When it comes to refugee response efforts worldwide, information regarding refugee mental health is extremely valuable and the need for it is great. CVT’s research department works tirelessly to contribute to meeting that need. In January, as part of a recent series of data collection initiatives to inform CVT’s work, CVT surveyed adults living in Ethiopia’s Nguenyyiel refugee camp in order to better understand the needs and perspectives of South Sudanese refugees. The results are documented in this report, titled, “Assessing Mental Health in Gambella, Ethiopia: A Representative Survey of South Sudanese Refugees in Nguenyyiel Camp.”

Nguenyyiel is the largest and newest refugee camp in Ethiopia’s Gambella region, where a majority of the refugee population are ethnic Nuer, who have fled violence – including forced recruitment, arbitrary detention, destruction of property, sexual violence and direct killings – since the start of the South Sudanese civil war in 2013. CVT’s survey was the first population-level assessment of the symptoms of mental health problems among refugees in Nguenyyiel.

50 people carried out the fieldwork – live interviews conducted in and around the respondents’ homes with paper and pencil questionnaires – for this assessment, including enumerators, team supervisors, researchers, psychotherapists, interpreters, drivers, community coordinators and administrative staff. The six teams each completed around 17 interviews per day over the course of seven days. Due to the sensitive nature of questions asked and the vulnerability of the 639 individuals surveyed, it was imperative that each team included members with mental health expertise who were able to implement trauma-informed high-risk and referral protocols and offer emergency support if necessary.

The questionnaire covered attitudes about mental health, difficulties in daily life, mental health-related problems or symptom areas, coping strategies, household mental health problems, torture, access to services and demographics.

Takeaways

Key findings from the report include the following:

• More than half of respondents indicated that mental health concerns, such as grief from loss of loved ones (70%) and worries about people at home (58%), were difficulties impacting their daily life. About a quarter of respondents (26%) said the same about basic needs such as food, shelter, or clothing.
• 43% of respondents reported current symptoms consistent with post-traumatic stress disorder (PTSD) and/or depression. From this, we estimate that 39 to 47% of the adult population in Nguenyyiel experience similar symptoms on a regular basis.
• One quarter of respondents self-reported that they were survivors of torture after being given a simple, brief definition of torture. Nearly half (48%) of respondents said they were separated from family members. Torture survivors and those separated from family suffer significantly more from mental health issues, problems functioning in daily life and chronic pain.
• Almost two-thirds (64%) of respondents reported concerns about ongoing violence in the camp, indicating that threats to refugees’ safety do not necessarily stop once they reach a place of refuge. Respondents who were worried about violence in the community tended to experience more frequent symptoms related to PTSD and depression.

Integrating these and other findings from the survey, CVT and other humanitarian actors and community stakeholders are better equipped to design evidence-based interventions that address the needs of this population.

Comment From a Researcher, Dr. Sarah Peters, evaluation & research lead

Unfortunately, there’s very little representative data on refugees – especially refugee mental health – outside of resettlement countries in North America, Western Europe and Australia. CVT uses rigorous survey methods to collect data that can help us better understand mental health issues, levels of trauma and access to services in humanitarian settings.

As a social scientist, I see representative, individual-level data as highly important for designing evidence-based humanitarian interventions and policy. It has been a privilege to work with the data collected in Gambella, both because of its practical implications and its potential to contribute more broadly to research on conflict and refugees.

Through our analysis, we are able to provide succinct recommendations for service providers in the camp, as well as to inform CVT’s own mental health interventions. In combination with CVT’s other survey findings, it also has the potential to contribute generalizable insights about the connections between violent conflict, trauma and mental health.

CVT’s work in Gambella is supported by the Bureau of Population, Refugees, and Migration from the U.S. Department of State.