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Understanding the Mental Health and Psychosocial Needs, and Service Utilization of Syrian Refugees and Jordanian Nationals - A Qualitative & Quantitative Analysis in the Kingdom of Jordan (2017)

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Assessment
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Executive Summary

INTRODUCTION

This report by International Medical Corps examines coping mechanisms and helpseeking behaviors among Syrian refugees in Jordan, and identifies barriers to service utilization. This assessment aims to inform a wider discussion among relevant national and international actors in Jordan on improving Mental Health and Psychosocial Services. Information is also presented in relation to the Jordanian host community and their coping and help-seeking behaviors to ensure an increased understanding within the humanitarian community on the needs of vulnerable Jordanians.

METHODS

The assessment relies on both quantitative and qualitative methods of data collection and analysis including: a desk review, individual interviews with community members, focus group discussions and key informant interviews. The quantitative arm of the assessment explored help-seeking behaviors, coping skills, barriers to receiving services, and perceived needed services. The quantitative survey reached out to over 6000 participants over the age of 18 years, in 10 governorates. These participants proportionately represented Jordanian nationals, as well as Syrian refugees in both camp and urban settings.

RESULTS

Syrian refugees have demonstrated remarkable resiliency in the years since the crisis began in their home country. Meanwhile, the people of Jordan continue to host and share scarce resources with refugees from Syria and with those who have fled to safety in Jordan from other conflicts in the region as well. The analysis in this document demonstrates that the Syrian refugee community in Jordan continues to face significant stressors, with children and older persons within the community being viewed as the most vulnerable. Respondents described a range of coping mechanisms, both positive and negative, and refugees in urban settings described more barriers to, and lack of information about services, than those in camps. Both Jordanians and Syrians shared concerns about access to healthcare and the inability to reach services.

Stigma surrounding mental health issues was frequently reported by respondents, which appeared to represent a significant barrier to help seeking behaviors. Women in particular, reported an increased need for privacy when accessing mental health services, for fear of experiencing stigma within the community. A sense of helplessness and hopelessness was strongly reported amongst the Syrian refugee community, with the Jordanian host community reporting lower levels of helplessness and a stronger tendency to use work as a distraction from emotional distress. For both the Syrian and Jordanian population, economic instability was found to be a source of great concern for both adult males and females, leading to a reported decline in mental wellbeing and the capacity to care for young children and older adults, particularly in light of the protracted nature of the crisis. Such themes with respect to financial concerns were common in camp and urban settings. Finally, key informant interviewees noted the importance of ensuring mental health and psychosocial service staff are well-trained and equipped to manage the complex presentations with which they are faced.

Recommendations

Key recommendations include the following:

  1. Increase awareness about mental health issues with a goal toward reducing stigma and encouraging those in need, to access available services.

  2. Support access to services where it may be impeded by factors such as transportation and expense, particularly in more dispersed urban settings.

  3. Consider methods that allow affected persons, especially women, to access information about mental health privately.

  4. Standardize and conduct mental health case management, ensuring a component of community outreach, to build trust among individuals and communities.

  5. Promote positive coping strategies which focus on fostering a sense of empowerment, self-reliance and resiliency.

  6. Prioritize developmental needs of children and youth (emotional, social, educational, physical, and cognitive), including support to parents desperate to ensure the wellbeing of their children.

  7. Consider the needs of vulnerable populations, such as older adults, when designing programs, with an emphasis on increasing access to appropriate services.

  8. Increase the focus on staff training and supervision to ensure high-quality service provision.

These recommendations build upon IMC’s existing programming, partnerships, organizational capacities, and well-developed relationships with refugee and host communities in Jordan. The recommendations are interrelated and should not be considered in isolation. IMC’s presence in Jordan is longstanding and this assessment demonstrates that it continues to bear a significant responsibility in supporting and promoting the health and wellbeing of the communities it serves.