Refugees are more likely to suffer from mental health problems than the average person due to their migration experiences and socio-economic status. Psychosocial support helps, but it should not stand alone. Further investment is needed in the social lives of refugees and undocumented migrants, for example by giving them access to work and education. This is the argument put forward by social scientist Tessa Ubels. “People often come to see their psychologist as a friend. That is not a problem in itself, but it is if they have no other friends.” Ubels will defend her thesis at Radboud University on 2 June.
The psychosocial consequences of (forced) migration are significant. Migrants often struggle with stress, loss and feelings of exclusion. “We already know that psychosocial support helps combat anxiety and depression,” explains Ubels. "But we didn't know much about the role of psychosocial support in the social lives of refugees. If your mental health is not so good, this often has an impact on your social life, because you tend to socialise less. When people have fewer social contacts, support programmes are less effective."
To map out this social situation, Ubels asked people how many contacts they had in their new environment and whether they were working. “Conversations with a psychologist work particularly well if someone also talks to friends or acquaintances in the area and is not solely dependent on the psychologist.”
The Netherlands and Uganda
Ubels conducted extensive research among a group of undocumented migrants in the Netherlands and refugees in Uganda. In the Netherlands, this includes rejected asylum seekers who are sometimes unable to return to their home countries and people whose residence permits have expired. “This is a group that is in a very vulnerable position,” says the researcher. “There are an estimated 40,000 undocumented migrants in the Netherlands, but because they often remain under the radar, it is difficult to keep in touch with them.”
In Uganda, it was easier to talk to refugees. Ubels visited a settlement there that has existed for almost 70 years and is home to more than 170,000 refugees. “In that community, refugees' rights are well regulated, but there are insufficient facilities. It's the other way around for undocumented migrants in the Netherlands: there is enough healthcare here, but this group has limited access to it."
Bread on the table
The people she followed participated in various aid programmes. In the Netherlands, there were undocumented migrants who regularly had conversations with a psychologist, while others attended group workshops or exchanged experiences with others about coping with stress or accessing healthcare. In Uganda, Ubels followed a programme in which refugees help each other in difficult situations.
“Psychosocial support is important to give people more confidence in themselves and in their future,” says Ubels. "But it is not the solution. In the Ugandan programme, refugees also set up their own small businesses or grow food, enabling them to support themselves. And in the Netherlands, people who do some (voluntary) work are often better off because people see them. If you want aid programmes to work in the long term, the basic conditions must be in place: enough money and food in the house." These basic conditions are coming under increasing pressure due to cuts in development cooperation and stricter migration policies.
According to Ubels, refugees and undocumented migrants in the Netherlands also benefit from aid programmes that are not specifically aimed at this target group. "Of course, there must be an approach that is specifically tailored to their situation, but some of the problems within this group are also societal, such as poverty or loneliness. By creating places where people from different backgrounds can come together, you create more diverse social networks. These kinds of initiatives already exist, mainly at neighbourhood level, and can be expanded. This means that refugees are no longer dependent on a single aid organisation."