The Mental Health and Psychosocial support of Jesuit Refugee Service
1. Introduction
Jesuit Refugee Service (JRS) is an international faith-based organization operating in over 50 countries. As a global ministry of the Society of Jesus, inspired by the compassion and love of Jesus for the poor and excluded, JRS is dedicated to accompanying, serving, and advocating for refugees and forcibly displaced individuals, empowering them to heal, learn, and determine their own futures. Our holistic approach addresses psychosocial well-being, gender responsiveness, safeguarding, community empowerment, and environmental stewardship, all essential for rebuilding lives and preserving dignity. Within this framework, we give a strong emphasis on Mental Health and Psychosocial Support.
In this perspective, “The Psycho-logical Approach to Missions in Conflict Zones” will reflect on the psychosocial determinants of mental health in conflict settings and the importance of a human rights approach in protecting the well-being of vulnerable refugees, migrants, and asylum seekers. The session will cover World Health Organization statistics and key facts regarding mental health difficulties in conflict settings, the main values and principles of Mental Health and Psychosocial Support (MHPSS) in humanitarian contexts—including “do no harm,” building on community strengths, and prevention strategies to reduce mental health risks. We will also discuss the importance of self-care and mechanisms to protect staff well-being within our programming.
2.Jesuit Refugee Service
Mission and
Priorities
2.1 A Holistic Service:
Cura Personalis
JRS was founded on November 14, 1980, by Fr. Pedro Arrupe, Superior General of the Jesuits, in response to the plight of Vietnamese refugees. Fleeing their war-ravaged homeland, hundreds of thousands of Vietnamese faced threats of pirates, storms, dehydration, and hunger while crossing the South China Sea. Many did not survive, and those who did often found themselves in camps awaiting resettlement. Moved by compassion, Fr. Arrupe affirmed that this as “a challenge to the Society we cannot ignore” and firmly believed that love for God must lead to concrete acts of love and justice for the marginalized. Thus, he initiated a thorough Ignatian discernment involving the universal Society, with a priority on “helping souls” and a commitment to serve wherever needed for the greater service of God. Consultation with the United Nations and other experts was also part of this discernment process to ensure an appropriate response.
Through this discernment JRS founder acknowledged the Society response should not be “only material: in a special way, the Society is being called to render a service that is human, pedagogical and spiritual,” reflecting the Jesuit tradition of education and care for the whole person. Indeed, he strongly stated, “We are not concerned just with the survival of refugees, but with their full development. Our apostolate should therefore aim at improving the quality of refugee work already being done rather than adding our name to the list of existing agencies.” This call reflects the Ignatian characteristic of Cura Personalis, or care for the whole person, by emphasizing individualized attention, the importance of considering all facets of a person’s life and needs, and respect for the dignity and well-being of each individual.
2.2 A ministry of Compassion and Healing
Over the decades, JRS expanded its mission, responding to civil strife in Central and Latin America, Southeastern Europe, and Africa. Today, JRS operates in 58 countries, serving over one and a half million refugees and other forcibly displaced persons in conflict zones, refugee camps, cities, and detention centers. Our team includes approximately 11,500 collaborators from various nations, fostering an inclusive environment that welcomes individuals from diverse cultural, religious, and secular backgrounds.
In all these diverse contexts, JRS is dedicated to accompanying, serving, and advocating for refugees and forcibly displaced individuals. Our mission is to help them heal, learn, and shape their own futures. By accompanying individuals on their journeys, JRS empowers them to recover from past traumas, acquire new skills, and reclaim control over their lives. Through our advocacy efforts, JRS amplifies the voices of the marginalized and challenges systems of oppression and exclusion.
2.2.1 Our Mission approach
We can identify three core elements of our mission with forcibly displaced individuals: “discernment, accompaniment, and empowerment.”
1.a) Discernment: Guiding JRS in both spiritual and practical matters, discernment shapes decisions on whom to serve and how. This encompasses the practice of communal discernment (Discerning Together) to identify:
- Whom do we accompany: Who are the most vulnerable and excluded persons in our midst, such as victims of rights violations, neglected by others, or not adequately served?
