Migrants fleeing Libya and suffering psychological stress will not be able to fully recover without continuous care once they have returned home or are resettled to another country, says IOM.
Of the nearly 1.2 million people who have fled Libya since the start of the crisis in February, more than 603,000 are migrants, many of whom have lived through traumatic experiences as they escaped the violence.
They display fear; disorientation; anger and sadness because of direct or indirect experiences of violence, the abrupt changes in daily routines and life plans and the stress and dangers of fleeing Libya and ending up in a transit country as well as experiencing frustrations related to an unplanned return home with no livelihood.
In addition, many tens of thousands of sub-Saharan Africans have had to cope with abuses and ill-treatment that took place in Libya prior to the conflict and with the targeting of Chadians in particular over claims they were mercenaries.
Many of those needing follow-up care are women and children. However, there are now increasing numbers of men in need of such attention. Their reactions can be very extreme sometimes but usually with consistent support they begin to relax and begin trusting other people again.
"We cannot under estimate the depth of fear, uncertainty and stress that the upheaval from Libya, a country where many migrants have been living and working for decades, is causing. It's not just about what they witnessed or endured during their flight, but also because they have been forced to give up their homes and jobs with nothing to go back to," says Guglielmo Schininà, Head of IOM's Global Mental Health, Psychosocial Response and Inter-cultural Communication Section.
IOM has been providing basic forms of emotional support, including psychological first aid, active listening, and group sessions to help those migrants arriving at border areas in Egypt and Tunisia and those returning to Niger and Chad.
These activities include psychiatric referral and follow up for those with pre-existing psychiatric conditions or those who have been affected by the violence in a way that makes them unable to function. However, for the vast majority of people, what is needed is just a word of reassurance, clear information and a venue to express freely their concerns and sadness.
Nevertheless, assistance at transit areas such as border points can only be limited in scope and time as the vast majority of migrants return to their home countries which often have poor mental health systems if any.
"There is a serious need to look at the psychological challenges people face upon return home and what follow-up support there is for them. It is a challenge. But we need to ensure that there is a continuity of care; that communities and families are educated on the issues so they understand what the migrants have gone through and what they are now facing. We also have to ensure that reintegration is somehow linked to regaining a livelihood. Without this support, how can people recover and resume a normal, productive life?" adds Schininà.
In Niger and Chad, which between them have seen about 160,000 migrants return, IOM is currently involved in assessment and support activities.
"Providing assistance in transit countries without a follow-up once they are at home can be counter-productive and even damaging," states Schininà.
However, funding for these kinds of issues and activities remains worrying low.
For further information, please contact Gulli Schininà, IOM Geneva, Tel: +41 22 717 9497, Email: gschinina@iom.int