'Anxiety, panic attacks' among displaced Syrians highlight critical gaps in mental health support

Displaced Syrian children feel scared, exhausted, and are afraid to go home, according to new paper by Save the Children.

• Syria’s refugee children reported feeling like there is ‘no safe place’ inside of Syria, that they suffer discrimination.
• Children said the very notion of the future is a source of fear and anxiety.
• Mental health services across Syria are critically inadequate, with only one psychiatrist for every 250,000 children.

Almost a decade of being uprooted by conflict is taking an immense toll on the mental health of Syrian children, a new paper by Save the Children revealed today^[i]. They feel scared, suffer discrimination, and are afraid to go home, interviews with almost 170 Syrian children showed.

Traumatic experiences in Syria have left children feeling ambiguous about returning home - even children who are desperate to go home suffer from anxiety and fear at the prospect. Parents reported that their children are experiencing extreme stress at the idea, including ‘panic attacks, relentless feelings of fear, self-isolation, and bedwetting’. 

Kinan* who is currently living in Jordan, is afraid to return to Syria: "I will be unhappy. I have so many fears about the war. I am afraid that someday a missile will hit the roof of my house and fall on my head while sleeping."

The impacts on displaced children’s emotional wellbeing reach far beyond the initial severe distress of being forced to flee the bombs and bullets that destroyed their homes, Save the Children said today,  and affected every aspect of their lives.

Being forced from their homes ripped stability from children as they lost their home, the routine of going to school, friends and other support networks, and the usual patterns of family life.

During the interviews, children showed a concerning absence of ways to cope with stress, which is compounded year on year as their displacement continues. Their self-worth and resilience are being diminished, and many children have not found a way to relax or to just be children.  

"Living [here], I feel terrible,” said 16-year-old Safaa*, a Syrian refugee in the region, as she began to cry, “I feel so much pain inside. We’re poor in a foreign country and I miss my country." 

Many displaced children are forced to grow up too fast and prematurely take on adult roles to support their families, Save the Children warned. Parents lamented the lack of toys and games available to their children.

Ten-year-old Dara* sells used toys in front of her family’s destroyed home to support her father whose disability prevents him from working. She told Save the Children: “I wish I could play with one of these toys, but I can’t. I sell them so we can live with that money.”

Children who are refugees outside of Syria reported continued discrimination, making them feel unsafe outside of their home. Twelve-year-old Fadi* fled Aleppo with his family and is now living in neighbouring country. He said: “We suffer from extreme racism in neighbourhoods and schools. It’s humiliating, making me feel that death in Syria would be easier for us than to stay in this place.”

Many children now think of the future as a source of stress and fear. Sari*, who is currently living in Jordan, said: “I think about the army. Could I go and fight in a battle? Do I know what I am doing? You’re going to kill your cousin, a human. Why do I have to do that?”

Despite the enormous need for support, the ongoing conflict has crippled the health system, including mental health services. Save the Children estimates that there is only one psychiatrist for every 250,000 people, well below the global average^[ii]. Critical psychosocial support and protective services at community level, including case management and safe places for children to grow and socialise are also at breaking point.

“Displaced children have lost so much over the course of the conflict – their homes, friends and families, and their childhoods. It’s unacceptable that they now view the future as a source of fear, rather than hope,” said Sonia Khush, Save the Children’s Syria Country Director.

“Syria’s children deserve better. As leaders gather in Brussels in the coming days, there is a real opportunity to ensure that children’s long-term mental health needs are prioritised and adequately funded. Together we can ensure that children have the help they need to feel safe and to look forward with hope,” Khush added.

Save the Children is calling on governments to use the Brussels IV Syria Conference to ensure that displaced children’s mental health is prioritised and is included as an integral part of any attempt to achieve durable solutions for Syria’s displaced populations.

*Name changed to protect identity

Please read more in Save the Children’s new paper, Psychosocial Safety: Pathways to psychosocial safety for Syria's displaced children and adolescents

Spokespeople are available. To arrange an interview please contact:

• Claire Nicoll in London: c.nicoll@savethechildren.org.uk; 00447825 663691
• The 24-hour press office in London media@savethechildren.org.uk;  0044 7831 650 409.

Notes to editors

• Quote in headline is from Zeina*, a Syrian girl currently living in Jordan
• Over 5.6 million people have fled Syria since 2011 and there are currently 6.6 million internally displaced within Syria. Over half of the displaced community are thought to be children. See UNHCR.

^[i] Save the Children spoke to 168 Syrian children and 57 parents or caregivers through Focus Group Discussions or In-Depth Interviews between February and July 2019in Jordan, Iraq, Lebanon, Turkey and Syria.

^[ii] The 2019 Humanitarian Overview from OCHA reports that there are 0.41 psychiatrists per 100,000 population currently active in Syria, well below the world median of 1.3 per 100,000. Given that children make up 50% of the population, the extrapolated ratio is that there is 1 psychologist for every 250,000 children. Please note that this refers to general psychiatry rather than child-focussed psychiatry.