Advertisement

Mental Health and Psychosocial Concerns and Provision of Services for Adolescent Syrian Refugees in Jordan

  • Yousef S. KhaderEmail author
Living reference work entry

Abstract

After years of the Syrian crisis, it continues to have an enormous social and economic impact on the countries hosting Syrian refugees. This chapter reviews the mental health and psychosocial support (MHPSS) problems and the provision of services for Syrian children and adolescent refugees in Jordan. The relevant literature and reports were reviewed. Conflict-related violence coupled with the ongoing stressors related to displacement had a significant and ongoing impact on the mental health and psychosocial well-being of Syrian refugees. Syrian children and adolescents in Jordan suffered and continue to suffer from various mental health and psychosocial problems including depression, anxiety, post traumatic disorders, racial discrimination, and behavioral and emotional problems. More than half of the children suffer from nightmares, various forms of sleep disorders, or bedwetting as a result of the distress they have been exposed to since the onset of the crisis. What is more troublesome is the limitations in child mental health services. MHPSS services provided by nongovernmental organizations (NGOs) are provided by mostly nonspecialized staff (75%) and specialized national staff (20%). However, such specialized services still only represent one tenth of services, with the remaining services focused on nonspecialist service provision, strengthening family and social supports, and the integration of MHPSS considerations into other sectors providing humanitarian aid. In conclusion, many psychosocial problems are still affecting Syrian refugee children and adolescents in Jordan despite the fact that many of them started living in Jordan many years ago, and as a result of these outputs, more psychosocial and financial support is still necessary to help them.

Keywords

Mental health Psychosocial problems Mental health services Syrian refugees Children Adolescents Jordan 

