Enhancing Mental Health and Well‑being
INTRO
Please watch our introductory video on mental health and well-being. In this segment, we will cover essential information regarding mental health, its importance, and the factors that contribute to overall well-being. Understanding mental health is vital for supporting refugees and others facing challenges in their lives.
In this section:
you will get information about the stages of the immigration process
you will get basic information about mental health
you will learn to understand which factors affect the mental well-being of immigrants with a refugee background
you will learn to recognize when it is good to refer the mentee to a professional
you will get practical tips regarding the mental well-being and coping of both the person being helped and your own
Immigration is a Major Life Transition
Everyone experiences moving to a new country differently. It is a process that involves various stages and emotions, such as joy and sadness.
While immigration can be described in terms of stages, it remains an individual experience for each person moving to a new country.
Watch the video (in Finnish, 2:10)
Source: Bremer L. & Haavikko A.: Ulkoisesti erilaisia, sisäisesti samanlaisia. Opas mielenterveystyöhön yli kulttuurirajojen. SMS-Tuotanto Oy 2009.
PowerPoint-esitys (mielenterveysseurat.fi)
Steps of the Immigration Process
Excitement and Anticipation
Arriving in the country is often a positive and hopeful time. Common feelings at this stage include excitement, relief, and gratitude.
Hopes and expectations are high, and there is strong faith in aspects such as learning a language and finding a job. Typically, there is also a lot of energy and activity directed toward organizing things.
Expectations and wishes can sometimes be unrealistic. Initially, it may seem that there are no challenges in the new country, and difficulties are often not immediately acknowledged.
Watch the video (in Ukrainian, 9:32)
Desires and Possibilities in Conflict
The attitude towards a new country becomes more realistic when a person has been in the country longer: problems are encountered everywhere. We also start to see the bad sides of the country and the people. It can be difficult to get into education and work. My own country starts to feel good in every way and the new country feels bad.
At this stage, a person often feels bad and suffers from various ailments. Feelings of loneliness and disappointment are common.
Strong Emotions
An uncertain future causes stress. New things and ways of working require a lot of concentration and consume strength and energy. Social relationships or their absence can be challenging. A suitable job may not be found right away and there may also be difficulties with housing, money, and food. This creates a psychological burden, strong reactions, and feelings that can surprise and feel scary. However, they are an understandable and normal part of adaptation.
Feelings and reactions familiar to many at this stage are:
fatigue, weakness, frustration, and despair
irritation, bitterness, anger, anger and aggressiveness
insomnia and nightmares
forgetting words, names, and appointments and difficulty concentrating
headache, upset stomach, and other physical symptoms
fear and suspicion
wouldn't be able to do anything or make contact with the new society
overactivity in taking care of one's own affairs.
It often helps to know that negative feelings are part of the normal immigration process and that this phase will also pass. Sometimes people fear that their personality has changed permanently; and that negative reactions and feelings remain a part of the self forever. This is not the case. You can move on from the stage when you process your thoughts and feelings. If things are not worked out, the result can be a deep crisis or depression.
Towards Balance
When you begin to see positive things around you, your attitude towards the future becomes more positive. Despite the difficulties encountered, faith in the possibilities of survival is strengthened. This can be seen on a practical level, for example, by the desire to create friendships or plan to get one's own apartment.
It can come as a big surprise to many immigrants that, for example, events in the home country cause a temporary setback in the immigration process. The strength of the reaction may depend on the distance to the home country and the possibility of visiting there. For a refugee, security may be an obstacle, for a migrant, for example, wealth. It is important to remember that moving backwards is temporary and the journey forward continues.
The basic feeling at this stage is often sadness, which also feels like homesickness. Grieving is natural and even necessary. You have to give up the old to be able to move towards the new. Only when you have mourned the things you have lost can you look to the future and the opportunities that the new country has. Grieving is a sign that you are ready to move on. Your life history turns into strength and memories into wealth.
At this stage of the process, a person begins to notice the positive aspects of immigration. He masters two cultures and knows how to act in both. Two cultures enrich life and give new opportunities. Man has adapted. Life includes the usual joys, sorrows, and calm again.
