Promoting Mental Health for Children and Their Caregivers Affected by the Syrian Conflict
The humanitarian crisis afflicting Syria is one of the gravest catastrophes worldwide, leading to the largest refugee displacement of our time and resulting in mass displacement of Syria’s population, both internally and as global refugees. Children are innocent victims of this conflict and are at particular risk of harm to their mental health and physical development. Two of the most important and modifiable factors related to psychological difficulties in children affected by armed conflict are parental support and monitoring. Improvements in these areas present great potential for preventive intervention. Although its importance is not often acknowledged, the care children receive from parents and primary caregivers during and after conflict can act as a significant protective barrier. Exploration of the impact of war and conflict on families often fails to recognize the significant link between this care and their emotional development and recovery from war trauma. Still, the challenges and stresses of war and displacement often affect parents’ capacity to provide children with the care they need. In this chapter, we explore the parenting challenges of Syrian families affected by conflict. We examine opportunities to design and deliver support for parents in this context, grounded in theory-based parenting principles and empirically identified needs. This design is constructed in order to inform interventions and policies that are family and system-focused, as well as culturally and contextually appropriate.
KeywordsSyria Conflict War Child Parenting Caregiver Intervention Program Refugee Displacement
- Barlow J, Smailagic N, Ferriter M, Bennett C, Jones H. Group-based parent-training programmes for improving emotional and behavioural adjustment in children from birth to three years old. Cochrane Libr. 2010. doi: https://doi.org/10.1002/14651858.CD003680.pub2.
- Basoglu M, Mineka S. Psychological preparedness for trauma as a protective factor in survivors of torture. Year Book Psychiatry Appl Ment Health. 1999;1999(5):229–30.Google Scholar
- Betancourt T, Agnew-Blais J, Gilman S, Williams D, Ellis B. Past horrors, present struggles: the role of stigma in the association between war experiences and psychosocial adjustment among former child soldiers in Sierra Leone. Soc Sci Med. 2010;70(1):17–26. https://doi.org/10.1016/j.socscimed.2009.09.038.CrossRefPubMedGoogle Scholar
- Betancourt T, Salhi C, Buka S, Leaning J, Dunn G, Earls F. Connectedness, social support and internalising emotional and behavioural problems in adolescents displaced by the Chechen conflict. Disasters. 2012;36(4):635–55. https://doi.org/10.1111/j.1467-7717.2012.01280.x.CrossRefPubMedPubMedCentralGoogle Scholar
- Betancourt T, Abdi S, Ito B, Lilienthal G, Agalab N, Ellis H. We left one war and came to another: resource loss, acculturative stress, and caregiver–child relationships in Somali refugee families. Cultur Divers Ethnic Minor Psychol. 2015;21(1):114. https://doi.org/10.1037/a0037538.CrossRefPubMedGoogle Scholar
- Bronfenbrenner U. The ecology of human development. Cambridge: Harvard University Press; 1979.Google Scholar
- Corps M. Advancing adolescence: getting Syrian refugee and host-community adolescents back on track. Portland, OR: Mercy Corps; 2014.Google Scholar
- Cummings E, Taylor L, Merrilees C, Goeke-Morey M, Shirlow P, Cairns E. Relations between political violence and child adjustment: a four-wave test of the role of emotional insecurity about community. Dev Psychol. 2013;49(12):2212. https://doi.org/10.1037/a0032309.CrossRefPubMedPubMedCentralGoogle Scholar
- Dubow E, Huesmann L, Boxer P. A social-cognitive-ecological framework for understanding the impact of exposure to persistent ethnic–political violence on children’s psychosocial adjustment. Clin Child Fam Psychol Rev. 2009b;12(2):113–26. https://doi.org/10.1007/s10567-009-0050-7.CrossRefPubMedPubMedCentralGoogle Scholar
- Folkman S, Moskowitz J. Coping: pitfalls and promise. Annu Rev Psychol. 2004;55:745–74. https://doi.org/10.1146/annurev.psych.55.090902.141456.CrossRefPubMedGoogle Scholar
- Furlong M, McGilloway S, Bywater T, Hutchings J, Smith S, Donnelly M. Group parenting programmes for improving behavioural problems in children aged 3 to 12 years. Cochrane Database Syst Rev. 2012;(2):CD008225.Google Scholar
- Hassan G, Kirmayer K, Ventevogel P. Culture, context and the mental health and psychosocial wellbeing of Syrians. Geneva: UNHCR; 2015.Google Scholar
- Hijazi Z, Weissbecker I. Syria crisis: addressing regional mental health needs and gaps in the context of the Syria Crisis. Washington, DC: International Medical Corps; 2015.Google Scholar
