The Psychology of the Refugee Experience: Ukraine

A million refugees fled Ukraine since the war has begun. Among the many stories of hope and resilience, there is always the inevitable trauma of war and its vast mental health implications. Psychologist and epidemiologist Dr. Manuel Carballo pioneered much of our understanding of refugee mental health. As Executive Director of the International Center for Migration, Health and Development in Geneva and consultant to the WHO and the European Center for Disease Control, his interest in the mental health of refugees is not purely theoretical. Carballo was born in a refugee camp and spent his early childhood there. He shares his perspective on what this moment means for the one million Ukrainians who have fled their homeland.

The visible and the invisible

For Ukrainians, the process of becoming refugees has been defined by their resilience in the global media. “When we look at the images of the war in Ukraine, we can inevitably be impressed by what seems to be resilience, strength and courage. Yet behind every image and video shared on social media there is a story of deep pain and anguish,” says Carballo. He encourages us to look beyond what is immediately visible. “The physical wounds of Ukrainian refugees are easily visible. We see the wounds, the bandages and the ambulances,” he adds, “but the mental health aspects of refugee status are less visible and perhaps even deeper.”

As more Ukrainian refugees cross the border in the coming weeks, millions of families will be disrupted. “Each of these separations is traumatic and influences the individual,” explains Carballo. “Within a few hours, many Ukrainians lost their physical possessions. But it’s not just a loss of physical memories, they also lost the living memories of their close family and loved ones. What Ukrainians are really forced to leave behind as they flee is an investment in the future.

Loss of control and mental health

According to Carballo, a fundamental aspect of mental health is the feeling of control. Yet, as Ukrainian families are separated by their refugee experience, control is short-lived. “It’s demoralizing,” says Carballo, “A lack of control takes away our power and undermines the extent to which we feel equipped to take care of ourselves in the future.” He adds, “We are deeply influenced by our feelings of control and when we lose that control we become vulnerable to a wide range of dangers and threats to our mental and physical health. Specifically, Carballo is ensuring that we pay special attention to vulnerable populations among Ukrainian refugees, such as the elderly and the disabled. “Many were vulnerable before it started,” he says, “Some weren’t in good physical health, some had psychological problems, some were on treatment that was interrupted. This group is caught up in this moment violent with everyone.

Another group of particular concern to Carballo are Ukrainian children who have been forced to flee. “The first thing for these children to do is provide a structure to play and eat together,” he says. “We have to be careful not to lose sight of the fact that these children may not be crying. We can witness a scene of children already playing on the playground. But let’s not underestimate what’s going on in their heads. We need to understand that the impact of Mental Health will not be immediately visible and we cannot expect it to be.

A brighter future ahead of you

Despite the many challenges faced by Ukrainian refugees, Carballo still remains hopeful. Having worked with the United Nations building refugee camps in Macedonia and Albania and working in war-torn areas bosnia, Carballo was encouraged by the openness with which many European countries welcome Ukrainian refugees. “Seeing how Europe is responding to the needs of the Ukrainian refugee population is a testament to the fact that we have, in fact, learned,” he adds, “we have a much deeper understanding of how we can help now”.

Carballo is optimistic about what the future holds for Ukrainian refugees: “It’s been a long time since we’ve seen something so encouraging – not for each individual, of course, but for humanity. It is a reminder of how the world can come together in solidarity for refugees. As a global community, we have learned that when crisis strikes, we can rise up and share not just the pain, but also the future.

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