Assessing the Psychological Situation of Internally Displaced Peoples
Internally displaced persons (IDPs) are not only one of the most marginalized groups, but also one of the most under-researched groups according to a study conducted by the University of Zurich (link to the full article is attached below). The psychological impacts of trauma witnessed, displacement, and detachment from home and familiarity all render high rates of post-traumatic stress disorder (PTSD), depression and anxiety cases in populations of internally displaced persons.
However, one of the most significant challenges to assessing the psychological situation of this population, is the restricted access to transparent information about these persons. The lack of transparency is in part caused by a lack of focus on internally displaced persons, as studies often emphasize refugees and post traumatic stress disorder over IDPS and mental health complications such as anxiety and depression. Another major cause of the lack of data on the psychological conditions of the internally displaced is the difficulty in accessing populations of internally displaced persons to conduct such psychological studies. According to the Zurich study, only 38 eligible studies regarding the mental health of IDPs was found after searching through over 900 mental health case studies. Mental health complications such as PTSD, depression and anxiety yielded the highest rates of prevalence at 88%, 80%, and 81% respectively, in the most extreme case studies analyzed. While it is essential to note the high variability between the rates of these psychological incidences, the variability of the data also indicates that there is a significant lack of established surveys of IDPs' mental health.
The lack of reliable studies is concerning as the grave mental health situation for IDPs continues to be neglected. People fleeing their homes due to armed conflict or natural disasters often face life-long repercussions, but without the familiarity of local hospital care and an absence of healthcare in a newly settled area, the crises they face can grow even more serious according to a report published by the World Bank (link to the full report is attached below). The three stages where internally displaced persons are particularly prone to mental health complications are the pre-flight, flight and resettlement stages. The pre-flight stage involves the initial infliction of trauma, where individuals experience casualties and loss. The flight stage is characterized by the harsh treatment and detention by government forces and uncertainty of a future. The final stage of resettlement often involves a transition into a state of living that is often subpar to the IDP's original status. Due to all three areas, IDPs are extremely prone to trauma-related illness and mental health complications. With the destruction that creates mass displacement, health centers and documents that are essential to access healthcare services including insurance and proof of citizenship can disappear. Without such basic requisites, it can become extremely difficult for IDPs to access mental health treatment.
1. Knowing the difficulties encountered by internally displaced persons in the three stages of displacement, what can international organizations and national actors do to ensure that there is continued access to healthcare and mental health treatment for IDPs?
2. How can data and accurate information about the situation encountered by IDPs be improved and how can studies regarding mental health be conducted accurately to reduce variability?
Zurich Study
World Bank Report
Photo: Internally displaced children in Sri Lanka look out of their temporary shelter
pensively. Children like them face a multitude of mental health complications that often go unaddressed due to a lack of services and studies available. (Photo provided by Saran Uthayakumar)
Greeting Delegates,
ReplyDeleteThe delegation of China supports the act of providing all IDPs with mental health treatment. In the past, China has dealt with multiple cases involving refugees and IDPs not getting the mental health care that they deserve. Throughout the past couple years, China has worked towards health care reforms to move the amount of coverage from 50% to provide more “effective” coverage. However, mental health care is more complex and costs more which China is not ready to do in their reform process. The New Rural Co-operative Medical Care System works in rural areas to decrease the cost of healthcare and that would cover health for IDPs and all who are citizens on China. Improving the health of their citizens with an aging population and eventually that will come back to thank them. When they reach that point in their process of reform, mental health coverage will be considered.
That situation, however, is in China. China proposes using pre-existing humanitarian organizations to expand their focus to mental health versus physical health. In addition, there should be a section under UNHRC that conducts studies regarding different areas around the world where IDPs are most prevalent to determine what type of mental health conditions are the most common as well as what sort of obstacles there are that prevent them from reaching their needed care. Money is the number one barrier in many countries, that prevent many from getting care as well as willingness from the country. The way that money can be spent effectively and work can be done to incentivize countries to contribute is through studies.
