Supporting people fleeing conflict

A friend of mine just got his kids to safety. They will be able to sleep again. Many others are still on the run or staying put in difficult circumstances.

Now these kids were in Ukraine, but it could also have been Ethiopia, Afghanistan, Yemen, or several other places.

Globally, well over 80 million people have been forced to leave their homes due to conflict and human rights violations.

The Australian news has shown a narrative of solidarity with refugees in the past few days. This is heart-warming to see and much needed to support those who are affected.

However, there is another side: Australia has a history of detaining people who are seeking asylum. In particular, those arriving by boat.

People seeking asylum by boat have been ‘processed’ offshore on two Pacific islands – Nauru and Papua New Guinea – and if determined to be genuine refugees, they have not been allowed to resettle in Australia. Many have endured multiple years of immigration detention.  

The concept of moral injury – the experience of your beliefs of what is right and wrong being transgressed – has gained attention in the trauma literature recently. Being exposed to moral wrongs, or even forced to participate in them, is a terrible type of injury.

Our team wanted to better understand experiences of moral injury and mental health related to immigration detention on Nauru.

It is difficult to speak with the people who are directly affected but we were able to interview 13 refugees who had been medically evacuated from Nauru to Australia. On average they had been detained on Nauru for 14 months, though there was quite a wide range (1 month to 3 years).

We derived the following main themes from the interviews:

  1. The risk at home and the expectation of getting protection as main reasons to flee to Australia
  2. The experience of deprivation, a lack of agency, violence, and dehumanization after arrival
  3. The feeling of being irreparably damaged as a result

One participant said:

“In my country they torture your body but in Australia they kill your mind.”

It seemed to convey the above three themes in combination. The participants appeared to make a distinction between Australian decision makers versus the Australian people, still feeling a connection with (and experiencing support by) the latter.

The full description of the findings has just been made available open access in the European Journal of Psychotraumatology.

It also includes a range of quotes by the interviewees. I’m sharing two, from different participants, here. They are confronting and important (as are the others that I’m not copying here):  

“We feel as an animal. It’s not what they do to humans. That time, I felt they were looking at me as an animal. But when they transferred me to Australia, I thought, no, I thought wrong because the people have a very nice behaviour with pets. When I went to the shop for the first time, I saw lots of food for dogs or cats. They have got toilets, they have got doctors. They have everything they need. So, we are smaller than that for the people who work in the detention camp or government.”

“If you don’t want to give me a life, okay kill me and shoot me and I will die one time. Why are you killing my brain? Why are you cutting my heart, every single day? When somebody uses a knife and you die, and when somebody kill you every single day, kill your brain and your mind, it’s totally different. It is better you die one time.”

These interviews show a need to make sure that all asylum seekers are met with safe conditions for their stay, ethical procedures to determine their status, and proper support.

While our very first priority should be to end violence and wars, for those who are already affected, we need to make sure they are not further harmed and given the opportunity to peacefully live their life and contribute to society.

If you are keen to support people who are fleeing conflict right now, there are multiple things that you can do. For mental health professionals, the European Society for Traumatic Stress has put together a helpful overview of suggestions. They are written for the situation in Ukraine but are just as applicable to those affected by other conflicts.

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Full reference:

Passardi, S., Hocking, D., Morina, N., Sundram, S., & Alisic, E.  (2022). Moral injury related to immigration detention on Nauru: A qualitative study, European Journal of Psychotramatology, 13, 1. https://doi.org/10.1080/20008198.2022.2029042

Photo by Simon Maage on Unsplash

Highlights of the European Conference on Traumatic Stress 2019

Didn’t get the chance (like me 😦 ) to attend the conference of the European Society of Traumatic Stress Studies this year?  

Maya Meentken and Marie-Louise Kullberg help us out!

We are Maya and Marie-Louise, two Dutch PhD Candidates, sharing some of our ESTSS conference 2019 – both scientific and non-scientific – highlights with you. It all started on Thursday with the inspiring pre-conference paper-in-a-day workshop: A collaboration of 7 young researchers from Germany, Israel and the Netherlands with an interest in (child) trauma, but with a widely varying focus: From burn injury-related trauma to childhood maltreatment, and an MRI study on dissociation to EMDR for medical-related PTSD.