- IMC & JHA. Displaced Syrians in Jordan: a mental health and psychosocial information gathering exercise. Analysis and interpretations of findings. Amman: International Medical Corps; 2013.Google Scholar
- Internal Displacement Monitoring Centre. Displacement caused by conflict and natural disasters, achievements and challenges. Geneva: Internal Displacement Monitoring Centre; 2012.Google Scholar
- James L, Sovcik A, Garoff F, Abbasi R. The mental health of Syrian refugee children and adolescents. Forced Migrat Rev. 2014;(47):42.Google Scholar
- Larson J, Farrag M, Jamil H, Kafaji T, Abdulkhaleq H, Hammad A. Hope and fostering the well-being of refugees from Iraq. Ethn Dis. 2007;17(2):83.Google Scholar
- Lazarus R, Folkman S. Stress, appraisal, and coping. New York: Springer; 1984.Google Scholar
- Marwa MK. Psychological distress among Syrian refugees: science and practice. Paper presented at the 12th World Congress on Stress, Trauma and Coping, Baltimore, US; Feb 2013.Google Scholar
- McMichael C, Manderson L. Somali women and well-being: social networks and social capital among immigrant women in Australia. Hum Organ. 2004;63(1):88–99. https://doi.org/10.17730/humo.63.1.nwlpjdj4d4l9756l.CrossRefGoogle Scholar
- Mollica R, Donelan K, Tor S, Lavelle J, Elias C, Frankel M, et al. The effect of trauma and confinement on functional health and mental health status of Cambodians living in Thailand-Cambodia border camps. JAMA. 1993;270(5):581–6. https://doi.org/10.1001/jama.1993.03510050047025.CrossRefPubMedGoogle Scholar
- Schweitzer R, Melville F, Steel Z, Lacherez P. Trauma, post-migration living difficulties, and social support as predictors of psychological adjustment in resettled Sudanese refugees. Aust N Z J Psychiatry. 2006;40(2):179–87. https://doi.org/10.1080/j.1440-1614.2006.01766.x.CrossRefPubMedGoogle Scholar
- Seino K, Takano T, Mashal T, Hemat S, Nakamura K. Prevalence of and factors influencing posttraumatic stress disorder among mothers of children under five in Kabul, Afghanistan, after decades of armed conflicts. Health Qual Life Outcomes. 2008;6(1):1. https://doi.org/10.1186/1477-7525-6-29.CrossRefGoogle Scholar
- Sirin S, Rogers-Sirin L. The educational and mental health needs of Syrian refugee children. Washington, DC: Migration Policy Institute; 2015.Google Scholar
- Steel Z, Chey T, Silove D, Marnane C, Bryant R, Van Ommeren M. Association of torture and other potentially traumatic events with mental health outcomes among populations exposed to mass conflict and displacement: a systematic review and meta-analysis. JAMA. 2009;302(5):537–49. https://doi.org/10.1001/jama.2009.1132.CrossRefPubMedGoogle Scholar
- Thorleifsson C. Coping strategies among self-settled Syrians in Lebanon. Forced Migrat Rev. 2014;(47):23.Google Scholar
- Tol W, Song S, Jordans M. Annual research review: resilience and mental health in children and adolescents living in areas of armed conflict–a systematic review of findings in low- and middle-income countries. J Child Psychol Psychiatry. 2013;54(4):445–60. https://doi.org/10.1111/jcpp.12053.CrossRefPubMedGoogle Scholar
- UN OCHA. OCHA Syrian report. United Nations Office for the Coordination of Humanitarian Affairs. 2016. http://www.unocha.org/syrian-arab-republic/syria-country-profile/about-crisis.
- UNHCR. Gender based violence. Echoes from Syria (Protection Sector); 2014. pp. 1–5.Google Scholar
- UNHCR. Global trends in forced displacement in 2015. 2015. https://s3.amazonaws.com/unhcrsharedmedia/2016/2016-06-20-global-trends/2016-06-14-Global-Trends-2015.pdf.
- UNHCR. United nations and partners in Syria 2011–2016. 2016. http://www.unocha.org/Syria/UNandPartners.pdf.
- Ventevogel P, Jordans M, Eggerman M, van Mierlo B, Panter-Brick C. Child mental health, psychosocial well-being and resilience in Afghanistan: a review and future directions. In: Handbook of resilience in children of war. New York: Springer; 2013. p. 51–79. https://doi.org/10.1007/978-1-4614-6375-7_5.CrossRefGoogle Scholar
- Vukcevic M, Dobric J, Puric D. Psychological characteristics of asylum seekers from Syria. Survey of the mental health of asylum seekers in Serbia. Belgrade: UNHCR Serbia; 2014. p. 73–85.Google Scholar
- White M. Working with people who are suffering the consequences of multiple trauma: a narrative perspective. Int J Narrative Ther Commun Work. 2004;2004(1):45.Google Scholar
- WHO. Mental health: new understanding, new hope. In: World health report 2001. Geneva, Switzerland: World Health Organization; 2001.Google Scholar
- WHO, & IMC. Assessment of mental health and psychosocial support needs of displaced Syrians in Jordan. Geneva, Switzerland: World Health Organization and International Medical Corps; 2014.Google Scholar
- Zwi M, Jones H, Thorgaard C, York A, Dennis J. Parent training interventions for Attention Deficit Hyperactivity Disorder (ADHD) in children aged 5 to 18 years. Cochrane Libr. 2011. doi: https://doi.org/10.1002/14651858.CD003018.pub3.