Response to Psychological Distress during Displacement

Amy J. Rezac, Case Western Reserve University

This pre-dissertation research funded by the SPA/Lemelson Fellowship explores psychological distress among forced migrants in Cairo, Egypt. Working with two non-governmental organizations (NGO) which provide the majority of psychosocial services for forced migrants and refugees in the area, my research inquires as to the various ways individuals express and negotiate psychological and emotional distress in a new sociocultural environment while also exploring how host communities respond to such distress.

For two months I observed psychosocial visits with providers at two independent NGOs in Cairo. Following the observations, interviews were conducted with both the client (i.e. forced migrant/refugee) and provider (i.e. therapist, social worker, psychiatrist, psychologist). The purpose of the interviews was to collect information on individual conceptualizations of psychological and emotional distress as well as motivations for seeking and providing services. In all, 10 providers participated in the research with 26 clients agreeing to take part in the study.

Preliminary analysis indicates dynamics that as expressed by both the providers and forced migrants influence psychological and emotional wellbeing as well as impede healing from past trauma, violence and loss. Existing dynamics include unsatisfactory interactions with the host community, few livelihood opportunities due to existing legislation and discrimination, overall poor living conditions, and in some cases, continued assaults and harassment by local security forces. Preliminary findings indicate that social and political factors were strong motivational forces when seeking and providing treatment — with healing and “feeling better” often an important but shared objective.

While both providers and forced migrants often described biomedical conceptualizations of illness and healing when speaking of specific personal encounters, etiologies and treatments were based in the social context of the individual often addressing the larger political and social environments. The structural organization of the NGOs influenced the encounters with many of the services impacted by the NGO’s mandates and organizational design. While analysis of this data is ongoing, the preliminary findings and over-arching themes emerging are illuminating areas which need further inquiry and this has greatly impacted and helped to shape the development of my dissertation research in both objective and design.