Abbreviations

CES-DC

The Center for Epidemiological Studies Depression Scale for Children

GIZ

Deutsche Gesellschaft für Internationale Zusammenarbeit

IMC

International Medical Corps

JHAS

Jordan Health Aid Society

JICA

Japan International Cooperation Agency

JRP

Jordan Response Plan

mhGAP

Mental Health Gap Action Programme

MoH

Ministry of Health

MOI

Ministry of Interior

MoSD

Ministry of Social Development

NCMH

National Center for Mental Health

NGOs

Nongovernmental organizations

NHF

Noor al-Hussein Foundation

OR

Odds ratio

PHC

Primary Health Care

PHQ

Patient Health Questionnaire

PTSD

Post Traumatic Stress Disorder

PTSDSSI

Posttraumatic Stress Disorder Semi-Structured Interview

RCADS-25

Revised Children’s Anxiety and Depression Scale

RMS

The Royal Medical Services

SDQ

Strengths and Difficulties Questionnaire

UNHCR

United Nations High Commissioner for Refugees

UNRWA

United Nations Relief and Works Agency

VAF

Vulnerability Assessment Framework

WHO

World Health Organization

References

  1. Achilli L (2015) Syrian refugees in Jordan: a reality check. Available from: http://cadmus.eui.eu/handle/1814/34904. Accessed 19 Apr 2019
  2. Al Ali NM, Gharaibeh M, Masadeh MJ (2017) Students’ perceptions of characteristics of victims and perpetrators of bullying in public schools in Jordan. Nurs Res 66(1):40–48CrossRefGoogle Scholar
  3. Al-Bitar ZB, Al-Omari IK, Sonbol HN, Al-Ahmad HT, Cunningham SJ (2013) Bullying among Jordanian schoolchildren, its effects on school performance, and the contribution of general physical and dentofacial features. Am J Orthod Dentofac Orthop 144(6):872–878CrossRefGoogle Scholar
  4. Almoshmosh N, Mobayed M, Aljendi M (2016) Mental health and psychosocial needs of Syrian refugees and the role of Syrian non-governmental organisations. BJPsych Int 13(4):81CrossRefGoogle Scholar
  5. Al-Rousan T, Schwabkey Z, Jirmanus L, Nelson BD (2018) Health needs and priorities of Syrian refugees in camps and urban settings in Jordan: perspectives of refugees and health care providers. East Mediterr Health J 24(3):243–254CrossRefGoogle Scholar
  6. Amnesty International. The state of the world’s human rights. Available from: https://www.amnesty.org/download/Documents/POL1048002017ENGLISH.PDF. Accessed 19 Apr 2019
  7. Arabiat DH, Shaheen A, Nassar O, Saleh M, Mansour A (2018) Social and health determinants of adolescents’ wellbeing in Jordan: implications for policy and practice. J Pediatr Nurs 39:55–60CrossRefGoogle Scholar
  8. Atoum M, Alhussami M, Rayan A (2018) Emotional and behavioral problems among Jordanian adolescents: prevalence and associations with academic achievement. J Child Adolesc Psychiatr Nurs 31(2–3):70–78CrossRefGoogle Scholar
  9. Baddoura C, Merhi M (2015) PTSD among children and adolescents in the Arab world. Arab J Psychiatry 26(2):129–3630CrossRefGoogle Scholar
  10. Boehm B (2018) Mental health amongst child Syrian refugees living in Jordan’s host community. Available from: https://www.researchgate.net/publication/323811701_Mental_Health_amongst_Child_Syrian_Refugees_living_in_Jordan's_Host_Community. Accessed 19 Apr 2019
  11. Care I (2017) 7 years into exile: how urban Syrian refugees, vulnerable Jordanians and other refugees in Jordan are being impacted by the Syria crisis. Available from: https://www.care.at/wp-content/uploads/2017/06/2017-summary-DRAFT-EMBARGO-14062017.pdf. Accessed 19 Apr 2019
  12. Conti-Ramsden G, Mok PL, Pickles A, Durkin K (2013) Adolescents with a history of specific language impairment (SLI): strengths and difficulties in social, emotional and behavioral functioning. Res Dev Disabil 34(11):4161–4169CrossRefGoogle Scholar
  13. Demaray MK, Malecki CK (2002) Critical levels of perceived social support associated with student adjustment. Sch Psychol Q 17(3):213CrossRefGoogle Scholar
  14. Department of Statistics (2017) Population and Housing Census Jordan Department of StatisticsGoogle Scholar
  15. Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) GmbH. Mental health and psychosocial problems and needs among Jordanian adolescents and Syrian Adolescents refugees. 2018Google Scholar
  16. Devi R, Verma N, Shekhar C (2013) Exploring strengths, difficulties and loneliness among children living in socioeconomically deprived environment. J Indian Assoc Child Adolesc Ment Health 9(2):26–42Google Scholar