During this year’s paper-in-a-day, hosted by Anne Krause and Lonneke Lenferink, we focused on child trauma utilizing the data from the Prospective studies of Acute Child Trauma and Recovery (PACT/R) archive. The archive includes data of 32 child trauma studies from e.g. US, UK, Australia, Switzerland, representing data from 5500+ children exposed to a single incident trauma, such as injury, disaster, interpersonal violence etc. and is openly available (!). Throughout the whole day Nancy Kassam-Adams from the PACT/R team joint us to answer all our questions and share her ideas on the rich dataset.

Just a sneak preview of our findings; with a latent class analysis we distinguished three groups based on presence of acute stress disorder symptoms and predicted group membership by several trauma and background characteristics. Discussing the methods and our findings plenary and in subgroups answered many of our questions and generated new ideas. The final paper can be expected soon! To all (early-stage career) researchers: We would highly recommend to participate in a next edition to encourage cross-border collaborations and sharing knowledge. (Eva: yay 🙂 )

On Friday the conference was officially opened with a wonderful performance of the four dancers of Amenti Collective. The next three days, many fantastic keynotes, masterclasses, symposiums, posters and talks followed. Just to mention some of our favorites: Talya Greene’s masterclass on network modeling of PTSD symptoms, the keynote of Mark Jordans on global trauma care and the sharp symposium on early screening for PTSD following emergency department admission by Mirjam van ZuidenJuanita HaagsmaKatharina Schultebraucks and Miranda Olff.

During the ESTSS Young Minds lunch on Saturday we did some speed-dating with other early-stage career researchers from the psychotrauma field. During the ‘speed dates’ we discussed various topics such as ‘life as a PhD student’, supervision, development etc.,  a nice way to meet some peers!

A last impressive program part we would like to mention is the screening of the documentary Reconstructing Utøya by Steffen Svedsen on Sunday. Next to all high-quality clinical and research presentations, the documentary added the compelling perspective of 4 victims from the horrific 2011-event. It gave interesting insights into the different personal perceptions of the event and the long course of recovery afterwards. It made us realize how vulnerable people are, but also how resilient they  can be, which underlines the relevance of all the research we absorbed the past three days.

Thank you to all the presenters and organizers, we’d hope to see you during a next ISTSS/ESTSS conference!

Thanks Maya and Marie-Louise, and everyone who made the ESTSS conference possible this year! The next ESTSS conference will be in Belfast (16-19 June 2021). The theme: Trauma and resilience through the ages: A life course perspective

Maya and Marie-Louise’s blogpost also appeared on the website of the NtVP

ESTSS Young Minds Events

ESTSS BolognaHave you got the conference of the European Society for Traumatic Stress Studies in your diary yet? It is a biannual meeting with a great mix of presentations and workshops. This year it takes place in beautiful Bologna, June 6th – 9th. The theme is “Trauma and its Clinical Pathways: PTSD and Beyond.”

It has two very nice events for early career researchers / professionals: Paper in a Day – after the success at the ISTSS meeting we now also propose it at ESTSS –  and the Young Minds Event, to share your ideas and network with renowned trauma experts.

More details are below, feel free to put any questions about the events in the comments. And please share the invitation with others who may be interested 🙂 Continue reading

Go and collaborate

Child trauma researchers should collaborate more. That was one of the messages of the meta-analysis my colleagues and I recently published. Until now, researchers have conducted a number of interesting studies but these were relatively small and used a wide variety of methods and designs, which doesn’t permit robust conclusions. By combining efforts (see also the ‘data sharing’ page) much more could be known faster.

Our message is still relevant, but there are also some beautiful examples of collaboration. One was presented by Nancy Kassam-Adams at the European Conference on Traumatic Stress Studies. With three colleagues from the US and Australia she is building a large database from datasets of individual researchers: the Child PTSD Prediction Project. The data of  2500 children have been included so far (that’s already 25 times the usual N in a study…). It will enable researchers to answer questions about early risk and protective factors, and about trajectories of posttraumatic stress symptoms in children. Go and collaborate!