This leads to the second question on how can studies help in this situation. Today, mental health of IDPs is often overlooked. However, the People’s Republic of China believes that more studies should be conducted under a section in UNHRC called AIDPS which stands for Aid for IDPs. This way China, as well as other countries, can effectively evaluate the mental health of their IDPs and create a plan of action on how to proceed. In addition to other actions that will work towards providing aid for IDPs, this section will work on research studies on IDPs. These studies will focus on finding the major problem areas of nations that are extremely affected by a large number of IDPs. With these studies, this section can work towards providing plans for each country on how much money they should spend on mental health care based on their financial status and political situations. Of course, this would only be a suggestion. In addition, these studies can help the country determine what the main mental health problem in their nation is, the cause of it, the regions most affected, and to help figure out a way to increase mental health care in the nation.
Countries can improve accuracy and decrease variability by increasing the level of importance of the studies of IDPs. By increasing the accuracy of the number of IDPs in a country, perhaps through national census questions, this will decrease the variability so that those counted in the studies are in fact IDPs. These questions asked during censuses can determine whether someone is an IDP based on what they answer to the questions and if they meet the requirements. Smaller scale studies with a selected group of people from that country with different situations proportionate to the countries population could also be surveyed. There could also be more detailed investigations if there is a dangerous area of conflict or if there was a sort of attack or event that could’ve causes many to be displaced. Of course, the People's Republic of China is open to suggestions and is looking forward to a great debate!
Thank you,
The Delegation of China
https://www.ajpmonline.org/article/S0749-3797(00)00282-8/fulltext
https://www.frontiersin.org/articles/10.3389/fpsyt.2018.00433/full
https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-018-3113-y
https://www.nytimes.com/roomfordebate/2011/11/01/is-china-facing-a-health-care-crisis/chinas-health-care-reform-far-from-sufficient
To the members of UNHRC,
ReplyDeleteVenezuela proposes international organizations and national actors to integrate IDP Health and Response Centers which provide accessible healthcare assistance during the pre-flight, flight and resettlement stages of internally displaced persons. These centers supply basic medical care and technology that are specially designed for emergency circumstances. An HD video link that connects medically trained translators who are able to speak in 50 different languages with doctors and nurses is also available within these centers. This allows patients to communicate with medical professionals without facing the challenges of language barriers. Through analyzing the referral pathways of displaced persons within a nation, these centers can be placed along these routes to provide an easier accessibility to professional healthcare.
Data and accurate information regarding situations encountered by IDPs act as a guideline for protection and placement. However, current systems lack updates on displaced individuals and their needs. In order to improve the accuracy of this information, Venezuela believes that these systems must adapt collaboration and monitoring components for region-specific needs and risks that IDPs face. This can be modeled after UNHCR’s protection strategy which utilizes data for assessment and response to these conditions. Through the enhancement of the binational protection networks, the strategy will have the capacity to provide stronger networks of information on asylum access and referral pathways.
Thank you,
Venezuela
Delegates of UNHRC,
ReplyDeleteJapan is in full support of finding effective measures for improving the psychological state of IDPs and their healthcare. As 21,000 IDPs remain within Japan as a result of the 2011 tsunami and resulting Fukushima nuclear disaster, it is a priority that these vulnerable groups of people are properly cared for and provided their rights.
The country of Japan recommends that current or potential IDPs are recruited by psychological support, healthcare, and humanitarian NGOs and companies. Candidates for these positions will also be required to have a minimum of secondary schooling and have to undergo a mental psych evaluation to ensure their capabilities. Upon passing these requirements, IDPs will be given training to specialize in a field of healthcare in order to provide a more educated opinion on situations and a course of action. IDP volunteers will be provided with medical equipment and necessities for life through the recruiting cooperation. This will be a long-term solution since training and certification can take long periods of time.
Enlistment of IDPs in healthcare organizations will allow for their fellow IDPs’ constant health support while developing more jobs to help reintegrate IDPs into their local economies that failed after the crisis. STEM fields will also become more widely inclusive as people of lower opportunity will have a chance for progress, education, and a permanent position in a medical field. IDPs trained for healthcare and psychological occupations will be able to perform data collection and provide straightforward information regarding the mental and physical health of IDPs of natural disaster, conflict zones, and other causes of displacement.
Thank you,
Japan