Mental health services help refugees transform their lives in Libya

Everyday life in Libya’s capital Tripoli has never been easy for 32-year-old Sudanese refugee Yusra*, a mother of four. Working long hours as a housekeeper to support her family, she said she was often the victim of discrimination and harassment.

---

But her lowest point came in November last year. Her husband was dropped off at their home after being found bloodied and half-naked on the street. He had been tortured and held by militiamen at a closed facility, before he was released with bruises and cuts all over his body. Ever since, Yusra said, he barely speaks and hardly ever leaves the house.

The experience left Yusra feeling terrified and with a lingering sense of dread, fearing that her whole family was in danger. She approached a Community Day Centre in Tripoli run by UNHCR, the UN Refugee Agency, seeking help.

"I was at point zero, but now, I’m so much stronger.”

“I was in a very bad situation. Here, I received a lot of help and support,” Yusra explained. “I was at rock bottom when I came; but now I feel like I have been lifted up, like I’ve been reborn. I was at point zero, but now, I’m so much stronger.”

Yusra is one of more than 200 refugees and asylum seekers who have received mental health and psychosocial support from UNHCR’s partner, CESVI, this year. The assistance includes individual sessions as well as group counselling.

After years of conflict and instability, demand for mental health services in Libya is high, but there is a lack of specialized public services to meet people’s needs. The World Health Organization (WHO) estimates that up to a fifth of the total population may be suffering from a mental health condition. 

• See also: ‘Before the pandemic, refugee mental health was severely overlooked. Now it’s a full-blown crisis’

Refugees and asylum seekers in Libya are particularly vulnerable, as many have been trafficked, faced physical or sexual violence, and spent long periods in detention, where conditions are dire and incidents of abuse are well documented.

Yusra’s husband is currently receiving individual counselling to help him recover from his ordeal, with his condition considered still too severe to participate in group sessions. Yusra herself, who was diagnosed with post-traumatic stress disorder, said she has found the group sessions particularly helpful.

“It helps me release negative energy and the feelings I have,” she said. “Through the doctor here, and the interactions with others, we share experiences and I feel more hopeful. I feel the benefit after listening to other peoples’ experiences.”

“Something I learnt from the doctor is that what is in the past has happened,” Yusra added. “Of course, we will not forget it, but we should not dwell on it. We use it as a lesson, as we might face other difficulties in our lives, [but] we need to think about what tomorrow will bring.” 

Yusra said counselling had also improved her relationships at home. “It has helped me with my children. Before, I would cry or get angry with them, but now these tantrums have stopped. I have become a different person,” she said.

Hamida*, a clinical psychologist working with CESVI, said mental health and psychosocial counselling can prove hugely helpful for refugees and asylum seekers in Libya, who have faced many challenges both journeying to and living in the country.

"Even if they haven’t personally experienced violence, they have seen it."

“For sure, most refugees need our help,” Hamida said. “They have gone through very difficult situations themselves. Even if they haven’t personally experienced violence, they have seen it. It affects their behavior, their way of thinking.”

She is particularly satisfied by the progress made during group sessions, which she carefully organizes by bringing together people from similar nationalities and ages who are experiencing similar situations in their daily lives. 

As a result of the COVID-19 pandemic, Hamida has had to split her former sessions into two groups to ensure physical distancing. Participants have to wear masks and have their temperatures taken when they enter the community centre, and hand sanitizer is also provided.

“Regardless of what they are suffering, whether mild or severe, it is easier to deal with the pain or sadness if it is shared in a group. This helps them release the stress and the other issues they have,” she explained. 

“We try to give them the skills to prevent relapses, because many are in very precarious situations and this is reflected in what they are thinking. For example, many are thinking about crossing the sea [to Europe] because they think: ‘I’m dead either way’. This way of thinking reflects a severe disturbance. And if there is anything we can do to help them, this is very, very important.”

• See also: Refugees find help with mental health effects of Beirut blast

Another woman helped under the programme is Shadia,* a 38-year-old Sudanese refugee who has epilepsy and severe depression. She had marriage difficulties and was very withdrawn, even attempting suicide several times.

“You can see the difference in me since these sessions,” she said. “Before, I was sick, stressed and tense. I was always thinking about ending my life and I had many seizures. Now I don’t have seizures and I don’t take any medicine anymore. In terms of my mental state, I feel very good about myself. I am positive about the future.”

Shadia is now an energized, confident woman who has recently began working, and she credits the sessions for her transformation and newfound empowerment.

“My character changed; I got strong and I was able to be involved in the community.”

“My character changed; I got strong and I was able to be involved in the community,” she said.

Such positive testimonies from those who have been helped, said Hamida, have also encouraged others to seek support from mental health specialists. 

“I might not feel their pain, but I understand it. They feel helped and assisted and this really changes their way of thinking; it relieves their stress and this, in turn helps them to improve,” she concluded.

*Names changed for protection reasons.