The increasing violence and insecurity in Afghanistan could force over half a million more people to migrate from the country by the end of 2022, adding to the population of almost 2.6 million Afghan refugees worldwide. And for these millions of migrants, the plight of serious mental health challenges is a concern that we cannot afford to overlook.
The Psychological Impact of Forced Migration
As a result of directly or vicariously experiencing traumatic events — from having lost one’s life savings and home to long-term exposure to high levels of stress — evidence suggests that all migrants will need some form of mental health and psychosocial support. Some studies show that trauma, if left unaddressed, can even alter the way in which DNA is expressed through epigenetics and thus affect future generations. Moreover, childhood trauma can have long-lasting effects, potentially leading to an increased risk of neuropsychiatric illness.
Trauma from forced migration and displacement due to violence also poses specific risks to the resettlement and mental wellbeing of those affected. The psychological impact of forced migration, for example, combines the stressors of extreme trauma with continued feelings of devastating loss and grief — thus compounding the likelihood for poor long-term adjustment and complicating livelihood challenges.
For Afghans, decades of mistreatment and marginalization at a community or societal level also have an impact — one that far exceeds the individual experience of trauma. When successive generations live within the context of war, the very social fabric of life is ruptured, meaning psychosocial support must be comprehensive and broader in scope.
The Role of Religion in Psychosocial Support
In an area only recently beginning to receive serious attention, a growing body of evidence points to religion, religiosity and spirituality as constituting a vital source for coping with mental health problems and illness within refugee and migrant populations. Thus, engaging with the faith sector offers opportunities at different levels for improving the effectiveness of services.
Although humanitarian assistance organizations and psychosocial professionals alike generally recognize the importance of religion in the lives of refugees and internally displaced persons, many do not feel equipped to include faith engagement in their work due to diverse reasons — including, for instance, lack of religious literacy on how to incorporate faith into their work, as well as insufficient understanding of cultural differences between people of non-Western backgrounds and Western clinicians.
Even though there is currently limited guidance on how psycho-spiritual interventions can be best utilized, recent USIP research on the intersection between religion, mental health and support to displaced trauma survivors in Colombia and Venezuela has helped to identify opportunities and best practices for providing effective, integrated approaches for those who have been displaced by violence or conflict. Findings from interviews with mental health experts, humanitarian workers and religious leaders providing psychosocial support in South America and in other geographical areas suggest that preliminary research results are pertinent and valid for contexts other than Colombia and Venezuela.
Recommendations for Religiously Informed Psychosocial Support
USIP’s initiative on Religion and Psychosocial Support for Displaced Trauma Survivors, which is currently focusing on Colombia and Venezuela, has identified specific actions which can bolster current efforts to assist migrants from highly religious contexts.
1) Facilitate Continued Religious Practice. Research shows that being able to continue religious activities and rituals is associated with resilience and the ability to cope during resettlement. Refugees have often lost their networks of support and most, if not all, of their material belongings. Frequently, the principal social bond still available to these migrants is their religious beliefs and practices, particularly when other social bonds have been disrupted or damaged.
Facilitating spaces for migrants to celebrate religious holidays, for example, becomes an opportunity for connection, healing and support. To alleviate further trauma, aid organizations can create spaces or rooms specifically for prayer or other rituals inside reception centers and refugee centers. Designating rooms for prayer (or other rituals) inside these centers is feasible and cost efficient. Additionally, tangible physical assets can be crucial to the maintenance of religious practices that support wellbeing. In addition to spaces for continuing religious practices, aid organizations can provide access to prayer mats, copies of religious texts, prayer beads, prayer shawls, hijabs and other items that are often lost, misplaced or left behind during transit.
Religious study groups and other faith congregation spaces can be leveraged to promote gender equality — fostering opportunities for men and women to rethink their identities and roles while addressing their trauma needs. Safe spaces for women to discuss their interpretation of religious teachings and their religious experience beyond men’s structures of power should also be considered.Other safe spaces for women can serve cultural-religious needs such as ritual bathing or traditional conflict resolution activities.
2) Incorporate Religious Support into Mental Health Services. For many migrants, “western” mental health services can be perceived as stigmatizing, contradictory to their culture and traditions, or deemed unlikely to help. However, religion is frequently valued and highly regarded, and sometimes considered a primary need — even more important for wellbeing than material support. In such circumstances, spirituality and faith are often the main mechanisms through which sense is made of reality and life purpose.
Programing is more effective if beneficiaries have access to religious-sensitive psychosocial and mental health services by trained professionals. Through religious-sensitive engagement, mental health providers can open pathways to care that might otherwise be impossible. Religious actors are trusted in their communities, which offers a vantage point to connect people experiencing trauma with the adequate services. Migrants will better accept mental health services if they see that those services display religious literacy and are open to engaging with migrants’ spiritual beliefs. A spiritual needs-based approach — or using a spiritual screening tool such as Fletcher’s ConnecTO— can be useful to respond to a migrant’s religious experience.
3) Involve Faith-Based Support Organizations at Every Step of the Journey. Engaging early and often is crucial, and faith-based organizations should proactively be part of policy- and logistics-related discussions on topics such as criteria for resettlement, relations with host communities and integration, and special measures to counter gender-based violence. However, partnerships between religious and humanitarian actors entail different discourses, practices and motivations — therefore reaching a consensus on realistic goals is essential. Religious- and faith-sensitive mental health support is crucial in the emergency response stage, especially to manage the expectations among those actors when collaborating.
However, perhaps even more important is its role in long-term resettlement and integration to new communities; in the prevention of worsening mental health issues; and in the success of all migration assistance efforts. Religious entities can be very impactful in generating conditions that promote cohesion and empathy towards migrants, allowing for more effective integration into reception communities. These entities can also help dispel assumptions and negative stereotypes — preventing and reducing discrimination, fear and hostility. Therefore, experts recognize that faith-inspired organizations, religious communities and individual religious leaders must be invited and empowered to participate actively in policy discussions to ensure that their knowhow and experience improves resettlement strategy and integration efforts.
Carolina Buendia Sarmiento is a research analyst for the religion and inclusive societies team at USIP.