The impact of the Rohingya refugee crisis on mental health

Among Rohingya refugees, young girls and women are particularly vulnerable to mental health negligence. Photo: Reuters

The negligence of mental health concerns is a widespread issue, even within affluent, educated, and economically prosperous societies. Consequently, it comes as no surprise that the Rohingya refugee community in Bangladesh who are facing significantly more daunting circumstances, encounters even greater challenges in addressing their mental health needs. 

However, in situations where even basic necessities are unmet, mental health might seem less urgent compared to other life essentials. Yet, the escalating vulnerability of this population's mental health poses a heightened risk of reduced productivity, increased burdens on healthcare systems, elevated suicide rates, adverse physical health consequences, involvement in criminal activities, and substance abuse, among other detrimental outcomes. 

The Rohingya people, who primarily reside in Myanmar (formerly known as Burma), are an ethnic minority, with a majority of them practising the Muslim faith. While they have been seeking refuge in Bangladesh since the 1970s, their plight took a distressing turn in 2017 when Myanmar's security forces launched attacks that destroyed nearly 400 Rohingya villages. 

During this period, an estimated 7,00,000 individuals, known as Forcibly Displaced Myanmar Nationals (FDMNs), sought safety in Bangladesh between August 2017 and January 2018, as reported by the Office of the Refugee Relief and Repatriation Commissioner, Cox's Bazar, GOB. Currently, the total number of FDMNs stands at 957,971 according to the Office of the Refugee Relief and Repatriation Commissioner, Cox's Bazar.

In addition to their harrowing experiences with human rights violations in Myanmar, Rohingya refugees have had to deal with challenging living conditions in refugee camps. These challenges include restricted movement, difficulties in meeting basic requirements, security concerns, and limited access to healthcare and educational resources. 

Becoming a "lost generation" is a growing risk for the Rohingya community. They do not have proper access to formal education and work opportunities making them vulnerable to traffickers and others who would exploit them for political or economic gain. 

Girls and women are particularly vulnerable to sexual and other forms of gender-based violence, including being coerced into early marriage and being excluded from school by their parents. The situation was further exacerbated by the Covid-19 pandemic which led to even more restricted movement, the closure of learning centres, and reduced on-site assistance by aid organisations.

The refugees faced new hardships in the form of a massive fire in March 2021, followed by a flood and landslides triggered by heavy monsoon rainfall. These additional challenges, coupled with the lasting trauma of violence and systematic human rights violations in Myanmar, have taken a severe toll on the mental health of the Rohingya refugees. This is evident in the high prevalence of conditions such as depression, anxiety, post-traumatic stress disorder (PTSD), anger, psychosomatic symptoms and even suicidal ideation according to a study by Riley et al. (2021).

The refugee influx exerts an impact not only on the Rohingya refugee community but also on the host community. Cox's Bazar, particularly the sub-districts of Ukhia and Teknaf, ranks unfavourably in terms of socio-economic development and is among the most disadvantaged areas in Bangladesh. 

Therefore, while the traumatic experiences of systemic violence in Myanmar and their current refugee status differentiate the Rohingya from the host community, both groups encounter similar challenges resulting from a sudden surge in population which has led to resource shortages, particularly concerning land, water, healthcare, education and transportation facilities. 

These issues are accompanied by socioeconomic difficulties such as job losses, heightened competition for employment opportunities, and diminishing wage rates over time. Moreover, conflicts between the two communities and environmental degradation due to overcrowding and deforestation for essential resources have given rise to psychological stress within both groups, compounding the physical challenges they face.

Still, more difficulties are prevalent in the Rohingya community in Cox's Bazar due to the trauma they have suffered. A recent study conducted by Ritsema H. and Armstrong-Hough M. (2023) has revealed that post-displacement stressors, such as ongoing exposure to crime and conflict, reduced household access to income, extended transit times to healthcare facilities, police and local harassment, food insecurity, income disparities, discrimination, and a pervasive sense of insecurity are associated with a significant increase in the likelihood of Rohingya refugees experiencing symptoms of depression. 

Interestingly, the effect of the displacement experience on mental health varies by gender. Specifically, women who had been living in Bangladesh before July 2017, and therefore did not have direct exposure to the 2017 genocide but spent more time in Bangladeshi refugee camps, exhibited a significantly increased likelihood of experiencing symptoms of depression.

A number of humanitarian organisations collaborate with the Government of Bangladesh to provide essential support to Rohingya refugees. In the ongoing response to the Rohingya Humanitarian Crisis, the 2023 Joint Response Plan (JRP) is a collaborative initiative led by Bangladeshi authorities, uniting the endeavours of 116 partners, including 57 Bangladeshi organisations. 

This comprehensive strategy integrates Mental Health and Psychosocial Support Services (MHPSS) as an essential component of its continuous service delivery, working in conjunction with government counterparts. MHPSS encompasses a wide range of local and external support aimed at safeguarding and enhancing psychosocial well-being while preventing or addressing mental health disorders. The 2023 Joint Response Plan emphasises integrating mental health and psychosocial support services within primary healthcare facilities and at the community level. 

Nevertheless, language barriers, different perceptions of mental health, mental illness and mental health services, and lack of coordination among MHPSS services are some obstacles to the expected positive impact on the mental health of both the Rohingya and the host communities.  

Furthermore, it's worth highlighting that a standard of living that meets the needs of an individual and their family plays a crucial role in supporting their mental well-being. Thus, ensuring an adequate living standard and addressing the challenges in providing MHPSS services through a comprehensive plan tailored to race, age and gender is imperative in addressing the Rohingya refugee crisis effectively.

Israt Hossain is the Senior Research Associate at the South Asian Network on Economic Modeling (Sanem). Email: hossain.israt698@gmail.com.

Disclaimer: The views and opinions expressed in this article are those of the author and do not necessarily reflect the opinions and views of The Business Standard.