  17. Doocy S, Lyles E, Akhu-Zaheya L, Burton A, Weiss W (2016) Health service utilization and access to medicines among Syrian refugee children in Jordan. Int J Health Plann Manag 31(1):97–112CrossRefGoogle Scholar
  18. Doren C (2011) Psychosocial problems of refugees: understanding and addressing needs. Available from: https://digitalcollections.sit.edu/cgi/viewcontent.cgi?referer=https://www.google.com/&httpsredir=1&article=2168&context=isp_collection. Accessed 19 Apr 2019
  19. El Arab R, Sagbakken M (2018) Healthcare services for Syrian refugees in Jordan: a systematic review. Eur J Pub Health 28(6):1079–1087CrossRefGoogle Scholar
  20. Francis A (2015) Jordan’s refugee crisis: carnegie endowment for international peace. Available from: https://carnegieendowment.org/files/Brief-Francis-Jordan.pdf. Accessed 19 Apr 2019
  21. Geha C, Talhouk J (2018) Politics and the plight of Syrian refugees in Lebanon. Available from: https://www.aub.edu.lb/Documents/Politics-and-the-Plight-of-Syrian-Refugees-in-Lebanon.pdf. Accessed 19 Apr 2019
  22. Gormez V, Kılıç HN, Orengul AC, Demir MN, Demirlikan Ş, Demirbaş S et al (2018) Psychopathology and associated risk factors among forcibly displaced Syrian children and adolescents. J Immigr Minor Health 20(3):529–535CrossRefGoogle Scholar
  23. Hassan G, Kirmayer LJ, Mekki-Berrada A, Quosh C, el Chammay R, Deville-Stoetzel J et al (2015) Culture, context and the mental health and psychosocial wellbeing of Syrians: a review for mental health and psychosocial support staff working with Syrians affected by armed conflict. UNHCR, Geneva, pp 14–15Google Scholar
  24. IMC (2015) Syria crisis: addressing regional mental health needs and gaps in the context of the Syria crisis. Available from: https://internationalmedicalcorps.org/wp-content/uploads/2017/07/Syria-Crisis-Addressing-Mental-Health.pdf. Accessed 19 Apr 2019
  25. IMC (2017) Understanding the mental health and psychosocial needs, and service utilization of Syrian refugees and Jordanian nationals – a qualitative & quantitative analysis in the Kingdom of JordanGoogle Scholar
  26. Jordan Health Aid Society and IMC (2012) Displaced Syrians in Jordan: a mental health and psychosocial information gathering exercise. Available from: https://data2.unhcr.org/en/documents/download/36230. Accessed 19 Apr 2019
  27. Jordan Ministry of Planning & International Cooperation. The Jordan Response Plan (JRP) For the Syria Crisis 2018–2020. Available from: https://static1.squarespace.com/static/522c2552e4b0d3c39ccd1e00/t/5a9d05ff24a69491feff8ba5/1520240134714/JRP+Summary+Final.pdf. Accessed 19 Apr 2019
  28. Kisilu AL, Darras L (2018) Highlighting the gender disparities in mental health among Syrian refugees in Jordan. Intervention 16(2):140CrossRefGoogle Scholar
  29. Milam A, Furr-Holden C, Leaf P (2010) Perceived school and neighborhood safety, neighborhood violence and academic achievement in urban school children. Urban Rev 42(5):458–467CrossRefGoogle Scholar
  30. Nijs MM, Bun CJ, Tempelaar WM, de Wit NJ, Burger H, Plevier CM et al (2014) Perceived school safety is strongly associated with adolescent mental health problems. Community Ment Health J 50(2):127–134CrossRefGoogle Scholar
  31. Norwegian Refugee Council. Delivering through a bleak, challenging year 2016. Available from: https://www.nrc.no/globalassets/pdf/annual-reports/2017/nrc_annualreport2016_230616.pdf. Accessed 19 Apr 2019
  32. Panter-Brick C, Hadfield K, Dajani R, Eggerman M, Ager A, Ungar M (2018) Resilience in context: a brief and culturally grounded measure for Syrian refugee and Jordanian host-community adolescents. Child Dev 89(5):1803–1820CrossRefGoogle Scholar
  33. Perkins JD, Ajeeb M, Fadel L, Saleh G (2018) Mental health in Syrian children with a focus on post-traumatic stress: a cross-sectional study from Syrian schools. Soc Psychiatry Psychiatr Epidemiol 53(11):1231–1239CrossRefGoogle Scholar
  34. Polanczyk GV, Salum GA, Sugaya LS, Caye A, Rohde LA (2015) Annual research review: a meta-analysis of the worldwide prevalence of mental disorders in children and adolescents. J Child Psychol Psychiatry 56(3):345–365CrossRefGoogle Scholar
  35. Ranttila J, Shrestha T (2011) Understanding depression in children and adolescents. Available from: https://www.theseus.fi/handle/10024/36696. Accessed 19 Apr 2019