- How can we best serve them, given our resources and personnel? Are there specific needs we are especially well-suited to address, considering our history, material, and personnel resources?
- Where can we most effectively intervene, considering longer-term consequences, novel contributions, and the lack of services catered to by other organizations?
- How can we redress the systemic causes of victimization in our mission of advocating for the forcibly displaced?
Accordingly, JRS prioritizes situations of great need, places where a more universal good may be achieved, needs that others are not attending to, and situations where it can make a special contribution because of its expertise or established partnerships.
1.b) Accompaniment: JRS fosters a sense of belonging and dignity for all through accompanying and embracing individuals with open arms and hearts. Rooted in compassion, accompaniment goes beyond mere service delivery to offer companionship, active listening, and solidarity, addressing individuals’ personal needs and concerns. It acknowledges the innate dignity of the most vulnerable and excluded persons in our midst, echoing the fundamental belief in divine presence on earth and expressing solidarity and compassion. Sometimes, all we can do is be present, sharing in the joys and sorrows of everyday life together. As strikingly said by Michael Schöpf SJ, the International director of JRS, “For me, accompaniment is ultimately a form of surrender. You enter into a relationship with a person, you become friends and share in some aspects of their life. It could be a detainee who is there for many months, sometimes years, or a migrant who lives destitute under a bridge, with nothing to eat, and who comes to see you once a week. You try to help in a very practical way. But sometimes these situations are so bare – there is so little you can do – that all you can do is to be present.” Furthermore, as share our JRS UK collaborators, sometimes, the unspeakably difficult experiences of refugees may lead us to think that accompaniment is only about trying to mitigate their hardship, frustration, and sadness. But there is much more to accompaniment than this. It is also about joy, about enjoying ordinary moments of everyday life together, laughing and smiling. In such seemingly mundane moments, life is renewed.
1.c) Empowerment: JRS equips individuals with the tools and resources they need to rebuild their lives and shape their own futures, restoring their self-worth and hope for the future. Providing holistic support, JRS addresses the physical, emotional, and spiritual needs of refugees and forcibly displaced individuals. Recognizing the central role of faith for many forcibly displaced individuals, JRS acknowledges it as a source of hope to cope with the trauma of war, loss, suffering, and displacement. Encouraging individuals to share their faith experiences fosters belief, consolation, resilience, and life-giving values in the empowerment and healing process.
2.2.2 Care for Collaborators
Within the Society of Jesus, including JRS, there is a growing awareness of our identity as collaborators in a mission where we serve rather than own. Collaboration defines our identity, and we recognize that we are all collaborators, refraining from perceiving others as mere recipients of our mission but as partners in sharing its Ignatian heritage and spirituality. This renewed understanding of our collaborative identity leads us to accept and appreciate the diverse individuals who enrich the common mission, presenting us with the task of discerning together how to integrate them into the apostolates through which the universal body contributes to the Lord’s mission.
Such collaboration emphasizes mutual accompaniment, particularly crucial for both the people served and JRS staff, especially in conflict zones where unique challenges arise. Ensuring the well-being of our staff is imperative, manifesting in practical commitments:
- Supporting overall staff well-being, facilitating a healthy work-life balance, and ensuring their safety and security worldwide through appropriate training and protocols, including evacuation procedures when necessary.
- Promoting the mental, emotional, behavioral, and spiritual health of JRS staff.
- Cultivating a healthy and supportive work environment for our staff.
- Fostering resilience among staff to sustain motivation, productivity, and fulfillment in their work and relationships. Psychological resilience is crucial, enabling individuals to adapt to stress and adversity, contributing positively to their community. We believe that ensuring staff feel safe, cared for, and supported enhances their well-being and resilience.
- Additionally, integrating long-term support and follow-up in crisis response strategies remains essential.
2.3. Mission Programmatic Areas
JRS’s approach to supporting victims of forced displacement is comprehensive, encompassing aspects such as psychosocial well-being, gender responsiveness, safeguarding, community empowerment, and environmental stewardship as keys for rebuilding lives and preserving dignity. Within this framework, we prioritize four programmatic areas for our mission: Reconciliation, Mental Health and Psychosocial Support, Education and Livelihood, and Advocacy.
