Editorial

Citation

Caan, W. (2015), "Editorial", Journal of Public Mental Health, Vol. 14 No. 2. https://doi.org/10.1108/JPMH-01-2015-0001

Editorial

Article Type: Editorial From: Journal of Public Mental Health, Volume 14, Issue 2.

This issue of the JPMH includes two papers on the mental health of refugees, by Campbell and by Laugharne. Last year the world saw numbers of people seeking refuge that were unprecedented in my lifetime (Sherwood, 2014). At the time of recent European Parliament elections, my Editorial considered the grave mental health consequences of xenophobia in affluent countries like the UK (Caan, 2014a). This winter just one agency, UNHCR, is attempting to help three million refugees from just one country: Syria (The Lancet, 2015). Experiences of displacement, trauma, loss and helplessness undermine mental health badly, whether people are fleeing war or natural disaster, and vulnerable children make up a high proportion of most refugee populations (Kett, 2005). When I worked with the pilot Asylum Seekers health service in the London Borough of Barking & Dagenham, the majority of new patients were chronically depressed, as well as in poor physical health and socially isolated. Summerfield (2008) is right to caution the use of some “western” concepts like post-traumatic stress disorder in heterogeneous populations of refugees. Making a therapeutic alliance may well be more related to social connectedness and each Man’s search for meaning than to any formal diagnosis.

The Syrian refugees are fleeing religious and ethnic violence on a huge scale. In the coming years we may witness more and more people fleeing the consequences of climate change (Caan, 2014b) or global economic instability (De Vogli and Owusu, 2015) unless our political leaders show more foresight and a capacity for international collaboration. Recently I had the privilege of hearing Kofi Annan, former United Nations General Secretary, talking about a Global crisis in mental health, using depression to illustrate this crisis as it is now the top cause of disability worldwide. Annan stressed the main challenge was lack of Global vision and leadership to address the issue:

There has been a failure to acknowledge the scale of the problem and to put in place the policies and resources to overcome it (Cagney, 2015).

However, one of the key competencies of Public Health professionals is “collaboration for health”. Neither Annan nor other thought leaders at that conference were pessimistic. However, at the present time when the UK is approaching a general election with a bitterly divided and predominantly cynical electorate, some political leaders view all migration as a “threat”. January’s horrific shootings nearby in Paris have compounded realistic worries about terrorism with unconscious, dormant xenophobia. Les Aliens (i.e. those other people) who live in our midst are the focus of many fearful projections, so how can we identify with and reach out to Aliens in distant refugee camps across the Middle East or even further away?

I take heart from Malala Yousafzai, the 2014 Nobel peace prize winner. She has been a victim of violence and forced migration. She has also been a powerful Peer Advocate for young people, for their education, health, wellbeing and participation in society. Miss Yousafzai is now a secondary school student in Birmingham. This July, Public Health England is hosting the 2015 School Nurses International Conference and I asked the English organisers to invite Malala to speak. What we learn about mental wellbeing during all stages of development is closely related to resilience in the face of adversity (Caan, 2015). Perhaps starting at the level of one street, then in community participation, then through national strategies and within a Global vision, we can all learn to welcome L’Etranger – and not find it strange, but a strength.

Seeking a refuge

The floods of History

Sweep old homes away

And toss the scared and scarred

To stranger shores.

It seems a mystery,

After many years,

That Planners find it hard

To open doors.

Woody Caan

References

Caan, W. (2014a), “Editorial”, Journal of Public Mental Health, Vol. 13 No. 3, pp. 129-31

Caan, W. (2014b), “Chekhov’s corner”, Journal of Public Health, available at: http://jpubhealth.oxfordjournals.org/content/early/2014/10/15/pubmed.fdu081.full.pdf+html (accessed 10 January 2015).

Caan, W. (2015), “Because you’re worth it”, Perspectives in Public Health, Vol. 135 No.1, p. 15

Cagney, H. (2015), “Depression: an economic and moral case to tackle the crisis”, Lancet Psychiatry, Vol. 2 No. 1, p. 20

De Vogli, R. and Owusu, J.T. (2015), “The causes and health effects of the great recession: from neoliberalism to ‘healthy de-growth’”, Critical Public Health, Vol. 25 No. 1, pp. 15-31

Kett, M. (2005), “Displaced populations and long term humanitarian assistance”, BMJ, Vol. 336 No. 3, pp. 992-4

Sherwood, H. (2014), “Global refugee figure passes 50m for the first time since the second world war”, The Guardian, 20 June, p. 3

Summerfield, D. (2008), “How scientifically valid is the knowledge base of global mental health?”, BMJ, Vol. 331 No. 9, pp. 98-100

The Lancet (2015), “Editorial”, Lancet, Vol. 385 No. 9964, p. 202

Further reading

Caan, W. (2014c), “Mental health interventions in schools”, Lancet Psychiatry, Vol. 1 No. 7, p. 500