  36. Refugee Regional & Resilience Plan 2016–2017. Progress report of the regional refugee and resilience plan (3RP) in response to the Syria Crisis. Available from: http://www.3rpsyriacrisis.org/. Accessed 19 Apr 2019
  37. Rigby K (2000) Effects of peer victimization in schools and perceived social support on adolescent Well-being. J Adolesc 23(1):57–68CrossRefGoogle Scholar
  38. Salemi C, Bowman J, Compton J (2018) Services for Syrian refugee children and youth in Jordan: forced displacement, foreign aid, and vulnerability. In: Economic research forum working paper series 2018 Apr (No. 1188)Google Scholar
  39. Save the Children (2017) The impact of six years of war on the mental health of Syria’s children. Available from: https://www.savethechildren.org.uk/content/dam/global/reports/emergency-humanitarian-response/invisible-wounds.pdf. Accessed 19 Apr 2019
  40. Shaheen AM, Hammad S, Haourani EM, Nassar OS (2018) Factors affecting Jordanian school adolescents’ experience of being bullied. J Pediatr Nurs 38:e66–e71CrossRefGoogle Scholar
  41. Sijbrandij M, Acarturk C, Bird M, Bryant RA, Burchert S, Carswell K et al (2017) Strengthening mental health care systems for Syrian refugees in Europe and the Middle East: integrating scalable psychological interventions in eight countries. Eur J Psychotraumatol 8(sup2):1388102CrossRefGoogle Scholar
  42. Sim A, Fazel M, Bowes L, Gardner F (2018) Pathways linking war and displacement to parenting and child adjustment: a qualitative study with Syrian refugees in Lebanon. Soc Sci Med 200:19–26CrossRefGoogle Scholar
  43. Sirin SR, Rogers-Sirin L (2015) The educational and mental health needs of Syrian refugee children. Migration Policy Institute, Washington, DCGoogle Scholar
  44. Song S (2014) Mental health psychosocial and child protection for Syrian adolescent refugees in Jordan. International Medical Corps (IMC), pp 47–52. Available from: https://www.alnap.org/help-library/mental-health-psychosocial-and-child-protection-for-syrian-adolescent-refugees-in. Accessed 19 Apr 2019
  45. Soykoek S, Mall V, Nehring I, Henningsen P, Aberl S (2017) Post-traumatic stress disorder in Syrian children of a German refugee camp. Lancet 389(10072):903–904CrossRefGoogle Scholar
  46. Stave SE, Hillesund S (2015) Impact of Syrian refugees on the Jordanian labour market. ILO, Geneva. Available from: https://www.ilo.org/wcmsp5/groups/public/%2D%2D-arabstates/%2D%2D-ro-beirut/documents/publication/wcms_364162.pdf. Accessed 19 Apr 2019
  47. The National Strategy for Health Sector in Jordan, 2015–2019. http://www.hhc.gov.jo/uploadedimages/The%20National%20Strategy%20for%20Health%20Sector%20in%20Jordan%202015-2019.pdf. Accessed 19 Apr 2019
  48. Tian L, Liu L, Shan N (2018) Parent–child relationships and resilience among Chinese adolescents: the mediating role of self-esteem. Front Psychol 9:1030CrossRefGoogle Scholar
  49. UNHCR (2017) Information sharing portal. Available from: https://data2.unhcr.org/en/situations/syria. Accessed 19 Apr 2019
  50. UNICEF, UNHCR, WFP (2017) Vulnerability assessment of Syrian refugees in Lebanon. Available from: https://reliefweb.int/sites/reliefweb.int/files/resources/VASyR%202017.compressed.pdf. Accessed 19 Apr 2019
  51. Wells R, Steel Z, Abo-Hilal M, Hassan AH, Lawsin C (2016) Psychosocial concerns reported by Syrian refugees living in Jordan: systematic review of unpublished needs assessments. Br J Psychiatry 209(2):99–106CrossRefGoogle Scholar
  52. WHO (2017) Depression and other common mental disorders: global health estimates. Available from: https://apps.who.int/iris/bitstream/handle/10665/254610/WHO-MSD-MER-2017.2-eng.pdf?sequence=1. Accessed 19 Apr 2019
  53. Wingo AP, Ressler KJ, Bradley B (2014) Resilience characteristics mitigate tendency for harmful alcohol and illicit drug use in adults with a history of childhood abuse: a cross-sectional study of 2024 inner-city men and women. J Psychiatr Res 51:93–99CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of Community Medicine, Public Health and Family MedicineJordan University of Science & TechnologyIrbidJordan

Section editors and affiliations

  • Hamed Al Sinawi
    • 1
  • Hanan Khalil
  1. 1.Behavioural medicineSQUHMuscatOman

Personalised recommendations