Creating an Ecosystem of Mental Health Support for the Rohingya Community

“Life doesn’t make any sense without interdependence. We need each other, and the sooner we learn that, the better for us all.” – Erik Erikson

Erikson’s quote resonates when we converse about mental health support systems; each of us being tied to families and communities that positively or negatively affect our mental and physical wellbeing. Recent conversations around mental health and psychosocial support have demonstrated that our mental health is just as important as our physical health. Developing help seeking behavior in case of mental health issues is an utmost necessary step.

In August 2017, after the Rohingya influx in Cox’s Bazar, it was realized that the Rohingya community, particularly children and women, needed psychosocial support. In order to address this need, BRAC Humanitarian Crisis Management Programme (HCMP) along with BRAC Institute of Educational Development (IED) integrated psychosocial support into their Humanitarian Play Lab(HPL) project which aimed to address playful learning and healing among children, and also support their mothers. In order to provide psychosocial support, para counselors and mother volunteers are employed, who are trained by certified psychologists. The mother volunteers are mothers recruited from the Rohingya community who possess great familiarity of the psychosocial needs and cultural context of their community, hence are able to provide services with empathy and understanding. Mother volunteers provide what can be termed as ‘mental health first aid’; initially, they provide basic psychosocial support to the community. If complicated cases arise, which are beyond their scope, they refer the case to para counselors and psychologists respectively.

BRAC JPGSPH has been involved a 5 years research project since 2019 to document the story of HPL and observed that the psychosocial support service is provided to caregivers and children, beneficiaries of the HPL program, giving many disadvantaged Rohingya children the opportunity to grow up in a healthy environment, which can stimulate their growth and development in the long run. In building a healthy environment, mothers play a vital role; a mentally unwell mother due to trauma, uncertain future, household work load and marital strife who is not able to take care of herself cannot be expected to provide a healthy environment for her children. The para counselors provide psychosocial support to the mothers by listening to them actively, showing empathy, not judging them and maintaining confidentiality, which are key tenets of their training. Gradually, they develop a close bonding with the mothers, and become a part of their mental-health support system. The mothers feel relieved by talking to the para counselors and over time, they started calling the para counselors ‘Shanti Apa’(Peace apa) as the para counselors became a symbol of peace to them. The para counselors not only listen to the mothers attentively but also suggest techniques to build attachment with their children. By practicing these techniques, the mothers found that it fostered positive relationships with their children and created lasting bonds.

“I play with my child; I draw with her. I do it just the way Apa(para counselor) has told me to. It makes my child happy, and her happiness also makes me happy.”

- A beneficiary mother from camp 11

By talking to the mothers, it was apparent that it will not be possible to create a healthy, simulating place for the mothers and the children if fathers are excluded in the process. Hence, the HPL model employed father volunteers whose role is akin to the mother volunteers, except that they provide services to the fathers. Prior to receiving this intervention, Rohingya fathers were reported to exhibit negative attitudes towards mothers and children at home, particularly during the Covid-pandemic. After receiving the psychosocial support service from father volunteers, fathers recognized their negative behaviors and are now taking small but steady steps to develop their relationships with their wives and children. The fathers are now making actions by thinking about the future of their children and by putting themselves in the shoes of the mothers. While developing the relationship with the mothers and the children, it is also creating a positive impact on the mental health of the Rohingya mothers.

“I used to hit my wife if she was late to serve my meals. By talking to the father volunteers, I realized that it is affecting my child and my relationship with my wife. Now I understand that being late is not my wife’s fault, she is late as she was doing other works for me and my children. Nowadays, I try to help my wife with household chores.”

- A Rohingya father from camp 11

Evidence from the above findings show that isolated psychosocial support services are not enough to ensure an individual’s mental wellbeing or build a healthy environment for the children. It is of utmost importance to ensure a holistic, ecosystem of support by fostering healthy relationships with the surrounding family and community. because everyone has the right to live with sound mental health. Mental health and human rights have a complex relationship wherein human rights violations can lead to harmful impacts on mental health. Hence, ensuring a human rights-based approach to create an ecosystem of support can make acceptance of and access to mental health support services universal, and it is an absolute necessity, as mental health is a basic human right. Provision of effective, inclusive mental health and community-based services that can protect, promote, and respect every individual’s right to sound mental health will need to be continued going forward.