3.The Psychological Approach to Missions in Conflict Zones: Mental Health and Psychosocial Support (MHPSS) in Forced Displacement Settings
3.1. Understanding MHPSS Basics
Mental health is a state of psychological well-being that extends beyond merely the absence of mental disorders. It encompasses the realization of one’s potential, the ability to cope with normal stresses of life, productive and fruitful work, and the capacity to contribute to the community. This holistic view underscores that mental health is a fundamental part of overall health; indeed, there is no health without mental health. It is influenced by a variety of factors, including socioeconomic, biological, and environmental elements.
3.2. The impact of Forced Displacement:
Statistics and Key facts
Forced displacement, especially in conflict zones, takes a heavy toll on mental health. Most people affected by emergencies undergo distress, including feelings of anxiety, sadness, and hopelessness. Over time, these normal responses can escalate into severe mental health issues, with approximately 22% of displaced individuals experiencing mental health conditions like depression, PTSD, and anxiety. The impact of forced displacement is profound, with higher rates of mental health difficulties observed among those who have experienced conflict and displacement compared to host populations. Both past traumatic experiences and ongoing daily stressors contribute to these challenges, highlighting the importance of addressing psychosocial needs to prevent deterioration of mental health.
Psychosocial support plays a crucial role in responding to and preventing daily stressors, while specialized interventions target specific diagnoses. Integrating mental health and psychosocial support into programming can yield numerous benefits, including improved outcomes, decreased risk factors, and enhanced social cohesion among displaced communities.
In essence, the statistics and information underscore the urgent need for comprehensive mental health and psychosocial support interventions in humanitarian responses to effectively address the complex mental health challenges faced by displaced populations.
3.3. Navigating Common Acute Reactions to
Distressing Experiences
In the aftermath of distressing events, individuals manifest a spectrum of physical, behavioral, cognitive, and emotional responses. While many individuals improve over time if their basic needs are met and they receive social support, a significant number (approximately 22%, as per DSM-5) develop severe mental health disorders such as depression, bipolar disorder, schizophrenia, and dementia.
Below is a list of common acute reactions to Distressing Experiences:
Physical | Behavioral |
– Fatigue
– Headaches – Muscle tension – Shakiness/weakness – Dizziness – Increased heart rate – Elevated blood pressure – Rapid breathing |
– Changes in sleeping patterns
– Changes in eating habits – Changes in other daily habits – Decreased personal hygiene – Withdrawing from others – Dependence on others |
Cognitive | Emotional |
– Changes in sleeping patterns
– Changes in eating habits – Changes in other daily habits – Decreased personal hygiene – Withdrawing from others – Dependence on others. |
– Difficulty concentrating
– difficulty making decisions – Memory disturbances – Flashbacks – A false sense of reality – Amnesia – Worrying about an event. |
It is important to acknowledge that distressing experiences can profoundly influence spiritual beliefs, potentially leading to one more multiple reaction including:
– Anger at God or a Creator
– Blaming a spiritual entity for the crisis or loss
– Changes in religious or spiritual faith
– Crisis in faith
– Seeking answers or support from faith
– Altered sense of self or inner power
– Loss of meaning
In summary, distressing experiences can elicit a broad spectrum of acute reactions across physical, behavioral, cognitive, and emotional domains. Furthermore, traumatic events can deeply influence spiritual beliefs, precipitating various spiritual reactions. Understanding these reactions, including those influenced by spiritual beliefs, is crucial for providing effective support.
However, solely adopting a biomedical perspective when analyzing the consequences of forced displacement may oversimplify the issue and risk undermining individuals’ identities and communities. Mental health challenges among displaced populations are influenced by a multitude of complex factors, including pre-existing conditions such as extreme poverty, political oppression, severe mental health disorders, and alcohol abuse, as well as emergency-induced problems like family separation, disruption of social networks, increased gender-based violence, and humanitarian aid-induced issues such as the undermining of community structures and anxiety stemming from uncertainty about food distribution and asylum processes. Additionally, both past traumatic experiences and ongoing daily stressors significantly shape mental health outcomes, with daily stressors posing chronic threats to psychological well-being and potentially diminishing individuals’ coping capacities over time.
