Finding a Safe Space for the Displaced

Scenes of damaged buildings and infrastructure stream from conflicts in Gaza, Haiti, and Ukraine in a near-constant flow of destruction and devastation. Unseen is the carnage that these conflicts can inflict on families—and particularly children—who are left to pick up the pieces long after the military and news crews leave.

How can we help children like these, and also those here in the U.S., with news this month from the Biden administration that asylum seekers who cross the U.S.-Mexico border illegally will be banned?

Around the world, more than 468 million children live in conflict areas. Social workers are helping these children with PTSD, displacement, and abuse. Children like 11-year-old Artyom Davtyan, who had emotional and behavioral issues and suffered abuse from an alcoholic father who has since vanished—all before having to flee Artsakh (Nagorno-Karabakh) in September. He is now living in Armenia with his aunt until he and his mother can reunite and return to Artsakh.

In 2020, armed conflict involving Azerbaijan and Armenia decimated the Armenian breakaway state of Artsakh. In 2023, Azerbaijan launched a large-scale military offensive against Artsakh, forcing the population to leave their homeland. With no other options available, all of the displaced individuals sought refuge in Armenia, the only accessible neighboring country.

We hope to pass on lessons learned in Artsakh to our mental health colleagues and humanitarian workers around the globe who sadly find themselves in similar situations.

Lesson 1: Address the Person, Then the Needs—and Do It with Empathy and Compassion

In conflict areas, people focus on physical survival mechanisms first. When access to essentials like medication, food, water, electricity, and heating is limited or non-existent, introducing mental health support programs is often premature. Well-meaning helpers in the region must prioritize establishing programs and infrastructure that meet these basic needs first, as these are often what the affected children and families urgently require. But it is crucial not only to provide food, water, and shelter, but also to offer support and assurance that individuals/families are not alone and are in a safe environment.

Therapy won't work when there is a hole in the roof. Therapy and psychological support cannot be effective if more immediate survival needs are unmet. For example, in Haiti, after the 2010 earthquake, many people declined therapy interventions because their immediate concern was finding housing. Similarly, in Ukraine, facilities and infrastructure built between 2022 and 2023 to deliver mental health support were repurposed as regional aid centers, aligning with the more pressing needs of the community.

Lesson 2: Focus on Resilience Building

The mental health support pyramid developed by the World Health Organization suggests shifting from a typical vulnerability-based approach paradigm to a resilience-building paradigm in crisis areas. Humanitarian aid typically continues for two years following a crisis, and it is not uncommon for people to become dependent on that aid if they are not equipped to become self-sufficient.

A significant part of our work involves helping individuals rebuild their social skills and networks, which is crucial as we begin the process of upskilling them. This, however, is not an easy task, especially when working with people who have lost their homeland, houses, livelihood, and, in many cases, a significant portion of their community and workforce. Our goal is to empower families to help themselves and to start thinking practically about their future—where to start, and how to rebuild their lives.

The resilience-focused approach encourages people to look forward and not just focus on past traumas. We have found that when this strategy is implemented properly right after a crisis, it significantly reduces the need for specialized psychological and mental health support later on.

Lesson 3: Balancing Structure and Flexibility

Children need structure to thrive, but they also need room to grow. This may sound counterintuitive to the strict protocols often employed in modern social work; however, we have found that flexibility is key when supporting children and families in conflict areas.

To address this, we established temporary social work centers in 13 of the most refugee-populated areas. These centers provide a space where children and families can interact, play, and re-establish social networks that they have lost. We provide support to overcome language barriers, facilitate introductions and orientations to new schools and cultures, and create a safe environment for children to express themselves, make friends, and just be kids.

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We typically initiate social activation and upskilling programs six months after displacement. This approach has significantly improved outcomes in these 13 communities. Mothers become more involved in their children's education, build new networks with other parents, and often engage in re-skilling and employment training.

Our primary goal extends beyond establishing rules; it is about fostering a positive example of resilience and recovery. It doesn't mean we ignore the past. Instead, we focus on setting a positive example of overcoming atrocities. It is crucial for children to see parents, counselors, teachers, and other adults demonstrating fairness, adaptation, and proactive behavior in a new environment. They need to see how to take charge of their lives, and to stand up for themselves and others. This helps children learn not only to survive but also to thrive in their new environments.

Lesson 4: Never Underestimate the Impact of Local Culture

Cultural norms can differ significantly even between neighboring villages, and it is impossible to develop a one-size-fits-all plan for an entire region.

For effective intervention, though, it is critical to have a deep understanding of family dynamics, local biases, levels of trust in government, and historical patterns of abuse. To bridge gaps in understanding and services, we employ a unique team structure: Each family is supported by a pair of social workers, one with local knowledge and another who is a refugee themselves.

This pairing ensures that each family has a social worker who comprehensively understands their history, current situation, needs, and strengths, and can develop a tailored support plan based on these insights. The approach allows the teams to balance their combined expertise effectively, addressing the challenges of displacement with an in-depth understanding of the local social, cultural, and political context. This ensures that our interventions are sensitive to the cultural nuances that influence the effectiveness of our support.

Lesson 5: Treat the Whole Family

Our primary goal is to reunite children with their families. In Artsakh, we are fortunate to work within a culture whose families are proactive in supporting one another. Our approach involves attaching/assigning social workers to families, enabling them to monitor and follow family dynamics over time, and identify any changes or challenges. This approach is crucial for identifying individuals who might otherwise be overlooked by the system.

Our teams ensure that children have access to education, healthcare, public services, and proper documentation. They also coordinate with local humanitarian efforts in that area to provide comprehensive support. In a country where the social-work system is underdeveloped, attaching social workers directly to families has proven to be the most effective form of assistance.

In Artsakh, we also encountered many elderly people living independently, supported only by neighbors as their families have been displaced or killed. In these cases, our focus shifts to fostering community bonds. We facilitate interactions that help people to get to know each other, form new networks, and establish strong and supportive relationships.

Rebuilding Lives, Families, and Communities

Whether the crisis stems from man-made conflict or a natural disaster such as the 1988 earthquake in Armenia that marked the beginning of my career, it is vital that children affected by conflict receive timely assistance. These young victims require ongoing support to navigate their pain and trauma. The combination of love, care, energy, and empathy, along with professional support, is vital. Social workers closely connected with families play a crucial role in addressing both immediate needs and deeper psychological suffering. This relationship builds trust and establishes the social worker’s credibility, helping individuals shift from recovery to becoming active and empowered, and ultimately reducing their dependency on humanitarian aid.

In the long run, fostering individual and community resilience allows for the efficient and effective use of limited resources. It significantly improves the physical and mental health of those in crisis zones, and is essential in rebuilding broken lives, restoring families, and revitalizing communities. This holistic approach not only addresses immediate needs but also lays the foundation for sustainable recovery and growth.