Venezuelan counsellors offer fellow refugees 'psychological first aid'

Even as David Marín Cabrera helps his fellow Venezuelans deal with the stress of life under COVID-19 lockdown through his twice-weekly online sessions, the 45-year-old psychologist and his family are grappling with some of the very same issues.

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“On many occasions, we have run out of food … and have had to rely on donations,” said David, who arrived in the Peruvian city of Cusco, along with his wife and children, in 2018. “The pandemic made a situation that was already difficult for many Venezuelans that much more difficult.”

More than five million Venezuelans have fled food and medicine shortages, rampant inflation, insecurity and persecution, mostly to other South American nations.

Before the start of the COVID-19 crisis, David conducted in-person group counselling sessions in Cusco to help distressed recent arrivals from Venezuela and local residents of his host community, with the assistance of UNHCR, the UN Refugee Agency.

As soon as Peru adopted COVID-19 lockdown measures aimed at stemming contagion, the sessions moved online. David now leads two-hour-long Google Meet sessions twice a week, each assisting around 20 participants.

“I see a lot of pain, anger and frustration that needed to be worked through.”

“I see a lot of pain, anger and frustration that needed to be worked through,” he said, adding that the pandemic has exacerbated deep anxieties that many Venezuelans harboured about making rent, putting food on the table and clothing their children in the diaspora.

Because those worries are so stark and immediate, fears about falling ill with COVID-19 tend to recede into the background for many, he said.

David himself is not exempt from these stresses. Because he does not charge for the sessions, he and his family sometimes struggle to get by on donations from former patients, as well as handouts from aid organizations.

Worldwide, the COVID-19 pandemic has killed more than 295,000 people, while lockdowns to curb the virus’ spread have sparked mass unemployment and plunged untold millions of people into extreme poverty.

The mental health and wellbeing of whole societies have been severely impacted by the crisis and are a priority to be addressed urgently, according to the UN Secretary-General, who issued a policy brief on COVID-19 and the need for action on mental health. Facing a daily battle for survival, many risk having their mental health needs overlooked entirely.

“Many people have lost their jobs and are constantly worrying about being evicted … or running out of food, and what to do with their kids being all cooped up,” said Loredana Hernández Giraud, a Venezuelan psychologist living in the Peruvian capital, Lima. She volunteers with a help-line run by Unión Venezolana, an NGO there that helps distressed Venezuelan refugees and migrants.

 “We see all sorts of cases, but a very common one is panic attacks because of the confinement.”

• See also: Coronavirus pandemic wreaks havoc on displaced Venezuelans

She defines her work on the hotline as dispensing “psychological first aid” and says she also regularly hears from people who are grappling with anxiety, depression and even suicidal thoughts, as well as what she calls “migratory mourning” – a sense of deep loss brought on by having had to flee one’s home country and community.

Like David, Loredana can empathize with those she treats. Since she fled to Peru in 2018, the 29-year-old psychologist has faced many of the same difficulties as her patients, struggling to rebuild her life from scratch in a foreign country.

In addition to her work on the hotline, Loredana is part of a group of around 50 or so Venezuelan mental health professionals scattered around South America who hold their own group sessions via Zoom. 

“We do a bit of therapy for ourselves, sharing our experiences and talking about how we’re managing in this situation,” she said, adding that, as refugees and migrants, “we, too, are vulnerable in one way or another.”

“We are resilient. We have gone through worse things.”

UNHCR is working to provide refugees, asylum-seekers and internally displaced people with mental health and psycho-social support. In Peru, the agency’s partner organizations have provided hundreds of mental health and psycho-social consultations throughout the pandemic.

UNHCR has appealed for resources to strengthen mental health initiatives as an integral part of its coronavirus response. Mental health was among the essential needs addressed in the Global Humanitarian Response Plan for COVID-19, launched by the UN Secretary-General in March and revised upward last week in the face of mounting needs.

“Mental health problems, including depression and anxiety, are some of the greatest causes of misery in our world,” the Secretary-General, António Guterres, said in a video message marking the launch of a policy brief on mental health amid the coronavirus pandemic. “Mental health services are an essential part of all government responses to COVID-19. They must be expanded and fully funded.”

Pieter Ventevogel, Senior Mental Health Officer with UNHCR, echoed those sentiments.

“Providing people with mental health support is not a luxury,” he said. “It won’t make difficult circumstances go away, but it will make it easier for someone to get through a tough situation if they feel better able to deal with these strong emotions. It can make the difference between coping and giving in to despair.”

• See also: Venezuelan doctor gives coronavirus tips to Ecuador’s most vulnerable

For Loredana, the help-line volunteer in Lima, the very tribulations that make refugees vulnerable to mental health issues are also a source of profound strength.

“We are resilient. We have gone through worse things,” she said. “That’s the message we try to get through to most people we treat.”

For more information on mental health and psycho-social support, see also: Basic Psychosocial Skills: A Guide for COVID-19 Responders.