UNHCR – Mental health issues can be both a driver and a result of displacement Donate

Leo Medina was just a teenager when he received a frightening diagnosis: schizophrenia. It was home in Venezuela in the late 1990s, when the South American nation was an oil and gas powerhouse and imported goods were widely available, including the drugs Leo needed to control his mental illness.


But as Venezuela slid into deep economic and political crisis over the past decade, Leo’s medicine became harder and harder to find. Mirroring food shortages in the country’s supermarkets, Venezuelan drugstore shelves have gradually emptied as medicines have become scarcer.

Faced with a shortage of supplies, Leo’s parents, Héctor and Yesmaira, had no choice but to reduce his daily dose. Leo was taking four pills a day, “but as our supply dwindled we went down to three, then two and finally just one,” Héctor recalls.

Leo flew off, overwhelmed by a terrifying series of mental health crises.

“I lost all interest,” says Léo, now 36 years old. “I spent a year and a half in a very bad state: I felt depressed and I couldn’t work. I just cried and screamed. I didn’t want to go on living.

The situation was so critical that Leo’s parents joined the ranks of more than 6 million Venezuelans who fled the country in recent years, leaving everything behind – a comfortable home, several cars and a thriving dessert business – in the goal of securing Leo the vital help he needed. The family moved to Guatemala, where Leo’s sister had been living since marrying a citizen of the small Central American nation several years earlier.

“I spent a year and a half in a very bad state.”

Here, doctors at a public hospital immediately treated Leo, changing his diagnosis – from schizophrenia to bipolar disorder – and providing him with the medication and treatment he needed. That was over a year ago, and while there have been setbacks, Lion’s change has been nothing short of remarkable.

“In Guatemala we lived a miracle,” Héctor said, adding that Leo, who was barely able to get out of bed when they arrived in the country, has now taken on the lion’s share of the job at the company. fledgling family – making a traditional Venezuelan sweet confection – that the medinas started from scratch from their modest rental home on the outskirts of Guatemala City.

  • Now feeling much better in his host country of Guatemala, Leo took on most of the work in the family confectionery business. © UNHCR/Ruben Salgado Escudero

  • Back on the drugs he relies on, Leo says he now feels like a new man.

    Back on the drugs he relies on, Leo says he now feels like a new man. © UNHCR/Ruben Salgado Escudero

  • Héctor, Léo and Yesmaira take a break from making sweets to enjoy a family breakfast.

    Héctor, Léo and Yesmaira take a break from making sweets to enjoy a family breakfast. © UNHCR/Ruben Salgado Escudero

  • Nicaraguan asylum seeker Óscar* reads on a tablet he uses for professional development classes.

    Nicaraguan asylum seeker Óscar* reads on a tablet he uses for professional development classes. © UNHCR/Ruben Salgado Escudero

  • The stress of Óscar's journey to safety triggered an acute mental health crisis.

    The stress of Óscar’s journey to safety triggered an acute mental health crisis. © UNHCR/Ruben Salgado Escudero

Given the scale of the humanitarian needs of people forced to flee their homes, the mental health issues of forcibly displaced people have long tended to take a back seat. But studies have shown that displaced people tend to struggle more with certain mental illnesses than the population as a whole. A 2019 study published in The Lancet showed that “the burden of mental disorders is high in conflict-affected populations”, while a 2020 study in Plos Medicine suggested that “adult refugees and asylum seekers have high and persistent rates of post-traumatic stress disorder (PTSD) and depression.”

UNHCR, the UN Refugee Agency, is striving to make mental health and psychosocial support an integral part of its work – particularly in the context of the ongoing COVID-19 pandemic, with its spikes in isolation, loss of livelihoods and uncertainty about the future.

“In Guatemala, we experienced a miracle.

And although mental health issues can sometimes trigger displacement, as was the case for the Medina family, fleeing home is often so stressful that it can lead to mental health crises in people who had never suffered before. such problems before.

Such was the case of Óscar*, an event decorator and gay rights activist who was forced to flee his native Nicaragua following a wave of anti-government protests that swept the country in 2018. Óscar took part to the protests and, as a result, he said he was the target of credible death threats.

A life-changing ordeal followed, as he left home and, narrowly escaping detention on numerous occasions, eventually crossed the border into neighboring Costa Rica. But with tens of thousands of other Nicaraguans also fleeing political persecution and seeking asylum in Costa Rica, it was difficult for him to make ends meet and he eventually decided to move once more, this time north. , in Guatemala.

“I’ve been on an emotional roller coaster.”

Here, Óscar found safety, but not peace: the stress of being a wanted man at home, the rapid changes in his life, and estrangement from family and friends all had devastating effects.

“I’ve been on an emotional rollercoaster and I’ve been through a deep depression,” he said, sitting on a bed that takes up most of the small rented room in Guatemala City where he lives. “I even got to a point where I never imagined I would be where I had to go to a mental hospital… Once I went five days without sleep and thought I was going crazy.”

Óscar briefly took antidepressants to help him through the worst of the crisis, but says what helped him the most were the weekly sessions with a therapist that UNHCR helped provide. He is now at the point where he can support himself and has started to look hopefully to the future again.

“I have setbacks and there are still times when I just don’t want to get out of bed, but I know I have to keep going,” said Óscar, whose youthful looks and short stature belie his 37 years. . “Although I look physically weak, I have a very strong character.”

*The name has been changed for protection reasons.

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