Mental Well-being and Mental Health
Immigrants with a refugee background may experience psychological stress and symptoms related to mental health. Many of them have faced war, violence, torture and death, as well as a dangerous escape. Also, moving to a new country and getting to know a new language environment and society always cause stress and burden for a person. Factors affecting the mental health of immigrants include, for example:
discrimination and racism
loneliness
financial uncertainty
lack of inclusion
linguistic and cultural challenges
difficulty in accessing social and health services
long processing times for asylum applications
uncertainty about the future
According to the health and well-being of asylum seekers survey
40% of adults experience significant symptoms of depression and anxiety.
about 30% of young people report significant psychosocial symptoms.
In a new phase of life, mental health can be supported in many ways. It is important to recognize mental health problems and guide those who need help to the right help. It is also necessary to ask about the use of substances, so that problematic use can be identified and help can be offered.
A Video Guide to Recognizing Challenges and Enhancing Well-being
A mental health-enhancing approach involves methods that aim to increase and strengthen a person's own factors that protect and support mental health. When discussing mental health, it is easy to focus on problems and symptoms or to be afraid to talk about it. Sometimes, mental health is associated with negative images. Through their actions, a helper can prevent and correct negative perceptions by discussing mental health as a positive resource that is part of overall health and well-being.
You can approach the topic by watching the following video created by professionals together: https://www.youtube.com/watch?v=i-7hIjlkKBo (in Ukrainian, 8:11)
The video discusses:
What enhances mental health
How to recognize when you have mental health problems
Why mental health can vary
Making Mental Health Conversations Easier
Comprehensible language and everyday examples make it easier to talk about mental health.
A professional can facilitate discussions by mentioning their awareness of common psychological symptoms, such as insomnia, low mood, or repetitive thoughts. They can then ask if the client has experienced similar or other symptoms.
When discussing mental health, it's best to avoid professional jargon or diagnostic terms like "depression." Instead, focus on mental health, well-being, and various symptoms, using concrete and everyday examples. This approach helps to normalize conversations about mental well-being.
Talking about mental health with some clients may require more time than usual, building mutual trust, and revisiting the topic multiple times.
During the discussion, it's also important to provide information about mental health, how to support it, various symptoms, and the available social and health services in a way that is clear and concrete.
Listen to Your Client's Experiences
An essential part of mental health assessment is the effort to understand the person's own experiences of symptoms or problems. An open approach, in which the helper is interested in the person's own experiences and interpretations, facilitates the identification of problems and increases the experience of being heard.
For example, the following questions can be used to help clarify possible problems:
How are you?
How do you cope with various everyday tasks (cooking, cleaning, taking care of your own hygiene, etc.)?
How do you eat and sleep?
How do you see your future?
What are you worried about?
Have you ever thought about harming yourself or killing yourself?
Where would you need support?
How can I help?
When to See a Professional?
A mentee with a refugee background should be referred to professionals if they exhibit any of the following signs or situations:
Strong psychological stress: If the client expresses strong psychological pressure, such as severe anxiety, depression, panic attacks, or other psychological suffering.
Trauma-related symptoms: If the client reports suffering from trauma-related symptoms, such as repeated memories of traumatic events, nightmares, or difficulties in adapting to life after the traumatic experience.
Suicidal thoughts or attempts: If the client expresses suicidal thoughts, plans suicide, or has attempted suicide.
Serious adaptation difficulties: When a client has significant difficulties adapting to a new culture, environment, or daily activities, and faces serious challenges.
Difficulties in social relationships: If the client struggles with forming social relationships, integrating into the community, or faces negative treatment in their environment.
Serious mental health disorders: If there is a suspicion of a serious mental health disorder, such as a psychotic state, an eating disorder, or other serious mental illnesses.
Repeated conflicts or threats of violence: When the client is repeatedly exposed to conflicts or threatening behavior, especially if it involves physical or mental violence.
When mentoring, it is important to be attentive to these signs and refer the client to a professional as early as possible for evaluation and support. This helps ensure that the client receives the specialized care they need as quickly as possible.
Below is a concrete list of signs that indicate the mentee should seek professional help:
Loss of appetite
Poor sleep
Persistent low mood
Obsessive thoughts (recurrent, intrusive thoughts that usually focus on fears, worries, and anxiety)
Intense anxiety
Suicidal thoughts
Panic attacks
Uncontrollable anger
Dissatisfaction with life
Inability to experience pleasure
Supporting Well-being
The immigrant population, like the rest of the population, has many different resources and factors that protect and strengthen mental health.
Social networks: Strong and supportive social networks such as family, friends and community can provide emotional support and a sense of belonging, which promotes mental health.
Cultural identity: A strong connection to one's own cultural background and identity can act as a protective factor. Maintaining cultural identity can bring strength and meaning in a new environment.