3.4. Adhering to the Do No Harm Principle
Humanitarian interventions must adhere to the “do no harm” principle, avoiding unnecessary harm even in efforts intended to support affected populations. Moreover, poor practices, such as psychological debriefing that forces individuals to discuss their experiences immediately after a distressing event, can be detrimental. Additionally, needs assessments must avoid overly intrusive questions that may re-traumatize individuals.
Examples of bad practices:
– Psychological debriefing, which involves forcing people to speak about their experiences right after a distressing event, with the misconception that verbal expression inherently helps.
– Similarly, when conducting needs assess-ments, ir ia crucial to avoid including sensitive questions such as “Please tell us about your story,” “Why did you leave your country?” and “What happened to you and your family?”
A 15-year-old girl who participated in one-on-one counseling sessions with a psychologist expressed her discomfort with sensitive questions, stating, “To be honest, I really don’t like these kinds of sessions because they ask about sensitive topics related to when bad things happened to me.”
3.5 Integration of MHPSS into Programming
Effective MHPSS necessitates a collaborative approach across all relief response sectors. Integrating MHPSS considerations into education, livelihoods, and other sectors cultivates resilience and enhances well-being among affected populations.
This integration yields various benefits, including enhanced cross-sectoral outcomes, diminished risk factors for individuals and communities, bolstered staff resilience and retention, destigmatization of help-seeking behaviors, and heightened social cohesion and connectedness within displaced communities.
3.6 Examples of Integrating MHPSS
In our mission of protection and healing programming, various initiatives demonstrate the integration of MHPSS principles. From providing MHPSS training for teachers to implementing Psychological First Aid (PFA) for all staff, these efforts address the psychosocial needs of individuals and communities, fostering environments conducive to healing and resilience.
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- Livelihoods: Integrated MHPSS assists in addressing and managing stressors, building problem-solving skills, and strengthening coping mechanisms, along with enhancing livelihood-related soft skills such as teamwork, confidence building, communication, and conflict resolution.
- MHPSS training for teachers: Enhances teachers’ ability to create supportive environments for children to learn and thrive, while also promoting self-care, particularly as teachers often hail from affected communities. This can improve outcomes for both teachers and students.
- Integration of MHPSS, such as Social Emotional Learning (SEL): Aimed at improving outcomes for student learning and development.
- Training all staff on PFA: Ensures that everyone is equipped with appropriate and supportive responses to individuals experiencing distress.
- HR-related: Providing PFA for staff care aids in helping staff cope with daily stressors and crisis events, fostering a supportive work environment that promotes staff retention.
4. Conclusion
In conclusion, the Jesuit Refugee Service is deeply committed to compassion, healing and justice. Through collaborative efforts, we accompany, serve, and advocate for refugees and forcibly displaced individuals worldwide. Central to our mission is the recognition of the essential role of Mental Health and Psychosocial Support (MHPSS) in addressing the complex challenges faced by displaced populations. By understanding the nuances of MHPSS, upholding ethical principles, and integrating support mechanisms into programming, we can effectively promote well-being and resilience in conflict zones.
Amidst the challenges we encounter in our mission, it is vital to prioritize self-care and support within our teams. Just as we extend care to others, we must also nurture ourselves and each other. By practicing self-care daily and fostering a culture of mutual support, we ensure that we can continue our mission with strength and compassion.
Furthermore, as we navigate these challenges, it is essential to reflect on our purpose. Why do we embark on this journey? Why do we stand in solidarity with forcibly displaced people? Our strength emanates from turning to the crucified and risen Christ, who leads us to the crucified of this world and guides us in this mission of healing, justice, and hope. As Fr. Pedro Arrupe aptly expressed when founding JRS, “God is calling us through these helpless people. We should consider the chance of being able to assist them a privilege that will, in turn, bring great blessings to ourselves…”
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