoughts and feelings related to his physical symptoms. Gaining self-understanding, Khaled was able to deal with the tense situations and change the pattern of thoughts into more positive ones.
Meanwhile, Khaled was also attending psychoeducation sessions which were very helpful for his case. In these sessions, Khaled was provided with information about his mental health condition, the causes, symptoms, and the process of treatment and therapy. He learned how to help himself, and acquired self-help skills to alleviate the symptoms. With time, Khaled’s family was also invited to receive these sessions to understand and accept his situation and know how to cope with it in a successful manner.
Khaled’s mental health improved gradually. Now, he only feels mild symptoms, and no longer experiences extreme anger. As a result, his relationship with his children has had major progress. “My children now sit beside me and play with me without any fear,” discloses Khaled happily. The impact of the therapy keeps motivating Khaled to attend the sessions.” I do not want to lose my family. All I wish is to provide my children with a secure and stable life with their parents.” The individual sessions will keep going until Khaled’s state is stable, and his symptoms completely disappear.
According to Khaled, there are a lot of hardships and challenges around us that we cannot control. What we can do is control our reactions so that we can face them wisely. While his insight has come at a great cost, his case shows the success that can be achieved when men seek mental health support.
Khaled* is a fictitious name used to maintain confidentiality
Invisible Burdens: Prioritising Mental Health and Livelihoods in Syria and Lebanon
As unprecedented economic crises unfold in Syria and Lebanon, JRS witnesses the heavy toll of poverty on the mental health of those we serve. We call on donors to prioritise mental health and psychosocial support (MHPSS) and livelihoods programmes with long-term investment. In tandem, we emphasise the need to strengthen national mental health services and combat medication shortages.