Providing Psychosocial Support to Refugees in Sri Lanka: Notes from the Field

Much of the work we do in mental health and migration involves trying to respond to the needs of hundreds or thousands of people. It can be challenging, especially in the context of emergency settings, to remember the individual stories that underlie the tragedy of forced displacement.

Here, as part of the #MHPSSMatters campaign – a collaboration between MHIN and MHPSS.net marking Refugee Week 2017 – we are privileged to share some insights from the field by Ashviny Jeyamohan. Ashviny is a psychologist with ZOA Netherlands in Negombo, Sri Lanka, where she works at a refugee centre supported by UNHCR.

As wars and conflict tear apart countries and communities, civilians have no choice but to flee the places they call home to protect their own lives and those of their loved ones. Sri Lanka’s three decade long civil war resulted in many tens of thousands of its citizens seeking refuge in countries across the world.  What is less well known, however, is that recent years have seen an increase in the numbers of individuals seeking asylum within Sri Lanka, to escape conflict and persecution in their own home countries.  

According to UNHCR’s statistics, at present, there are currently approximately 1200 refugees and asylum seekers in Sri Lanka originating from various countries; the majority being from Afghanistan and Pakistan with a smaller number from Iran, Yemen, Syria, Palestine, Maldives and Myanmar seeking support and resettlement to countries that accept refugees.

Struggling to exist in an alien setting, uprooted from everything that was familiar to them, they find themselves having to cope with the loss and separation from their family, friends and belongings, consequences of violence and war, and a huge uncertainty about their future as they wait for their refugee ‘status’ to be determined or for resettlement.  As described by a Sri Lankan advocate for refugees’ rights, the conditions for refugees in Sri Lanka are far from welcoming as

the government “doesn’t ensure rights of housing, food, education, healthcare or legal employment to asylum seekers and refugees.”

Osman*, an asylum seeker from Afghanistan, suffers from night terrors after witnessing his loved ones being killed in fighting during the war. He experiences flashbacks of images of his friends laying dead in rubble. With no opportunities to work legally in Sri Lanka, his savings dried up quickly in the country he escaped to, and insecurity about his future as he awaits the lengthy process of applying for resettlement. Osman worries about how he will provide for his children and take care of his siblings, while trying to cope with depression, serious symptoms of stress and great sorrow.

As a psychologist working with refugees and asylum seekers in Sri Lanka, I know that this daily anguish is faced by far too many.  The women, men and children that my colleagues and I work with are almost all grieving over someone in their lives who was tragically lost.  They are anxious, tense and many suffering from the consequences of their traumatic experiences, as well as the hardships of their current status. Many show signs of clinical depression.

In the coastal town of Negombo, approximately 1 hour from the capital of Sri Lanka, where more than 80 percent of refugees and asylum seekers reside, the refugee centre I work at provides a range of practical, social and psychological supports to these individuals and families.  

The refugee centre provides individual and group therapy for adults, youth and children, helping them learn coping skills and resilience mechanisms to best deal with their current circumstances, whilst also providing art, music and play therapy for children and teenagers. Their living situations and psychological states are assessed on an ongoing basis, and practical support is provided for them to access local hospitals and health services.

The refugees and asylum seekers also take part in progressive relaxation sessions and mindfulness awareness exercises as a way of dealing with the consequences of traumatic experiences. Therapeutic sessions are provided for single mothers and pregnant women to enhance their reproductive health and wellbeing.

 Motivational and team building programs are also conducted to help both youth and adults have more self-confidence and social competencies. These activities help them mingle with groups and communities different from their own, work together across socio-cultural boundaries, thus preparing them towards acceptance of different communities that will be required when they move to resettle in another foreign land. 

The vulnerable population is also provided with educational and life skills classes in addition to sports and recreational activities with the help of local volunteers, to help them keep occupied and engage in ways that also prepare them for future challenges and opportunities.

Whilst psychosocial support to refugees and asylum seekers cannot address all the extremely difficult circumstances that they face in Sri Lanka, these forms of support can be very helpful to enable them to endure, cope with and sometimes thrive in spite of these conditions. 

*Name has been changed to protect his identity