Education and employment: Opportunities for education and employment are key factors that can promote self-fulfillment and financial independence, which in turn can strengthen mental health.
Culturally sensitive support: Available culturally sensitive support can increase knowledge and understanding of the new country's ways of working and help with integration.
Involvement in the community: Participation in the local community, for example in hobbies, volunteer work or religious communities, can bring meaning to life and increase the sense of community.
Learning a language: Learning a new language and communication skills can make everyday life easier and increase refugees' participation in society.
Recognizing trauma-related symptoms and getting support: Being able to get appropriate support helps to deal with possible traumatizing experiences and promotes mental health.
The importance of nature and exercise: Outdoor activities and exercise can be a resource for mental health. Nature and physical activity can provide stress relief and positive effects on mood.
Religion: Religion can maintain hope and create a sense of security.
Video: Improving Mental Health
Taking care of your well-being is essential for mental health. An individual's ability to enhance their mental health can be improved through psychoeducation, which involves sharing information about mental health and the factors that influence it.
Mental health is a key aspect of overall health and well-being. It's important to discuss mental health as a positive resource that can be strengthened and promoted at the individual, community, and societal levels.
Mental health, like general health, is built on fundamental aspects such as:
Exercise
Sleep
Healthy food
Good relationships
Meaningful activities
Below is a related video:
Watch the video on YouTube (in Ukrainian, 8:46)
Empathy Exhaustion and Vicarious Traumatization
When we talk about the mental health of mentees from a refugee background, we cannot ignore issues related to the mental well-being of the mentor.
Those who work with people in difficult life situations and traumatized individuals often face the emotional burden of their clients' experiences, which can expose them to vicarious traumatization and empathy exhaustion. These refer to the phenomenon where the traumatic experiences of people encountered at work are transferred to employees and the work community, potentially causing psychological stress and burnout.
The symptoms of vicarious traumatization and empathy exhaustion can be very comprehensive. Vicarious traumatization can manifest as various psychological and cognitive symptoms, such as memory and concentration difficulties, low mood, withdrawal, cynicism, and irritability. Distressing images can also enter the mind, and physical symptoms like aches, pains, tense states, stomach issues, and sleep problems are common. Often, the condition develops gradually, making early recognition challenging, though a single event can also lead to vicarious traumatization.
The key to preventing vicarious traumatization is awareness and recognition of the phenomenon both at the individual level and in work communities. Employees should be offered adequate training and job guidance, as well as the opportunity to address challenging and emotional situations that arise at work, and access to professional help if necessary. To effectively help others, we must take care of ourselves. Being aware of and respecting one's own involvement, resources, and professional boundaries is crucial for acting in the best interest of those who need help.
Support for Mentors
Immigrants with a refugee background often face traumatic situations, violence, and various losses, which mentors may encounter indirectly. A person may share their difficult experiences with a trusted mentor. If these situations are not addressed or persist over time, they can increase the mentor's emotional and psychological burden.
What will help?
Identifying and addressing signs of vicarious traumatization
Providing adequate training and education
Effective work management
Peer support
Awareness and use of personal recovery and coping methods (e.g., nature, music, exercise, art hobbies)
Clear delineation of work responsibilities
Establishing clear rules and boundaries related to work
These measures are essential for maintaining your own coping and well-being.
Source: Turvaa, toivoa ja toimijuutta (hdl.fi)
Levander M., Luotonen K. & Vartio A.: Security, hope, and agency - information about the trauma of being a refugee for early childhood education and teaching professionals. Helsinki Deaconess Institute Foundation sr 2022
Where Are You?
Consider reflecting on your own activities using the attached diagram. Which part of the pattern do you recognize in yourself?
Summary
Everyone experiences moving to a new country differently. It involves various stages and emotions such as joy, sadness, loneliness, and hope.
Immigrants with a refugee background may have endured difficult experiences in their home country and during their escape, which can lead to psychological stress and mental health-related symptoms. Stress associated with the relocation process can also impact their well-being.
Recognizing when a mentee with a refugee background should be referred to professionals is crucial.
In this new phase of life, mental health can be supported through various means: exercising, getting enough sleep, eating healthy food, maintaining relationships, and engaging in meaningful activities.
Those working with people in difficult life situations and those who are traumatized may be at risk of vicarious traumatization and empathy exhaustion.
It is important to be aware of this: to effectively help others, we must first take care of ourselves.